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Wednesday 18 July 2012

Concussion Basics

Posted at 12:25 PM

Concussion Basics

If you suspect you have recently sustained a concussion, please see your doctor immediately, go to the emergency room, or walk-in. A medical professional, knowledgeable about concussions, needs to first make sure there are not severe complications such as bleeding in the brain or other injuries.
 
What is a concussion? A concussion is a chemistry experiment your brain goes through when it is hit at just the right angle with just the right amount of force. The metabolism and chemical process is altered for, typically days-to-weeks, and in some cases months. Since we don’t have the technology to measure these changes in the field or office, concussions are diagnosed based on symptoms and signs. So, if you are wondering, “Was it really a concussion?”, then ask yourself: 1) Was the brain jarred? 2) Did it result in immediate or soon thereafter changes in thinking (e.g., confusion, brief memory loss), seeing (stars, blurry vision, blackout), feeling (headache, nausea, light/noise sensitivity) or moving (balance or dizzy)? Although not exhaustive, this takes care of most. So, if you had a headache and felt a little weird after contact to your head, most likely this was a concussion.
 
How severe was it? A concussion is a traumatic brain injury (TBI). It is a mild TBI. There are three types of TBI: Mild-Moderate-Severe. Concussion severity is typically based on: 1)Length of loss of consciousness (which really only occurs in 10% of concussions) 2)Length of posttraumatic amnesia (that’s the memory loss around the time of the hit, during which the concussed individual can score touchdowns and do other very complex things…just have no memory during that time). There is no formal rating scale to judge a concussion within the mild TBI range. However, clinical experience, severity of symptoms, results of cognitive testing, and initial signs all play a role.
 
When can I get back to my normal activities (or, when can I play my next game)?
Basically, all symptoms need to go away and cognitive testing normalize (if a baseline test is available, results should have returned to that individual’s baseline). There is a specific stepwise process of increasing activity under the direction of a medical professional. Full clearance for all activities is bestowed once no symptoms or cognitive signs are apparent after the activity level is systematically increased.
 
How do I recover fastest? The current medical consensus is to rest. They call it “Brain Rest.” This does two things: 1) Prevents another concussion from occurring (very rare to have another concussion while resting) and 2) Reduces brain activity which reduces the symptoms and is believed to help the chemical process normalize.
 
The Wisconsin Interscholastic Athletic Association (WIAA) provides policies and procedures in line with the most recent consensus on concussion conference and has a lot of good information (http://www.wiaawi.org/index.php?id=430).
 
If you have any questions on concussion, we’d be happy to discuss.
 
-Michael Mohrland, PsyD
Rehabilitation Psychologist/Neuropsychologist