Here is a recent article I wrote on Concussion Syndrome. I hope you enjoy and find it informative. Concussion Syndrome In this issue I would like to address what is referred to as Concussion Syndrome or Concussion. A traumatic blow to the head usually causes a concussion, but not always. Receiving any kind of “violent” whipping motion from the diaphragm up can cause it. An important factor to keep in mind when evaluating for a concussion is that concussions can be immediate, come on within minutes or be delayed for hours to even a couple of days. Concussions are common in contact sports such as Roller Derby, Football, Rugby and so on. The brain tissue is about the consistency of gelatin, and floats in a fluid known as cerebrospinal fluid that acts like a cushion for everyday type of jolts to the head. However a violent blow or shaking of the upper torso can cause the brain to slide back and forth forcefully against the inner wall of the skull. The concussion occurs because as with most injuries there is a certain amount of swelling that occurs. In the head the swelling pushes against the skull and onto the brain causing the concussive symptoms that alter your brain functions. These effects are usually temporary and can include problems such as headache, difficulty in concentration, memory loss, poor judgment, balance and coordination problems or any combination of all of the above. It is important to note that in some cases this may lead to bleeding in or around the brain causing prolonged drowsiness and confusion. This may develop immediately or over a period of time, which is why it is important to monitor a person with suspected concussion syndrome. After a concussion, the levels of brain chemicals are altered. It usually takes about a week for those levels to stabilize again, although it can vary depending on the extent of the trauma, and/or repeated traumas. As stated above the signs and symptoms of a concussion can be subtle and may not be immediately apparent. Signs and symptoms you want to look for are: headache, confusion, amnesia, dizziness, ringing in the ears, nausea and/or vomiting, slurred speech, fatigue. These symptoms can last for days, weeks or even longer. There are certain risk factors that make someone more susceptible to concussions and they are: People who are involved in high contact sports such as Roller Derby, Football, Soccer, Hockey, Cheerleading, being involved in a motor vehicle accident, domestic violence or abuse, falling especially in the elderly or young children, having had a previous concussion. Some potential complications of a concussion include: Cumulative or additive effects of multiple brain injuries. Recently we have seen studies on football players receiving brain autopsies showing the amount of scar tissue that occurs from multiple hits to the head, even while wearing protective helmets. “Second Impact Syndrome” this occurs when receiving a second concussion to the head before the symptoms of the first concussion have resolved. It may result in rapid and typically fatal brain swelling. Epilepsy, people who have suffered a concussion double their risk of developing epilepsy within five years after the injury. Recently I have started testing for another type of concussion, one that involves the inner ear, known as a vestibulocochlear concussion. This is often missed and is easily detected by checking vertical and horizontal gaze. I’ll put two fingers up in front of the athlete and say, “I want you to take your eyes and look back and forth between my two fingers without moving your head, and I want you to look up and down between my two fingers using just your eyes.” For someone who has a headache or is nauseous this can be difficult. If you see any lag of the pupil on movement or a jumping of the pupil, do not let the athlete return to play and have them follow up for further medical care. Concussions are typically mild but can be serious or life-threatening/fatal. Make sure that you are familiar with the signs and symptoms and do not let a teammate return to play if any symptoms are present.
Posted on: Fri, 01 Nov 2013 15:47:34 +0000
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