Acute Concussion

The definition of a concussion is:

A complex pathophysiological process affecting the brain, induced by biomechanical forces. The force can be a direct blow to the head/neck or through impulsive forces to the body.

Concussion typically results in the rapid onset of short-lived impairment of neurologic function that resolves spontaneously.

Symptoms can include headaches, dizziness, loss of balance, hypersensitivity to light/sound, fatigue, irritability, insomnia, visual impairments, difficulty with memory/concentration and emotional disturbance.

In the immediate post-injury phase, there is no other treatment for concussion other than REST. A concussion or a mild traumatic brain injury (mTBI), is essentially an energy deficit inside the brain, complete with ion imbalances and blood flow abnormalities. Rest has two very important features when it comes to concussion. First, it keeps the injured person from putting themselves in harms way until they have recovered sufficiently to avoid a devastating second injury. Secondly, rest allows them to get a jump-start on their recovery so that all available energy is allocated to helping recover imbalanced brain cells.

The general consensus within the research and medical community is, anything that could potentially burn energy, such as mental stimulation or concentration as well as physical exercise, will in-turn delay recovery! Therefore, COMPLETE PHYSICAL and COGNITIVE REST is prescribed during the initial recovery period. This means: no school, no homework, no texting, no computer/video games, no television, no physical activity. Often times, athletes are encouraged to sit in a dark room so that they are free from light stimulation (this is not necessary, but the patient may prefer this if they are light sensitive).

The use of medications should be reserved for extreme circumstances and should only be used if directly prescribed by a physician who is familiar with concussion injuries.

The next stages of rehabilitation from a concussion injury involve a gradual return, first to cognitive activity and then a gradual increase in physical activity, with each stage separated by a period of at least 24 hours. This process must be monitored by a clinician with extensive training in concussion injuries, as there are numerous signs which could delay recovery if not properly addressed. The athlete must have NO SYMPTOMS at any one of the stages in order to be progressed to the next stage. If symptoms are encountered, this is indication of not being ready for the complexity of the task, and the athlete should drop back to the previous stage for a 24-hour period before attempting the next stage again. The final stages involve monitored increases in physical exertion to assess blood flow within the brain, as well as extensive testing of neurological, mental and physical systems, to ensure that your brain has recovered and you are safe to return to activity without causing further damage.

Most concussions resolve in 7- 10 days with rest but when signs and symptoms last for longer than that, it is post concussion syndrome.