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Andrew, aged 22 years, presents to you the day after playing a game of football (soccer). In the first half of the game, he tried to head a ball but missed and fell heavily onto the right side of his body. He states the impact ‘jolted’ his entire body and head; he then ‘didn’t feel quite right’ for approximately 10–15 minutes but then ‘came good’. A similar episode occurred in the second half when he again attempted to head the ball but missed and landed on his back. He states he felt his ‘entire body and head jolt’. He again ‘didn’t feel quite right’ and ended up with a headache, which is getting worse. He states that he was a ‘little confused’ for a few hours after the game. Andrew tells you the team doctor assessed him after the game and conducted a Sport Concussion Assessment Tool – 5th Edition (SCAT5), which he gave to Andrew, and told him to see you today for review.
Andrew is a third-year student studying engineering at university. He lives with both parents and his sister, aged 24 years.
His health is otherwise good. He has no other significant medical history, does not smoke and drinks approximately five standard drinks on most weekends. 1.What is the SCAT5, and how is it used? 2.How would you proceed with this consultation? 3.How would you proceed with your history and examination? 4.What conditions would you consider as part of your differential diagnosis? How would you attempt to rule these in or out? 5.What is your interpretation of the results so far? 6.How would you manage Andrew’s condition? 7.Are any further investigations required? 8.What are your recommendations, and how will you oversee Andrew’s return to sport? #Week17_Case1
