According to UnityPoint.org, concussions, or traumatic brain injuries, are the eighth most common injury in sports.
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MEDICAL ANIMATION TRANSCRIPT: A concussion is a brain injury resulting from a violent head impact or rapid head acceleration deceleration. The brain is a soft and pliable organ, and requires physical protection from the environment. The walls of the cranial cavity provide a hard external shield from outside impacts. Inside the cranium, the brain floats in and is surrounded by cerebrospinal fluid. Cerebrospinal fluid provides a protective cushion as everyday movements of the head gently jostle the brain. A violent impact or rapid acceleration deceleration of the head can cause the brain to rotate and strike the inside of the skull. This injury compresses the brain and sends shock waves rippling away from the point of impact. The impact force stretches or tears neuronal axons, resulting in a mild form of the traumatic brain injury called diffuse axonal shearing. This injury compromises normal brain function because it interrupts communication between neurons. Physical symptoms of concussion include headache, nausea, poor muscle coordination, dizziness, light sensitivity and blurred vision, ringing in the ears, and loss of consciousness. Cognitive and emotional symptoms include disorientation, confusion, amnesia, inability to focus and concentrate, irritability, and depression. Treatment for concussion depends on the severity and duration of symptoms. Mild concussions require plenty of rest, increased fluids, and close monitoring of symptoms for 24 to 48 hours. Although mild pain medication, such as acetaminophen or ibuprofen may be prescribed, alcohol and illegal drugs should be avoided. Severe concussions require immediate professional medical evaluation. In many cases, steroids are used to decrease swelling and inflammation in the brain. A CT scan or MRI of the brain may be needed to rule out gross internal damage or hemorrhages.
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How can you tell if it’s a concussion? Neuropsychologist Summer Ott discusses signs and symptoms that may be indicative of concussion.
Learn more about the IRONMAN Sports Medicine Institute Concussion Program at http://spr.ly/6005yOd5H.
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How Long Do Concussion Symptoms Last? What is Post-Concussion Syndrome (PCS)?
Dr. Gabella discusses how long concussion symptoms typically last and what to do when symptoms don’t resolve. Treatment for Post-Concussion Syndrome & Brain Rehabilitation.
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Can I get CTE from one concussion?
Dr. Robert A. Stern
Professor of Neurology, Neurosurgery, and Anatomy & Neurobiology
Director of Clinical Research, BU CTE Center
Boston University School of Medicine
In this video, Dr. Stern explains that chronic traumatic encephalopathy (CTE) is a result of repetitive sub-concussive trauma to the head, and not from major, obviously symptomatic concussions.
How do you know if you had a concussion? Dr. Alina Fong P.h.D. explains how you can determine if you have post-concussion symptoms.
Brain Facts is created and run by Cognitive FX. Cognitive FX is the world’s premier center for concussion treatment and does cutting-edge research on concussions and neuroscience.
Functional MRI is a scan that we use at Cognitive FX to see which parts of our patient’s brains are underperforming by mapping their blood flow to their brain. This is a technique that is only done at our clinic and the reason why we bring in people from all over the world.
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Have you been dealing with symptoms for longer than 3 months after your concussion, traumatic brain injury, whiplash, or another head-related injury? Sign up for a free consultation with us, and one of our doctors will help you on your pathway to recovery. Click this link here to sign up!
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Stop dealing with the symptoms of Post-Concussion Syndrome, and start living your life again, to the same level or better than before!
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It may look like Jell-O, but this brain is the same consistency as a real brain!
As Dr. Christopher Giza from UCLA demonstrates, the brain is made of soft tissue and floats in fluid inside of the skull. When the skull moves quickly, the brain can jostle around a lot, which can lead to neurological symptoms.
“Most concussions are recoverable,” Giza said.
But concussions can be difficult to identify and some people suffer more serious symptoms, particularly after multiple concussions.
Lab studies have shown a “window of vulnerability” after a first concussion, Giza said. Concussed athletes are three to six times more likely to get another concussion. If they rush back to play, their reflexes, reaction time and thinking may be slower, putting them at risk of a second concussion and longer recovery period.
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(Inside Science) — When someone arrives at an emergency room in a coma, someone with a serious brain injury, there is a long and well-established set of processes in place that allow for doctors to rapidly evaluate, triage and manage their treatment. The procedures for evaluating people who have a milder form of traumatic brain injury, a concussion, have historically been a little less well-defined. But experts say things have gotten better in recent years.
“At this point, our emergency department colleagues are quite adept at the evaluation and management of the patient with a concussion and the proper triage and steering of those patients into the expert hands, and that is often a neurosurgeon or a neurologist. But we also have primary care physicians who have sought additional specialty training. And we now have a pretty large army in the United States of people who can properly evaluate a patient with a concussion,” said David Okonkwo, clinical director at the UPMC Brain Trauma Research Center.
