Five Concussion Facts That Will Blow Your Mind

Fiction: You have to lose consciousness in order to be considered to have suffered from a concussion.

Fact:

     Losing consciousness is only one of the criteria that can determine if the injury is a concussion and it only happens in about 10% of concussion cases. To be diagnosed with a concussion, you only need to have at least one of the following:

1.       Any period of loss of consciousness (0-30 minutes)

2.       Any loss of memory about events that happened immediately before or after the incident

3.       Any alteration in mental state (feeling dazed or “fogginess”, confused, inability to clearly think, and not being able to answer simple questions at the time of the incident) 

Fiction: If you didn’t hit your head, you can’t sustain a concussion.

Fact:

     Do you remember the old commercials with the egg that said, “This is your brain, this is your brain on drugs?” Well, let’s use that. In this example, the eggshell is your skull and the yolk is your brain. When the egg gets shaken, the yolk sloshes around and can collide with the shell. A direct hit to the shell (your head) from the outside, isn’t necessary to damage the yolk (your brain). A jolt to the body or a whiplash-type injury to the neck can cause what is known as an inertial concussion. Inertia refers to an objects tendency to be at rest unless it’s acted upon by another force. That force could be a hard tackle to the body or even the abrupt start and stop of a rollercoaster. Military personnel in blast-zones have been known to sustain concussive injuries with no obvious external signs of trauma due to the over-pressure wave from an explosion. This phenomenon used to be known as “shell-shock.”

Fiction: Concussions heal on their own with rest.

Fact:

     Based on the physiology of a concussion, an initial period of rest can prove to be beneficial. This is referred to as “cocooning.” It allows for healing of the energy deprived brain and potentially avoid a dangerous secondary concussion, called “Second Impact Syndrome”.

     However, more recent research indicates that prolonging the cocooning period can actually delay full recovery and trigger other conditions, such as depression. Vestibular rehabilitation, coupled with ongoing assessment, balances the brain’s need for rest and the need for targeted activity.   

Fiction: Once a concussion heals, it’s like it never happened.

Fact:

     After the first concussion, you are three times more likely to suffer a second concussion. Following the second concussion, you are eight times more likely to suffer a third concussion.

     After each concussion, less force is necessary to cause a subsequent concussion because the brain becomes hypersensitive to additional injury. At that point, even sub-concussive blows to the head or body which normally would not cause injury, could actually be a big problem.

Fiction: If a CT scan looks normal, there is no concussion injury.

Fact:  

      A concussion is a functional brain injury, so damage from a concussive injury is not able to be detected on a brain CT scan or MRI. These tests determine if there are more serious complications, such as brain swelling or bleeding. They do not diagnose concussion injuries.

     The best way to diagnose a concussion is to review the symptoms that are being experienced and complete a focused neurologic/vestibular exam with computerized diagnostics, as well as a cognitive assessment.