Overview

Concussion is a mild type of brain injury, but it should be taken seriously.

A concussion occurs when a hit or jolt to the head or body causes the brain to bounce around inside the skull. These movements can damage brain cells and cause chemical changes within the brain. Common causes of concussion include blows or falls during sports, falls at home, car crashes, and being violently shaken. Up to 3.8 million concussions occur nationally each year from sports or recreation alone, according to government estimates.

Symptoms may start immediately or up to several weeks later, and may include a wide array of symptoms, including:

• headache
• neck pain
• nausea
• vomiting
• sensitivity to light/noise
• dizziness
• balance problems
• fatigue

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The information below is from the UPMC Sports Medicine Concussion Program website. It lists myths and facts about concussions.

Myths

1. A concussion only occurs as a direct blow to the head.
2. A concussion occurs only when an athlete experiences a loss of consciousness.
3. Everyone is at the same risk for concussion.
4. It is safe for a player to return to the same game or practice after suffering concussion-related symptoms.
5. All concussions, treatments, and recoveries are alike.
6. You must be placed in a dark room to recover from a concussion.
7. Having one concussion places you at increased risk for future concussions.
8. Concussions definitively cause long-term brain damage and chronic traumatic encephalopathy (CTE).
9. Helmets and mouth guards can prevent concussions.

 

Facts

1. A concussion may be caused by a direct blow to the head, face, neck, or elsewhere on the body if the force of impact is transmitted to the head
2. Concussions can occur with or without loss of consciousness (LOC), and about 90% of concussions do not result in LOC.
3. Various factors, including age, gender, and medical history put an individual at risk for sustaining a concussion.
4. There are many different signs/symptoms of concussion. Anyathlete who displays these concussion symptoms shouldn’t be allowed to return to the current game or practice, even if the symptoms clear quickly.
5. No two concussions are identical. Our research has identified six different clinical trajectories for concussion.
6. Eviodence-based active treatments for concussion exist, including vestibular therapy, vision therapy, exertion therapy, and medications.
7. Proper clinical management is the best form of prevention; recovery from one should not put an athlete at risk for another. But there are some inherent conditions (i.e. migraines) that can put you at higher risk.
8. Potential long-term effects from concussion come primarily from poorly managed injuries. Scientific studies linking concussion and long-term effects are still in progress and no definitive conclusions can be made.
9. While helmets have been shown to protect against skull fracture and sever traumatic brain injury, there is very little evidence that a particular brand of helmet reduces the incidence of concussion. Mouthguards, too

 

Evaluation

Our initial forms include a Post Concussion Survey Form. When the doctor performs his initial evaluation, he will review this form to determine if a concussion may have occurred. If he feels that a concussion may have occurred, he will perform an exam to evaluate eye movement, coordination, and balance. Additionally, he will have you perform testing of your thinking and memory. One example of this testing is called an IMPACT test, which is administered by computer.

If your symptoms continue beyond the usual recovery period of four to five weeks, you may benefit from further testing, such as MRI evaluation, neuropsychological evaluation, and/or psychological evaluation.  

A neuropsychological evaluation tests a person’s mental abilities and mood, including attention and concentration, learning and memory, planning and abstract thinking, language and communication, motor and sensory functions, academic skills, and other intellectual abilities. The test is done through a questionnaire and typically take four to six hours.

Psychological evaluation would identify any emotional or behavioral challenges, which can be caused or worsened by a concussion.

 

Treatment

In most cases, patients should stay home and rest for two or three days after a concussion, then gradually increase their activity level over the next few weeks.

In addition to resting the brain, a program of home based exercises will be provided that will augment the program of therapies and exercises you will be performing in our office. Our treatment program for concussion will based upon your specific needs. Gentle manual therapy for the cervical spine may be performed, as well as a variety of oculomotor and vestibular therapies to correct problems associated with eye focus, eye movement, balance, and memory.

Our doctors can advise you on the right pace for your return to normal activities, including work and/or school. In fact, either too much rest or too much activity can delay your recovery, so it’s important to strike the proper balance between the two.

Most people recover fully from a concussion, but the process can take weeks or sometimes months. Patients must rest to allow their brain to rest as they perform specially designed exercises to treat the problems found during the examination. As they improve, they will be allowed to gradually return to normal activities of work, sports, and school.

People who’ve had a concussion are more vulnerable to future concussions, and it’s especially important to avoid another head injury while recovering from one. Athletes, for instance, should be removed from play immediately if a concussion is suspected. The risk for a second concussion is greatest in the first 2-3 weeks after an initial concussion. Therefore, it’s especially important for anyone suspected of having a concussion to immediately stop their activity – especially if they’re playing a sport.