Concussion

What is a concussion?

Concussion, also known as mild traumatic brain injury (mTBI), is the result of a sudden movement or deceleration of your head. When the brain moves within your skull, the compression/twisting forces can cause structural and/or biochemical disturbances in your brain, which creates symptoms of pain or abnormal function. These symptoms can appear immediately or several days or weeks later. You don’t have to hit your head or lose consciousness to have aconcussion. For example, a trip on the sidewalk and landing on your hands and knees or “whiplash” from a car accident, can leave you concussed.

If your symptoms continue past 10–14 days in adults or >4 weeks in children, you have post-concussion syndrome (1).

What is post-concussion syndrome?

Post-concussion syndrome is the continuation of several or all of the initially reported symptoms that were associated with a concussion. PCS can last months to years, or possibly a lifetime (2).

What are the symptoms someone with a concussion or PCS might complain of?

  • Headache or pressure in the head
  • Dizziness, balance difficulty or lightheaded feeling
  • Memory loss/laps
  • Confusion
  • Blurred vision/ double vision
  • Difficulty understanding what is being said
  • Difficulty forming a complex sentence
  • Have “brain fog”Light and or sound sensitivity
  • Difficulty going to sleep or staying asleep
  • Difficulty staying awake
  • Feeling irritable and or fearful
  • More emotional (laugh or cry inappropriately)
  • “Don’t feel right”/detached from normal awareness of self and surroundings
  • Nausea/ vomiting
  • Loss of appetite
  • Loss of interest in favorite activities
  • Bothered by electronic media (computer, phone, TV)

The above list is not exhaustive, but includes many common symptoms.

What are the signs that you might observe in a loved one or friend that has a concussion or PCS?

  • Loss of affect (decrease of facial expression, loss of inflection in speech, loss of normal/upright posture)
  • Sleeping more or less than usual
  • Slowness or absence of response to questions or requests
  • Slowness of movement
  • Vomiting
  • Balance issues
  • Withdrawal from family and friends
  • Irritability/anger/defiance
  • Sadness/negativity

The above list is not exhaustive, but includes many common symptoms.

soccer
Football soccer player visiting doctor after injury

References

1) McCrory P, et al, Consensus statement on concussion in sport—the 5thinternational conference on concussion in sport held in Berlin, October 2016, British Journal of Sports Medicine, Volume 51, Issue 11

2) Hiploylee C,, et al, Dufort PA, Davis HS, Wennberg RA, Tartaglia MC, Mikulis D, Hazrati LN, Tator CH, Longitudinal Study of Postconcussion Syndrome: Not Everyone Recovers, J Neurotrauma. 2017 Apr 15;34(8):1511-1523. doi: 10.1089/neu.2016.4677. Epub 2016 Nov 29.

Additional Resources

Morgan CD, Zuckerman SL, Lee YM, King L, Beaird S, Sills AK, Solomon GS, Predictors of post-concussion syndrome after sports-related concussion in young athletes: a matched case-control study, Journal of Neurosurgery: Pediatrics, 2015 Jun;15(6):589-98. doi: 10.3171/2014.10.PEDS14356. Epub 2015 Mar 6

Peter Leo, Michael McCrea, Translational Research in Traumatic Brain; Chapter 1 Epidemiology; Laskowitz D, Grant G, editors. Boca Raton (FL): CRC Press/Taylor and Francis Group; 2016

Robert A Laskowski, Jennifer A Creed, and Ramesh Raghupathi. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects, Chapter 4: Pathophysiology of Mild TBI: Implications for Altered Signaling Pathways

Testimonial

My junior year of High School I sustained a catastrophic concussion. Prior to the incident, I was achieving excellent marks in honors and AP classes, but suddenly I was unable to look at a page in my textbook for more than a minute. Traditional doctors told me to rest and prescribed my stimulants as a means of “fixing” my problem; I fell behind in school, my grades dropped dramatically, and I felt like a hollow shell of my former self. Although the drugs helped me focus and the rest kept me awake, I was merely subsisting, not recovering. I finished junior year having completed just two classes—the rest were incompletes, and I was faced with the prospect of doing extra years of high school to reach college, or perhaps not reaching college at all.

 

The future was grim, until I met Dr. Duffy. It is difficult for me to come up with enough superlatives to describe my experience with him. Dr. Duffy immediately highlighted my deficiencies in a manner no traditional doctor had, identifying tangible issues with my processing speed and eye movements, rather than relying on buzzwords like “foggy” to determine my course of treatment. Further, he recognized issues I was having but had never even brought up in the context of my concussion—neck and jaw problems, balance issues, facial twitches. My initial assessment left me bewildered, but Dr. Duffy comprehensively touched on nearly every issue I was experiencing without me having to express them to him.

 

My course of treatment with Dr. Duffy did wonders for me. One week having three treatments per day changed my life; after returning home, I closed my incompletes, and was able to read and write like my former self. Further, I regained the confidence to argue with the school to restore my normal AP heavy schedule, as they had wanted to limit me to taking only 3 classes my senior year. I attained a perfect score on the ACT, something only 1,407 students did that year, was nominated to be a Presidential Scholar, one of 3,900 candidates in the country, and was a National Merit Scholar finalist, one of 7,600. Finally, I was accepted to my dream school, an Ivy League institution that I wouldn’t have dreamed of attending were it not for Dr. Duffy.

Matthew W.

Connecticut

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