August 11, 2009
Concussions Can Have Longer-Lasting Effects Than Most Believe
By Dr. Andrew Dennison, Brain Injury Specialist
Walton Rehabilitation Health System
Augusta, GA—A concussion may seem like a rite of passage, just part of the game of life. But it’s not. As a traumatic brain injury, even a minor concussion can have long-lasting effects.
While many concussions improve after simple rest and acetaminophen, some people may also develop “post-concussive syndrome.” These side effects of a concussion can last for weeks or months, and aren’t related to how severe the concussion is. So they can develop even if a person has a minor blow to the head, and may not occur after a major concussion. About 10 to 20 percent of patients who suffer a concussion continue to have these symptoms one year later.
Symptoms are varied but may include:
• Memory and concentration problems
• Mood swings, personality changes
• Fatigue or excessive drowsiness
• Noise and light sensitivity
While there is no specific treatment for the syndrome, the symptoms can be treated. A rehabilitation center can typically provide medications, testing and therapies to relieve or work around symptoms. Headaches can be treated by the same medications used to treat migraines and tension headaches. Memory, thinking problems and dizziness may improve through focused rehabilitation. And anxiety and depression may be relieved by talking to a psychologist who specializes in brain injury.
Prior to the start of a season, athletes—whether amateur or professional—and others who are at high risk for concussion can consider asking their primary care provider for a prescription for a baseline screening by a neuropsychologist. Should you sustain a concussion, a baseline screen is a helpful comparison tool to gauge the extent of your concussion and your recovery.
Most importantly, patients with post-concussive syndrome should have both physical and mental rest until symptoms subside. Athletes in particular should sit out until symptoms subside. Returning to play before complete recovery puts patients at risk for second-impact syndrome, a rare, but often fatal, brain swelling that can occur when a second concussion is sustained. Repeated concussions can also lead to dementia pugilistica—also known as being “punch drunk”—which manifests as Parkinson-like symptoms, problems with memory, declining mental ability, speech problems and unsteady gait.
While concussions are most often sustained during sports or recreational activities like biking and skateboarding, automobile accidents and falls are other major causes of concussion. To help reduce risk of concussion:
• Always wear a helmet or head gear during sports like football, baseball and softball, bicycling, horseback riding, skateboarding, soccer and more.
• Avoid uneven surfaces when biking or skateboarding.
• Examine and replace any sports equipment or protective gear that is damaged.
• Obey traffic signals, and be aware of pedestrians and bicyclists.
• Always wear your seatbelt.
• In the home, remove trip or fall hazards like rugs or loose electrical cords. Put away toys and use safety gates at stairs if you have young children. And if you are older, consider installing grab bars and no-slip mats in the bathroom.
Teens are more susceptible to concussion than adults, but adults are more likely to suffer from post-concussive syndrome. No one typically expects a concussion to have such long-lasting effects, but if you still feel that something just isn’t right after you’ve experienced a concussion, it’s important that you speak to your physician and get the help you need to get back to the game of life.
Dr. Andrew Dennison is board-certified in physical medicine and rehabilitation and fellowship-trained in traumatic brain injury.
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