“It is a heterogeneous disorder. No two concussions are alike. And we see people have issues with migraines. We see people who have issues with dizziness and vestibular problems. We see other patients who have issues with memory and cognition. And then we also see patients who have a mental health manifestation of their concussion, be it in the form of anxiety or mood disturbance. These are just a short list of an even longer list of the ways in which a concussion can manifest itself,” said Okonkwo.
Dealing with concussion is complicated by the fact that people with the injury can experience completely different symptoms. The proper identification of the exact form of concussion an individual suffers is key, the experts say, because it helps to guide treatment.
“If it’s a balance-related issue, then you work on balance therapy. If it’s a visual-related issue, you work on visual therapy,” said Mark Proctor, neurosurgeon-in-chief at Boston Children’s Hospital.
For the majority of folks, treatment for a concussion starts with rest. The question of how long to rest has also evolved in recent years.
“So there used to be this concept of brain rest being, well, you put a child in a dark room until every symptom is gone. And it was discovered through some work at our hospital that that’s not always the right — well, clearly that’s not the best way to treat them. There’s a real benefit to near-total rest for about two to three days. But you don’t have to wait till someone’s completely asymptomatic before you get them out, you get them back to school, etc., because there’s other determinates such as social isolation and depression that start to factor in if you keep them out for too long,” said Proctor.
Proctor and his colleagues treat 400 to 500 mostly sports-related injuries every month at the brain injury center he directs. His experience there and the experience of doctors at other hospitals suggest a mostly good prognosis.
“For most people who sustain a concussion, there can be an expectation of the spontaneous resolution of symptoms and the spontaneous resolution of the problem over the course of days to a few weeks,” said Okonkwo.
“Eighty, 90 percent will be better in 10 to 14 days. And really no treatment is necessary other than the rest. What really is the vexing problem is that sort of 10 to 15 percent where those symptoms go on for a prolonged period of time,” said Proctor.
However, it’s very hard to predict who is going to be fine in two weeks and who isn’t. One of the challenges is that there is no specific biological test for concussion.
“We see this in so many other fields of medicine, where if you have a blood test that would clearly show that you had a concussion, that would be an enormous asset,” said Okonkwo.
Nor are there imaging biomarkers — ways of spotting a concussion on an MRI or CT scan. But many tools are now moving through development.
“We can have a reasonable expectation in the next two to three years of things crossing that FDA clearance hurdle and being put to use in routine clinical practice,” said Okonkwo.
For now, coaches and trainers have different forms of assessment tools. Cognitive tests can indicate if there’s a problem to determine if a player needs to be taken off the field, and taken to a doctor for further evaluation. Another advance that doctors hope for are better ways to treat specific types of brain injuries and concussions. There are still no existing FDA-approved drugs for the management of brain injury.
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A sports medicine pediatrician demonstrates an exam for concussion with a high school athlete. For more: http://www.chop.edu/concussion
Christina Master, MD, a concussion expert at The Children’s Hospital of Philadelphia, reviews how to take a history, elicit information about the incident, and perform a physical exam in patients who may have concussion.
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The information provided in this video is from Section 12 of the Ontario Neurotrauma Foundation’s Guideline for Concussion/Mild Traumatic Brain Injury and Prolonged Symptoms. Section 12 is on Return-to-Activity/Work/School Considerations: https://bit.ly/2VT8kFx
Resources mentioned in this video can be accessed here:
Table 12.1: https://braininjuryguidelines.org/concussion/fileadmin/media/tables/table-12-1.png
Algorithm 12.1: https://braininjuryguidelines.org/concussion/fileadmin/media/algorithms/algorithm-12-1.pdf
Music in video provided by www.bensound.com
Joe Congeni, MD, the director of sports medicine at Akron Children’s Hospital, discusses the symptoms and treatment of concussions in this report about the multiple concussions suffered by Tommy Schadl, a former football player at McDonald schools. Originally aired on http://www.wkbn.com on January 29, 2019.
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FRONTLINE reveals the hidden story of the NFL and brain injuries.
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The National Football League presides over America’s indisputable national pastime, but the league is under assault: Thousands of former players have claimed it tried to cover up how football inflicted their long-term brain injuries. What did the NFL know, and when did it know it?
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Funding for FRONTLINE is provided through the support of PBS viewers and by the Corporation for Public Broadcasting. Major funding for FRONTLINE is provided by the John D. and Catherine T. MacArthur Foundation and the Ford Foundation. Additional funding is provided by the Abrams Foundation, the Park Foundation, The John and Helen Glessner Family Trust, and the FRONTLINE Journalism Fund with major support from Jon and Jo Ann Hagler on behalf of the Jon L. Hagler Foundation.
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