Concussion: Promoting Facts over Media-Sensationalized Fiction
Updated: Apr 10, 2020
The discussion of concussions has exploded in popular media in the last few years. It seems nearly every popular media site has done at least one or two pieces, sometimes many more, on the impacts of concussion and it's related symptoms. In today's blog post, Dr. Ghilain goes over the symptoms of concussion and provides readers with the facts- while dispelling common myths.
A concussion is a mild blow to the head that causes a neurochemical response in the brain. It is described as neurochemical because there is no change to the physical structure of the brain itself. Common causes of concussion include falls, sports injuries (such as collisions on a football field or head-to-head contact during a soccer game), or the accidental striking of the head on an object. Typically, the initial symptoms of a concussion can include dizziness, lightheadedness, sensitivity to light or sound, nausea, feelings of fogginess, clumsiness, or other similar experiences. It is possible that the individual might lose consciousness for a brief period of time, or may have difficulty recalling details about events that occurred just prior to the concussion. Neck sprains or tightened neck muscles are common and can cause stiffness and headache pain as well. All of these symptoms are completely normal, and these symptoms typically subside within a couple of weeks.
If the individual is taken to an emergency department for evaluation immediately following concussion, it is unusual for a hospital to complete a brain scan (e.g., a head CT or MRI). Typically, a scan is not ordered unless the person is coming in and out of consciousness, difficult to arouse, repeatedly vomiting, or having seizures. These symptoms are indications that a more significant brain injury may have occurred. If a scan is ordered (out of an abundance of caution), brain neuroimaging is typically normal following concussion- hence why it is rarely ordered.
What is important for parents/family members to realize, as well as the individual who suffered the concussion, is that the concussion sufferer will likely feel not so great for a couple of weeks. They may have difficulties sustaining focus and attention, may sleep more or less than usual, and may have ongoing headaches, light sensitivity, or general feelings of fogginess. Again, this is completely normal and will subside. It is important to know that symptoms of a concussion, while inconvenient, will go away. Individuals will recover fully from a concussion and resume a perfectly normal life.
So why is it that some individuals seem to have a concussion that goes on much longer than a few weeks? Research has demonstrated that there are five major factors that can cause an individual to experience symptoms of a concussion for longer than expected. Nonetheless, these individuals also recover fully, it just takes them a bit longer.
These exacerbating factors include:
- a history of a learning disability
- attention deficit hyper activity disorder (ADHD)
- a previously diagnosed concussion
- a history of migraine headaches
- a history of mood disorder (e.g., depression, anxiety)
As you can see, there are many reasons why an individual may experience additional concussion symptoms for longer than a few weeks. In these cases, symptoms may last closer to a month or two, but then will subside.
Getting into some of the myths that are floating around popular media, while a concussion is termed a mild traumatic brain injury (mTBI), it does not mean the individual is brain-damaged. It also does not mean that the individual will not recover. As discussed above, individuals recover fully from a concussion and neuroimaging (in the rarest of cases when it is ordered) is normal.
A second myth is that the individual requires a dark room with little to no stimulation for weeks on end to promote recovery. In next weeks blog, Dr. Ghilain will discuss ways to support rapid recovery following concussion. Though Dr. Ghilain and Dr. Morgan create "return to sport" and "return to learn" protocols specifically tailored to the individual patients with a concussion they see, there are general things family members can do to promote recovery. While supports may be encouraged, it is important to note that these are temporary and not permanent modifications to a person's life.
Finally, during the recovery period, individuals may experience an increase in concussion symptoms while exerting themselves (e.g., when gradually returning to activities or sports or when initially returning to work or school). Though uncomfortable at times, these symptoms do not mean that the individual is further "damaging" their brain. Just like any other muscle in the body, the brain requires gradual ramping up of activities that may temporarily cause soreness (e.g., headache) or fatigue. This is not a sign that the person is re-injuring or damaging their brain in some way, it means they are on the road to recovery!