Concussions and Its Treatment

Concussions can happen to anyone in any setting. They are not strictly sport related injuries however they occur more commonly in sports such as combat or high contact sports.  Another name for this condition is called a Subdural hematoma.  Subdural is a layer deep to the dura mater in the skull and a hematoma is bleeding due to an impact in that area.  Subdural Hematomas can be simple and complex. 

Simple is when blood collects in the cranium but there was no injury to the head and Complex is when there are contusions (bruises) on the brain surface associated with cerebral swelling or a concussion.  This condition causes increased intracranial pressure here are some signs to look out for; irregular eye tacking, increased blood pressure and body temp, pupil dilation on the affected side and severe headaches coupled with nausea and vomiting.  

What is a Concussion? 

It is a brain injury that cannot be seen on an MRI, CT scan or X ray.  It can affect the way an individual with this condition thinks it causes a variety of symptoms.  It can occur when there is trauma to the head, neck, face or somewhere else in the body that causes a jarring movement to the head.  A concussion does not have to be from a direct blow to the head.  An individual does not have to be knocked unconscious to have symptoms of a concussion and many people can develop delayed symptoms.

  

Symptoms of a Concussion

     Symptoms can be physical, emotional, cognitive and can affect sleep.  Physical symptoms include headaches, blurred vision, nausea/vomiting. Emotional symptoms include heightened nerves and anxiety, sadness, and fogginess.  Cognitive symptoms include sensitivity to noise, confusion, and loss of memory.  Sleep symptoms include insomnia, too much sleep or poor sleep quality.  

Signs of a Concussion

     Signs are physical responses linked to a fact that is detected by doctors, bystanders, physicians etc… while examining someone.  Some signs of a concussion include the suspected person lying motionless, hard to get up, disorientation, holding their head, loss of balance or blank stares.  There are very important red flags to be aware of including neck pain, increased confusion, repeated vomiting, seeing double and feelings of numbness or tingling in the extremities.  If any of these signs are visible or if the athlete or individual complains of any symptoms it is extremely imperative that you understand that they must be removed from play immediately and they must not be allowed to return to work, school or play unless they undergo physiotherapy.  

Managing a Concussion 

     Remove the suspected athlete or individual from play or the area in which the concussion occurred.  The individual must get both physical and mental rest and if the individual with a concussion wishes to return to play it must follow this order.

– No Activity – Reintroduce school 

– Light Aerobic Exercise – Activities that will increase the HR of the individual with less exaggerated movements 

– Sport Specific Exercises – Add movements to the exercises 

– Non-Contact Drills – Exercises with coordination drills and cognitive thinking drills

– Full Contact – Restore your confidence and eventually return back to full gameplay 

Post Concussion Syndrome 

     This is characterized by decreased attention, persistent headaches, fatigue, memory loss and blurred vision.  Symptoms can last for weeks to months and this syndrome occurs mostly in women there really isn’t any specific treatment but you can attend Cranial therapy, manual Cervical therapy or vision and balance exercises. 

 

Second Impact Syndrome 

     Second head trauma sustained while experiencing symptoms from a previous trauma, secondary symptoms are normally minor as it shows that the athlete is able to continue playing.  Pressure in the cranium and brainstem become compromised causing the athlete to collapse, have dilated pupils, can fall into a coma, have respiratory failure and can lead to death.  The progression is about 2-5 mins and an emergency action plan must be conducted 9-1-1 must be contacted.  Prevention is key.

Final Thoughts 

Recognize – The Signs and Symptoms 

Remove – Remove the athlete from play or individual from work 

Refer – To a health care professional for therapy and management 

Return – To school, work and play 

     Preventing concussions from happening is very crucial in sports there are many ways in which concussion can be prevented these include wearing protective gear that covers the face, head and neck, reducing the amount of physical contact in sports for example no hitting from behind or fighting in sports.  Accidents do happen and it is always better to reduce the risk of a concussion than to actually sustain one and not be able to play again.