Are Concussions Being Taken Seriously Enough?

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

This week’s Healthy Kids and Safe Sports Concussion Summit at the White House had the President addressing the increasing number of mild traumatic brain injuries (mTBI). With the White House now focusing on the situation, surely, word is getting out and parents, coaches and trainers are taking this diagnosis seriously, aren’t they?

ImageUnfortunately, though, even with national-level attention, some folks still aren’t getting the message.

Just this week, I saw a BMX (bicycle motocross) parent whose child has suffered a concussion. During our conversation, I heard phrases like “it was only a little concussion” and “everybody gets a little dinged,” proving that the BMX community is another sport where we can still make inroads. HeadFirst Concussion Care is committed to doing just that by attending local and state BMX championship events to educate fans, parents and coaches that mTBI is truly a serious injury.

Another recent case involved a parent who was reluctant to admit her daughter had a concussion, despite advice from several HeadFirst health providers. Several of us had noted oculomotor deficiencies (when the patient has trouble with movement of the eye) and recommended a referral to an ophthalmologist. Four weeks later, the child still had not been taken to the specialist.

After a follow-up exam, I demonstrated to the young patient’s parents that she had bilateral lower field deficits and used the ImPACT test to demonstrate deficits in her peripheral field. For the second time, I emphasized to the parents the importance of following our recommendations and in getting their young child to have an eye examination.

Despite all the press about concussions, I’m still seeing encounters like these all too often. So, what can we do?

One solution may involve a change in semantics. Instead of words like “concussion” and “mild traumatic brain injury,” use terms like “significant neurological event that involves a change in mental status” or “traumatic brain injury that involves (x) symptoms.”

Additionally, emphasize to parents that concussions are a silent injury. Many of them would treat a broken bone or sprained ligament with more care than they would a brain injury. But, a brain injury should be taken just as seriously, if not more so, as a visible wound.

Student Athletes Just Want to Get Back to Playing

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

Parents beware… kids want to get back in the game. Injured or not, playing their sport is, after all, their passion. Who can blame them?

Often in the event of a concussion, the course of treatment is fairly straightforward.  Kids experience a traumatic brain injury and they go through a sequential recovery. After an initial period of rest the patient gradually returns to normal functioning.

Some of latest new research may indicate that the metabolic process of recovery normalizes for most mild head traumas around 30 to 40 days after the initial injury, which coincides with the timeframe of when many youth athletes are recovering from their concussion. However, with spring sports playoffs coming up, some athletes will try to push through their recovery faster to get back onto the field.

HeadFirst-Catcher

Even with all our advances in science and medicine, it still generally takes six to eight weeks for a human bone to heal. And, whether you’re 5 or 65 years, that’s just how long it takes for a bone to heal. When my patients have broken bones, I put brain injuries in perspective by asking if they’d go back onto the field with a break that hadn’t healed.  Inevitably, they answer, “Of course not, because I might do permanent damage.” At this point, I have to draw the parallel to having a traumatic brain injury and that returning to play too soon also could lead to lasting permanent brain damage.

I once treated a 15-year-old elite-level lacrosse player with a traumatic brain injury whose recovery was moving along nicely in the right direction. After 24 days, he had no symptoms and was completely back in school. When I performed a follow-up exam, everything looked great except his ocular-motor functioning, fine motor speed and neurocognitive test reaction time was a bit slow compared to other athletes at his level. He excused his slow performance by saying that he wasn’t trying as hard as he could have, but I saw that there were too many data points and subtle findings to indicate the young man was still recovering.

My patient, like so many athletes, was obviously anxious to get back to the game. He knew his teammates were counting on him but I had to remind him that protecting his brain was of the utmost importance.

Emotional Symptoms of a Concussion Last Longer than Physical Problems, Study Finds

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

An interesting new study has recently been released from Children’s Hospital in Boston, which finds that the emotional symptoms of a concussion often longer than the physical repercussions like headache, blurred vision, fatigue and difficulty concentrating.

Researchers found that, while symptoms such as headaches and dizziness show up initially after a concussion, emotional symptoms show up a bit later and can last much longer.

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The study tracked 235 children aged 11 to 22 with diagnosed concussions for three months. Among the findings: most children recovered within two weeks after the injury, but 25 percent still had headache a month after their injury. Additionally, more than 20 percent suffered from fatigue, and nearly 20 percent reported taking longer to think for a month after their concussion.

Although the word is getting out, parents and caregivers should expect that recovery from a head trauma that caused a significant neurological event — a change in cognitive, emotional or behavioral processing — will take weeks of treatment to reach recovery. In addition to brain rest and a gradual return to full activity, medical providers use a host of treatments to help individuals fully recover from a traumatic brain injury.