
CONCUSSION EXPLAINED
Caring for your Brain
WHAT IS A CONCUSSION?
A concussion is a head injury caused by moving forces such as a bump, blow, or jolt to the head, that results in a variety of symptoms and temporary changes in mental status, coordination, and balance.
Definitions are constantly updated based upon new research, but a concussion is a form of a traumatic brain injury. In fact, it’s the most common traumatic brain injury.
After a concussion, the symptoms that occur differ from patient to patient. These include headaches, dizziness, vision problems, trouble concentrating, feeling slowed down, repeated vomiting, sleep problems, and even irritability and sadness. Symptoms may not appear for days or weeks after the injury.
While sport-related concussions are the most commonly talked about, concussions can happen from falls, car accidents, or other traumatic events. The good news is that over 80% of patients diagnosed with a concussion usually get back to normal within three weeks, but some may have symptoms that last longer.
WHAT CAUSES A CONCUSSION
Many people think that contact sports are the primary cause and that concussions are mostly a sports injury.
Actually, according to research, falls are the main cause of concussions. When a concussion occurs, there is an energy crisis in the brain. The impact of the brain against the skull can cause the brain to swell. It can even be life-threatening in rare cases.
Anyone can be at risk for a concussion. They occur frequently in sports (especially contact sports), but they can happen from falls, car accidents, and noncontact sports too.
Unfortunately, there isn’t a “cure-all” for the injury. There’s not a perfect way to prevent them, either. An individual who has had a concussion can feel entirely back to normal with a short period of rest and proper treatment or rehabilitation.
MELBOURNE SPORTS CONCUSSION CLINIC PROTOCOLS
Our concussion protocols at MSCC is a standard for healthcare providers on how to diagnose and care for the injury.
Our protocols cover a complete and holistic approach to concussion including education, prevention and management. This includes but not limited too:
• Pre-season education for parents and students;
• Comprehensive baseline testing procedures ImPACT Testing;
• Sideline evaluations after an injury SCAT6;
• Clinical evaluation after an injury;
• Return to learn procedures;
• Return to play requirements.
HOW TO TELL IF YOU HAVE A CONCUSSION?
Concussions can be tricky. Even trained healthcare providers may have a hard time diagnosing concussions because of its varying signs andsymptoms.
The majority of the time, concussions don’t show up on CT scans or MRIs. But justbecause a CT scan or MRI is negative, does not rule out a concussion.
Healthcare providers have to rely on clinical expertise, world consensus guidelines on concussion diagnosis including the SCAT6 sideline test and objective tools like ImPACT and ImPACT Pediatric to help them diagnose and treat concussions. Keep in mind: most of the time concussions do not involve a loss of consciousness.
WHAT ARE CONCUSSION SYMPTOMS?
Concussion symptoms can vary drastically from person to person. Some show up right after the injury, like vomiting, dizziness, or headache. Some may show up days or weeks after the injury, like irritability, depression, or sleep problems. It is important to communicate regularly with your healthcare provider about any changes in your symptoms.
Research has shown that pre-existing risk factors may influence which concussion symptoms are experienced. For instance: an individual with a family history of migraine will likely experience migraine symptoms after head trauma. An individual with a lazy eye may experience vision problems after the head injury. Be sure that you talk about any medical conditions you have when you visit a healthcare provider for a suspected concussion.
Check-in with your healthcare provider if you experience any concussion symptoms and have recently experienced a blow to the head. Concussion symptoms can include:
• Problems with concentration/memory
• Dizziness or lightheadedness
• Sensitivity to light or noise
• Change in sleep pattern
• Double or fuzzy vision
• Feeling foggy
• Headache
• Nausea
HOW LONG DO CONCUSSION SYMPTOMS LAST?
Concussion symptoms can last anywhere from a few days to weeks or months. This usually depends on whether or not the concussion is properly cared for. Post-concussion syndrome refers to lingering symptoms that last longer than the expected recovery time (about 3 weeks in adults, and up to a month in young children and adolescents).
Repeated concussions can cause symptoms to get much worse and can even cause life-threatening issues and long-term damage. It’s important that individuals speak up if they notice any concussion signs and a colleague acting out of character.
Concussion symptoms may sometimes look like other disorders, including depression or chronic migraines. If it’s happening to you or someone you know, visiting a healthcare provider to check for a concussion is the best option.
HOW DO WE DIAGNOSE A CONCUSSION?
Healthcare providers use multiple tools and techniques to check for a concussion. There is no one perfect diagnostic tool. Clinicians rely on objective tools as well as clinical expertise and symptom reporting to help determine whether a patient has a concussion.
We use a number of tests & tools to help make a concussion diagnosis:
• Clinical examination
• Balance testing – ImPACT testing
• Baseline vs Post Concussion ImPACT testing results
• Vestibular ocular testing (SCAT6)
• Symptom inventories (SCAT6)
• Neurocognitive testing (memory, reaction time,
Etc - SCAT6)
HOW TO TREAT A CONCUSSION?
Concussion is treated differently depending on the symptoms a person has. Research has shown that active rehabilitation and actively targeting deficits a person is experiencing is an excellent way to treat a concussion.
Similarly, someone who sustains a concussion for the first time will be treated differently than someone who has had repeated concussions. Common concussion treatments at Melbourne Sports Concussion Clinic include vision therapy, vestibular therapy, and exertion therapy and neck conditioning exercises.
WHAT ARE RETURN TO PLAY CRITERIA?
If a healthcare professional removes you from activity for a suspected concussion, they will conduct a sideline assessment to determine if you have a suspected concussion. If you are suspected of having a concussion, you will not be allowed to return to play that day.
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Following your sideline test by a first aider you will attend a healthcare professional to confirm if you have sustained a concussion. Once your brain is healing and your's showing progress, you'll go through a gradual return to activity process supervised by a healthcare provider.
This process includes the following steps:
• Symptom-limited activity
• Light aerobic exercise
• Sport-specific exercise
• Non-contact training drills
• Full contact practice
• Return to activity
In order to return to play, you'll need to be:
• Symptom-free:
- At rest
- With cognitive exertion
- With physical exertion
- Without any recovery medications
• Within normal limits on:
- Balance (BESS)
- Vestibular Ocular Screening (VOMS)
• Back to (or better than) baseline on neurocognitive testing scores