We are heading into football playoff season. As many of you know, there is an unprecedented amount of media attention regarding the concerns of sports related concussion. Just a few days ago, an article was published in the medical journal, Pediatrics, suggesting that high school football should be banned. Certainly, the discussion is quite controversial but what is agreed upon is that concussions should be taken seriously. It is also agreed upon the importance to RECOGNIZE, to REST and RECOVER from a concussion. We should continue these conversations around concussion, including that concussions are not isolated to sports. The majority of concussions actually occur from falls and are much more prevalent in individuals 65 years of age and older compared to those age 5-25 years. It is also important to increase the focus on the recovery of concussions and rethink concussions as a manageable injury that more frequently than not results in a complete recovery when treated appropriately.
A concussion can result from a direct blow to the head or indirectly to another part of the body that results in a jolting force through the head. Because a brain injury does not require direct contact to the head, whiplash injuries can result in a number symptoms associated with concussion. Just ten years ago, we categorized the severity a concussion by a loss of consciousness (LOC) and the length of time having a LOC predicted the recovery.
Now, we know that LOC occurs less than 10% of the time. Standard imaging (e.g., MRI or CT scan) is typically normal. Such testing, however, is often performed in the emergency department in those 65 years of age and older due to the life threatening concerns of a more traumatic brain injury.
The most common symptoms include headache, dizziness, difficulty with concentration and memory, vision problems, decline in balance, mood changes and/or poor sleep patterns.
Any severity of head trauma warrants a comprehensive neurological examination that should include gathering information of symptoms and past medical history along with an assessment of vision, balance, inner ear function and cognition. Other areas to address are headaches/migraines, neck pain and anxiety. If there are hearing changes associated with the concussion then a comprehensive hearing test should also be performed.
The brain can heal, and rest in the early phase is critical as is proper rest and nutrition. Lingering symptoms can be addressed in a customized rehabilitation program. One of the ongoing questions of debate is clearly defining when to begin rehabilitation. We have been managing patients with concussion for 20 years – both sports related and non-sports related. There are times that our assessment indicates that starting a recovery program as early as 3 days is appropriate. At other times, we are more conservative and may wait 7-10 days before starting visual or vestibular (inner ear) exercises.
As with all types of recovery programs and maintaining health, we know that staying active is important. Identifying what activities and at what intensity varies among individuals. In other words, once you have seen one concussion, you have seen one concussion. Every individual is unique in their presentation and, above all, in their recovery process. It takes a comprehensive approach that is customized.
We Can Help.
We provide expert care for dizziness, balance, tinnitus and/or hearing disorders. We offer both testing and treatment services with more than 75 years of combined experience. Call us today at 512-345-4664!