CONCUSSION MANAGEMENT
Time does not heal all wounds, effective treatment does!
Concussion, also known as mild traumatic brain injury (mTBI), is a type of brain injury resulting from an external mechanical force, such as a blow to the head or body, that causes the brain to move rapidly within the skull. This movement can lead to temporary changes in brain function, manifesting as various cognitive, physical, and emotional symptoms. Unlike more severe brain injuries, concussions typically do not involve structural damage visible on standard imaging tests like CT scans or MRIs. However, the impact on brain function can still be significant and long-lasting.
Concussions are common, particularly in certain populations and settings. It is estimated that up to 1.15% of the population sustain a concussion in any one year, however, this number may increase as the awareness of concussion and their symptoms improve. The incidence is notably higher in contact sports, where athletes may experience repeated head impacts. For example, football, hockey, rugby, and soccer are associated with high rates of concussion, especially at the collegiate and professional levels. In children, one in five sustain a concussion, also prevalent due to the participation in sports and recreational activities, as well as falls and accidents.
Concussion symptoms can be diverse and may include headaches, dizziness, confusion, memory problems, balance issues, nausea, vomiting, sensitivity to light or noise, and mood changes. Symptoms can appear immediately after the injury or may develop hours to days later. In some cases, symptoms persist for weeks or months, a condition known as persistent concussion symptoms (PCS).
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Best Forms of Management:
The management of concussions has evolved significantly in recent years, with a focus on careful monitoring and gradual return to normal activities. Key strategies include:
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Immediate Relative Rest: After a concussion, it is crucial to rest both physically and mentally to not exacerbate symptoms. This includes limiting activities that require concentration, such as reading, screen time, and work to sub-threshold levels. However, complete rest for days is no longer the best form of management.
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Medical Evaluation: A healthcare professional with training in concussion management should evaluate anyone who sustains a concussion within five days of injury to rule out more severe injuries and provide timely guidance on recovery.
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Gradual Return to Activity: Once symptoms begin to improve, a gradual, step-by-step return to regular activities is recommended. This process should be guided by a healthcare provider, especially for athletes returning to sports.
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Symptom Management: Over-the-counter pain relievers, like panadol, can be used to manage headaches. However, anti-inflammatory drugs like ibuprofen or aspirin should be avoided immediately after the injury due to the risk of bleeding.
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Monitoring for Persistent Symptoms: If symptoms persist for more than a ten days, further medical evaluation is necessary. Specialized treatment, such as vestibular therapy, manual therapy to the cervical spine, cognitive rehabilitation, nutritional support and counseling, may be needed for ongoing symptoms.
Concussions are a serious form of mild traumatic brain injury that requires careful management to ensure full recovery. While many people recover completely within a few weeks, some may experience prolonged symptoms. Early recognition, appropriate management, and gradual return to activity are key to minimizing long-term consequences.
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Our staff at the TMJ & Headache Clinic have undergone extensive training in concussion management, baseline testing and return to sport assessment and clearance.