March is Brain Injury Awareness Month
Did you know that a concussion is a form of mild traumatic brain injury, (mTBI)? According to the CDC at least 1.7 million Traumatic brain injuries (TBIs) occur either as an isolated injury or along with other injuries. Of these, approximately 75% are placed in the category of mild TBI / concussion. A concussion described by the CDC a concussion is “caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, stretching and damaging the brain cells and creating chemical changes in the brain” (CDC). Think of your brain as Jell-O in a bowl! Frequently the affects from these injuries resolve within a few days if managed properly. However, mismanagement of these injuries can result in prolonged and in some cases deadly lingering affects. Read on for some tips!
Make sure you know the signs and symptoms of a concussion. Most importantly, don’t ignore them. Sometimes the injury isn’t obvious and symptoms can vary from concussion to concussion as well as from person to person. Remember that concussions can occur at any age AND you don’t need to be “knocked out” to suffer a concussion. In the youth sports arena it is up to the coaches and parents to ensure that they are educated on the pertinent signs and symptoms. Don’t assume you know all the facts. Your doctor should be alerted in the case of all head injuries.
In some cases a blow to the head can cause a blood clot that puts pressure on the brain. This is a medical emergency and requires immediate medical attention. (CDC)
- A worsening headache , weakness, numbness or decreased coordination
- Repeated vomiting or nausea
- Slurred speech
- Look very drowsy or cannot be awakened.
- Having one pupil (the black part in the middle of the eye) larger than the other.
- Having convulsions or seizures.
- Cannot recognize people or places.
- Getting more and more confused, restless, or agitated.
- Unusual behavior.
- In the case of a child, inconsolable crying, refusal to nurse or eat
Diagnostic Imaging such as MRI and CT scans do not diagnose concussions
Concussions are considered functional vs. structural injuries. This means that while the affects of the injury present as an interruption in a person’s ability to function, we are not likely to see structural changes within the brain. Although different imaging techniques may be used at the time of an injury or even later on, they are not used to diagnose concussions at this time. CT Scans and MRIs are used to assist in the diagnosis of a “bleed” or other structural abnormalities in the brain or head.
Research is currently being done to allow for improved imaging that will allow for better evaluation of concussions with MRI. However at this time, this is not utilized as the standard or available to the general public.
What is Second Impact Syndrome?
Second Impact Syndrome (SIS) occurs when a second concussion or head injury is sustained before a person is fully healed from the initial injury. Additional trauma to the head when the brain is still vulnerable and recovering puts the individual at greater risk for injury. In second impact syndrome the brain swells rapidly and can result in severe disability or death. This is a medical emeregency.
So, What Do We Do?
Evaluation by a medical professional trained in the management of concussion is essential. Your care team may inckude your PCP, a neurologist, a neuropsychologist as well as physical therapists. Research is ongoing in the area of rehabilitation and recovery following concussion. However, gone are the days of waking up the concussed individual every hour to check on them following a concussion. While medical professionals advocate for observation of an injured individual, they agree that rest is the best method early on to assist in the return to daily function across all age groups. However, additional research at this time also looks at a more active approach to recovery. How one is treated following a concussion is determined by the signs and symptoms they exhibit. This may include addressing vestibular, ocular, cognitive, muscular or anxiety/mood issues. The appropriate treatment pattern can be very different for each person.
What about safety equipment?
– Helmets: At this time there is no evidence that a helmet will prevent concussions. No helmet can stop the brain from bouncing around inside the skull. However, helmets can definitely assist in the prevention of skull fractures as well as subdural hematomas and should be worn for specific sports.
– Seat Belts: Also important to remember that concussions don’t just happen in sports! Make sure to wear your seat belt when in the car
– Elderly: For our elderly and those with impaired balance we should also ensure a safe living space. Consider using handrails and improved lighting to decrease the risk of falls.
– Young Children: For our young children look to use window guards and safety gates to keep children away from potentially dangerous situations.
It’s all about technique!
More and more evidence now looks at our technique during sports to assist in decreasing our susceptibility toward concussions. Of course, sometimes accidents happen but there are still some things we can do. Take look at technique! Think of tackling in football, heading in soccer and checking in hockey. Is our technique solid? We also need to look closer at limiting hits and tackles in such sports as hockey and soccer (as is being done in many states now as we speak) as well as limiting heading in soccer until a specific age. Adequate neck strength can also play a role in improving our resistance to concussions.
Make Sure you Know the Signs, Make sure you know the Symptoms.
When in Doubt Sit Out! Check out the CDC’s “Heads Up Concussion” in youth sports program.
Questions on how physical therapy may assist you in your recovery from concussion? OPT Physical Therapists work hand in hand with your doctors to provide a balanced and individualized program to assist in your return. Call our offices for more information.