concussion

In a pair of studies published in Neurology, the medical journal of the American Academy of Neurology, researchers have discovered that even mild blows to the head can cause measurable damage to the brain, even when there are no signs of concussion from the blow.

In the first study, published in December 2013, a group of 80 football and ice hockey players were compared to a group of 79 skiers and track runners.  The football and hockey players were equipped with helmets that measured acceleration of blows to the head.  Both groups were given brain scans and a series of cognitive and memory tests before and after the season.

Although none of the athletes suffered blows serious enough to cause concussion, 20% of contact athletes and 11% of non-contact athletes showed a significant decline in test scores, of a degree that would be expected in less than 7% of a typical population.  The athletes that had the greatest declines in test scores showed the most significant changes in the corpus callosum and in the white matter.  The surprising result of this study was the number of athletes who showed declines and signs of damage despite not engaging in contact sports.  

In the second study, published in July 2014, a group of 33 people who had suffered mild brain trauma and a group of 9 people who had experienced moderate brain trauma were compared with 44 people who had not suffered any recent brain trauma.  All of the participants were given diffusion tensor imaging scans.  These scans are a type of MRI that is specially designed to identify damage to brain cells.  The brain injured participants were given the scans and tests an average of six days after the trauma.  

The participants who had experienced trauma scored 25% lower on tests of cognition, memory, learning and verbal fluency than the participants without trauma.  The the scores correlated strongly with the amount of damage observed on the scan images, with lower scores associated with greater damage.  A year after the first scans, 23 of the participants with brain trauma repeated the scans and the tests.  Their scans still showed signs of damage, though their test scores were similar those of the uninjured participants. 

These studies are the first of their kind to examine what happens to the brain in the wake of mild to moderate brain trauma and blows to the head that do not cause noticeable symptoms of concussion.  This is significant because 90% of all brain injuries are mild to moderate, and because many people suffer blows to the head without necessarily suffering concussion.  Further research is needed to find out whether there are factors other than force of impact that influence the degree of damage cause by a blow to the head.  They also illustrate the importance of protecting the brain from the effects of impact to the head. To get help with concussion and concussion effects call 03 9034 7735 or click here to book a consultation online.

 A study indicates that even when there is no actual concussion, impacts to the head occurring during just one season of full contact sport such as football or hockey can negatively affect the white matter in the brain, as well as cognitive skills and memory.  The study was published online in Neurology, the journal of the American Academy of Neurology in 2013.  

White matter is a component of brain tissue that is critical in the ability of nerve cells to transmit messages.  Study author Thomas W. McAllister, MD, of Indiana University School of Medicine in Indianapolis explained that the researchers compared the white matter in the brains of those college varsity athletes who played contact sports with varsity athletes who played non-contact sports and found marked differences between the two.

As part of the study, 80 concussion-free college football and ice hockey players, along with 79 non-contact athletes, such as those who ran track and skiers.  Before the season began, all of the athletes had their brains scanned and were given a series of learning and memory tests.  The football and ice hockey players wore helmets that were equipped to measure acceleration of impacts to the head during the season, and the scans and tests were repeated shortly after the end of the season.

Researchers discovered that a subgroup of 20% of contact athletes and 11% of non-contact athletes scored significantly lower than expected at the end of the season.  In a normal population, less than 7% of people would be expected to show this degree of decline over the same time frame.  The athletes who exhibited this decline also showed a greater degree of change to the corpus callosum area of the brain than those who scored as expected.  In addition, those who scored the lowest on the tests showed the greatest degree of change in white matter.

The corpus callosum is a wide, flat bundle of nerve fibers that connects the left and right sides of the brain.  The research suggests that even minor blows to the head that do not cause concussion are still capable of causing damage to both the white matter and to the corpus callosum.  The research raises the question of what makes some athletes more susceptible to damage from blows to the head than other athletes and what other factors could explain changes in cognition and memory.  Further research is needed to determine whether these changes are short-term or long-lasting.

Almost all concussions heal in 2-4 weeks. However, symptoms can be delayed for weeks and months, which is why concussion sufferers should know how long can a concussion last, and what concussion treatment to get if it doesn’t go away.

If you have been cleared after your initial injury, but continue to have a headache, feel dizzy, or suffer any other symptoms after about 2-3 days, it’s a good idea to check in with your doctor to make sure it’s not a more serious injury. If you haven’t been assessed at all following your concussion, be sure to see your doctor.

Reduced blood flow in the brain with concussion.

Post-concussion bleeding is rare and should be treated by the hospital if it occurs. However research has shown that blood flow to the brain can be reduced in concussion for 2-4 weeks, even if you are recovering normally. As a result you should be careful about doing too much too soon.  In people that have persistent symptoms, blood flow may be altered for months.

Symptoms of a concussion.

• Reduced concentration, memory, and cognitive function.
• Memory: Memory is usually affected as well as your ability to think and make decisions. This can happen for up to a month after a concussion.
• Brain fog: Many people with concussion suffer from prolonged “brain fog” – feeling like you’re “not quite with it”.
• Headaches: If your headache lasts more than 1 hour or you are dizzy after your head hurts, it’s a sign that you have a concussion.
• Dizziness: This is similar to feeling “foggy” but unlike with fogginess, dizziness often persists even after the head has stopped hurting.

According to the American Academy of Orthopedic Surgeons (AAOS), the most common type of concussion symptoms are headache, dizziness, loss of consciousness, vomiting, confusion, amnesia and double vision. Some people may have a stiff neck, muscle spasms, difficulty focusing, headaches, and difficulty thinking and reasoning.

Treating concussions with Physiotherapy.

Physiotherapy can help reduce post-concussion symptoms. Supervised return to activity can make sure that your brain is ready to handle the stress of work, school or sport. If you’ve injured your neck or other muscles or joints then getting physiotherapy is a good idea.

At Focal Allied Health, we can address the balance  issues associated with concussion using vestibular rehabilitation therapy. We can also create a personalised treatment program to help you get back to normal. Call us on 03 9034 7735 or click to book an appointment online.