Concussions are starting to be looked at in a very different way. First of all.. not all concussions are the same, especially in how people respond to them or their rate of recovery. We don’t know why some people may have more symptoms than others and why some recover quicker than others. But some clues are starting to emerge.
Here are some myths that need to be clarified:
1. A person who has lost consciousness will have more symptoms and a longer recovery period.
The fact is that only a small number of concussions involve loss of consciousness. Contact sports are not the only activities that puts athletes at risk. You can actually have a concussion without even hitting your head!! Any violent movement to the head or the body that causes the brain to move rapidly inside the skull (ie. ballet, roller coaster rides, military exposed to bomb blasts by the sound wave from explosions) can cause a concussion.
2. Concussions affect everyone the same way and are short-lived.
The fact is that the nature of the injury, the mechanics, how and where you hit your head doesn’t matter. Some people are more genetically predisposed to sustaining a concussion who may have long recovery periods. Also, people with a medical history of migraines, motion sickness, or history of depression, anxiety or other mental illness are at higher risk for a long and arduous recovery. We know that concussions can cause cumulative damage to neurons.
3. Make sure you wake a person up every few hours after they have suffered a concussion.
Actually rest is the best medicine in this case (unless they are unconscious). If the person is breathing normally, not having a seizure, not vomiting or waking up with a worsened headache, theres no need to wake that person up. According to research, if patients do not have altered consciousness or impaired cognitive function after 6 hours from their injury, the danger of having a brain bleed is 0 percent!
4. It’s best to lay in a dark room with no work, socializing, physical activity, reading or watching TV to fully “rest the brain” and recover.
This can easily not only cause someone to be bored, frustrated and even depressed, but can actually slow down recovery. This information was never evidence-based in the first place and is outdated. Studies show that people who rested for 5 days had more issues than those who resumed activity after 2 days. It’s best to rest the initial 2 days then go about your daily life until symptoms show up then stop. Rest. Repeat. You will slowly recondition your brain as long as you pay attention to your symptoms.
Here are some things we DO know:
!. If you think you have a concussion…make sure you don’t hit your head again.
This is the concern with professional athletes (or teens) that take to the field soon after sustaining a concussion. Suffering a second concussion after still experiencing symptoms from the first puts a person at risk for long term symptoms lasting months or even years! In rare cases it can even lead to permanent brain damage or death.
2. Concussion Clinics are becoming more common. This usually includes a team of practitioners such as neurologists, psychiatrists, sports medicine or physiology specialists, and physical and occupational therapists. The symptoms of headache, memory and cognitive issues, vestibular problems (dizziness, vertigo) and visual symptoms are all treatable to some degree.
3. A new type of brain scan called “Diffusion Tensor Imaging (DTI)” is designed to investigate the connections between cells, known as the axon tracts. It can look at the extent of damage in a concussed patients brain. Axons are the long channels between nerve cells (neurons) that are used to communicate with one another and with different regions of the brain. In a severe concussion, these axons can break. The DTI can look at the damage to these axons.
4. A new diagnostic test is being developed to look for axon proteins in the blood. When axons break, they release a variety of proteins and chemicals, some of which can trigger more damage to nearby cells. This test could also indicate the level of damage in the brain. These diagnostic tests may be the breakthrough needed to assist in developing drug therapies and other types of rehab treatments.
Concussion symptoms can be very subtle for some, yet to the patient, it can be a very disturbing and stressful time. People recovering from a concussion look very normal but their symptoms are usually noticeable only to themselves. There are no objective tests as of yet so practitioners have to take the patient’s report of symptoms as face value. With more research and diagnostic tests we hope that will soon change.
References: Schrock, S. “Six Things You Should Know About Concussions. Scientific American Mind, Jan/Feb 2016 pp. 52-57
Landro, L. “Fresh Efforts To Improve Teens’ Concussion Care”. The Wall Street Journal- Health & Wellness. Nov. 20, 2012