Concussion

Concussions are the most common type of traumatic brain injury (TBI). They can occur as a result of a motor vehicle accident as well as various sports. Symptoms can vary greatly from person to person and not everyone may be aware that they have experienced a concussion when in fact they have.

Causes
As mentioned above, the causes of concussion can be varied. Most often, people relate a concussion to loss of consciousness. However, this is not necessarily the case. Concussions are often the result of a direct blow to the head, but can also be caused by a violent force or shaking in the upper body. For example, whiplash of the neck may result in concussion because the excess force applied to the body. Concussions may also be experienced after a large tackle that causes an unnatural jolt of the upper body. The brain sits in a pool of cerebrospinal fluid. It can move within your skull (cool, huh?). So, basically anything that projects a strong force onto the skull or nearby structures (e.g. the spine) can cause a concussion.


What's actually happening?
During the initial blow, the brain bumps into the bony skull. This may not sound like much, but considering how many complex and intricate structures are in your brain (and there are a lot!), damage can be done. Concussions are a hot topic for research these days, and there is still much to learn. It is believed that the bumping of the brain against the skull disrupts important neural connections (kind of like your brain is short-circuiting).

Symptoms
Symptoms of concussion are many and varied, ranging from complete loss of consciousness to a mild headache. Symptoms may also include: drowsiness, insomnia, difficulty concentrating or remembering, an abrupt change in personality/character, feeling more emotional, dizziness, nausea/vomiting, feeling like you're in a fog, sensitivity to light and noise and loss of balance or coordination. These may be very mild, or very severe. The SCAT tool nicely outlines these symptoms as well as testing that can be done for concussion (read here).

I think I have a concussion, now what?
If you've recently experienced a force to the head or upper body and are feeling any of the above symptoms, you should go to the doctor to have these assessed and properly diagnosed. Early intervention is important so you can start the recovery process. Typically, it is recommended that you are at complete mental and physical rest for 24 hours (no exercise, no physical activity, no reading and definitely no screen time). The blue light from your phone or computer screen can aggravate your symptoms if you have a concussion. It is also recommended that you avoid caffeine and alcohol and that you have somebody check in on you every few hours while you are sleeping to make sure other more serious conditions are not present (e.g. brain bleeding). After this first 24 hours, you may introduce light activity (such as walking or slow pedaling on a stationary bike). You must experience no symptoms for another 24 hours. If symptoms are still present, you will need to return to the previous stage. Each stage is outlined below. There is a minimum of 5 days to return to play, with a doctor's assessment required prior to returning to contact sports.


Treatment
There is no specific treatment to treat a concussion. Instead, focus is on alleviating the symptoms felt by the patient, and make sure to track progress to report back to the doctor. Both physiotherapy and massage therapy are excellent options to help relax the muscles around the head and calm the body. Acupuncture may also be effective in calming the nervous system. Together, these treatments may aid in a quicker recovery. Recovery from concussion symptoms can occur within a few days or several months. Again, the span is huge as concussions will affect every person in a different way.

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