• Dr. Ghilain

Concussion Continued: From the International Neuropsychology Society Conference in Denver, Colorado!

Updated: Apr 10, 2020

Few things are more invigorating than a conference jam-packed with talks given by peers discussing the latest in diagnosis, research, and treatment across a plethora of neuropsychological conditions! While Dr. Ghilain is bringing you this blog post from snowy Denver, today's post is a follow-up from our last post about Concussion. Tune in during the upcoming weeks for recaps of some of the talks attended at the INS conference, with summaries of exciting new research advancements in our field!

As discussed in the previous blog post, individuals who suffer a concussion make a full recovery! That said, there are many things that may prolong or extend recovery for certain individuals (if you missed those "risk factors," pop back to the prior post for a comprehensive review). So what do neuropsychologists recommend to promote and support more rapid recovery?

A comprehensive neuropsychological evaluation is not always necessary following a concussion. This may be surprising, especially coming from a neuropsychologist, but we know that individuals go on to recover and return to their normal life! However, consultation with a neuropsychologist and brief testing may be warranted- particularly for those individuals with complicating risk factors (ADHD, prior concussion, learning disabilities, emotional disorders, migraines, etc.) or those who are unfamiliar with what to expect when a concussion occurs. In this session, the neuropsychologist will review the person's background history, and provide "psychoeducation." Psychoeducation is a fancy term for information to help individuals and their families understand what to expect and the recovery trajectory in the coming weeks. It is a time of empowerment for families, and it includes tips, tricks, and strategies to support ongoing rapid recovery.

Brief testing may be warranted, though this is not always the case. If testing is completed, the neuropsychologist will review the results and provide feedback. Most importantly, the neuropsychologist will provide tailored plans for returning to sport or exercise, as well as returning to work or school. These are often termed "Return to Sport" and "Return to Learn" protocols. These tailored protocols can be particularly helpful for children in order to ease the transition back to school, and to set realistic expectations for returning to physical activities.

In general, the goal is to assist the concussed person with getting back to normal life as quickly as possible.Though this blog is no substitute for medical or tailored neuropsychological treatment, the following are some general recommendations:

- Maintain routines as much as possible.

- Get adequate sleep as sleep promotes recovery and can reduce fatigue.

- Fuel the body with healthy, nutrient-dense foods that provide adequate energy.

- Stay hydrated, with a particular emphasis on adequate water intake and less of an emphasis on caffeinated or high-sugar drinks.

- Promote gradual return to activities with a goal of systematically increasing duration and intensity.

- Reduce screen time, particularly around bedtime hours. Typically, it is best to minimize use of electronics and screen time, though a limit of up to two hours per day can be implemented if symptoms (e.g., headaches, light sensitivity) are not exacerbated.

- Respond appropriately to symptom exacerbation: if a particular activity causes headache or increases symptoms, take a small break, and then return to the activity again. It may also be beneficial to reduce the intensity when returning. For example, if jogging causes headache, perhaps take a short break, and return by briskly walking. As discussed in the prior blog, symptoms do not mean "more brain damage" and the brain, like any other muscle, needs to be exercised!

- Limit high-sensory experiences initially, with again a gradual return. For example, heading to a loud and crowded sporting event or bright-lighted concert may not be particularly enjoyable for an individual who recently sustained a concussion. It may be best to postpone these plans for a few weeks after, when the individual is recovered.

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