According to the CDC, a concussion is a type of traumatic brain injury—or TBI—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. Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life threatening. Even so, the effects of a concussion can be serious.

The American Association of Neurological Surgeons (www.aans.org) defines concussions as: a clinical syndrome characterized by immediate and transient alteration in brain function, including alteration of mental status and level of consciousness, resulting from mechanical force or trauma.

People with concussions often cannot remember what happened immediately before or after the injury and may act confused. A concussion can affect memory, judgment, reflexes, speech, balance, and muscle coordination. Paramedics and athletic trainers who suspect a person has suffered a concussion may ask the injured person if they know their name, what month/year it is and where they are.

Even mild concussions should not be taken lightly. Neurosurgeons and other brain-injury experts emphasize that although some concussions are less serious than others, there is no such thing as a “minor concussion.” In most cases, a single concussion should not cause permanent damage. A second concussion (second impact syndrome) soon after the first one, however, can lead to long-term disability and in some cases death (a result of suicide).

In the United States, the annual incidence of sports-related concussion is estimated at 300,000. Estimates regarding the likelihood of an athlete in a contact sport experiencing a concussion may be as high as 19% per season.

The following are concussion symptoms:

  • Prolonged headache
  • Vision disturbances
  • Dizziness
  • Nausea or vomiting
  • Impaired balance
  • Confusion
  • Memory loss
  • Ringing ears
  • Difficulty concentrating
  • Sensitivity to light
  • Loss of smell or taste

Common Signs Reported:

  • Headache
  • Nausea
  • Balance problems or dizziness
  • Double or fuzzy vision
  • Sensitivity to light or noise
  • Feeling sluggish
  • Feeling “foggy”
  • Change in sleep pattern
  • Concentration or memory problems

The skull does its best to protect the brain against trauma but does not absorb all of the impact. The brain is cushioned inside the skull by the surrounding cerebrospinal fluid.

Despite this, a blow to the head, or even a rapid deceleration, can cause the brain to contact the inner side of the skull. As a result, there is potential tearing of blood vessels, pulling of nerve fibers and bruising of the brain substance. In severe cases, the brain tissue can begin to swell and this can compress the brain and its blood vessels, limiting the flow of blood. Without adequate blood flow, the brain does not receive the necessary flow of oxygen and glucose. A stroke can occur.

A blow to the head can lead to additional concerns that are equally serious in nature. A contusion is a bruise of the brain tissue involving bleeding and swelling in the brain. A skull fracture occurs when the bone of the skull breaks; the broken skull bones cause bleeding or other damage by cutting into the brain or its coverings. A hematoma is a blood clot that collects in or around the brain. If active bleeding persists, hematomas can rapidly enlarge, and can even be life-threatening.

The warning signs of a serious brain injury are the following

  • Pain: Constant or recurring headache
  • Motor dysfunction: Inability to control or coordinate motor functions, or disturbance with balance
  • Sensory: Changes in ability to hear, taste or see; dizziness; hypersensitivity to light or sound
  • Cognitive: Shortened attention span; easily distracted; overstimulated by environment; difficulty staying focused on a task, following directions or understanding information; feeling of disorientation, confusion and other neuropsychological deficiencies.
  • Speech: Difficulty finding the “right” word; difficulty expressing words or thoughts.

Treatment

What we have learned so far in the research, there is no specific treatment for postconcussion syndrome beyond rest. Instead, doctors treat individual symptoms that may include headaches, depression, and anxiety.

1. Medications commonly used for migraines or tension headaches, including some antidepressants, appear to be effective when these types of headaches are associated with post-concussion syndrome.

Examples include:

  • Amitriptyline
    This medication has been widely used for post-traumatic injuries, as well as for symptoms commonly associated with post-concussion syndrome, such as irritability, dizziness and depression. Amitriptyline may be combined with propranolol (Inderal, Innopran XL) to treat migraine-type headaches.
  • Topiramate
    Commonly used to treat migraines, topiramate (Qudexy XR, Topamax, Trokendi XR) may be effective in reducing headaches after head injury. Common side effects of topiramate include weight loss and cognitive problems.
  • Gabapentin
    Gabapentin (Gralise, Neurontin) is frequently used to treat a variety of types of pain and may be helpful in treating post-traumatic headaches. A common side effect of gabapentin is drowsiness.

Other agents used to treat migraines and tension-type headaches may also be helpful in some individuals. Keep in mind that the overuse of over-the-counter and prescription pain relievers may contribute to persistent post-concussion headaches.

2. Memory/Cognitive Therapy
No medications are currently recommended specifically for the treatment of cognitive problems after mild traumatic brain injury. Time and rest may be the best therapy for post-concussion syndrome if you have cognitive problems. Certain forms of cognitive therapy may be helpful, including focused rehabilitation, relaxation therapy, grounding, and memory games.

3. Neurofeedback
Neurofeedback, also called EEG biofeedback or neurotherapy, is a research proven way to help you improve your brain function through intensive brain training exercises. The technology may be sophisticated, but the process is simple, painless, and non-invasive.

Simply, you learn to alter your brain activity the same way you learn every other skill through feedback and practice. What is new in neurofeedback is that you are guided by a form of feedback that was previously not available to you – instantaneous information about changes in your brain’s electrical activity. Every half second, your brain activity is compared to your targets for change. You get a signal and “reward” when you meet the goal. No signal or reward when you do not.

4. qEEG
The qEEG is an extension of the analysis of the visual EEG interpretation, which may assist and even enhance the understanding of the EEG and brain function. Quantitative Electroencephalography (qEEG) is a non-invasive procedure that processes the recorded EEG activity from a multi-electrode recording using a computer.

Related

BrainInjuryNetwork.org

TraumaticBrainInjury.com/

BIAusa.org

AANS.org

CDC.gov/traumaticbraininjury

BrainLine.org 

BrainWorksNeuroTherapy.com

EegInfo.com

 

* All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.