Brain Concussion (cont.)

Time is the ally in concussion treatment since most symptoms resolve relatively quickly. Treatment is directed at symptom control for headaches, nausea, dizziness, and insomnia.

Brain rest is an important concept. In today's high tech connected world, the brain is often asked to process information at a high rate of speed from television, computers, and smartphones. Limiting use of those devices may be helpful in allowing the brain to recover more quickly.

Ultimately, the brain will recover at its own pace. While 80% to 90% of concussion patients will recover within 7 to 10 days, some patients will experience symptoms for weeks or months. The length of recovery is not necessarily related to the initial injury.

Discussion with employers may be needed to alert them to issues of poor work performance due to difficulty with concentration and comprehension. Similarly, school officials should be notified about the potential for decrease in school function.

Return to sports depends upon complete resolution of concussion symptoms and it is important not to return to practice or competition too soon. A concussed brain may be more prone to repeated injury.

As with most accidents, injury prevention is the first consideration. The following are all important steps to prevent concussion and severe head injuries:

• workplace safety using helmets where required or recommended;
• using seatbelts in motor vehicles;
• wearing helmets while bicycling and motorcycle riding; and
• head protection should be worn when participating in some sports. Proper technique is also important to prevent injuries.

Public education is important in raising awareness for concussion and its complications. Players, coaches, and parents are being educated in how to recognize symptoms and prevent the return of the player to the field until it is safe. Similarly, educational efforts at the workplace are increasing awareness of the signs and symptoms of concussion.

Research continues as to the when the best time is to return to full activity. A variety of computer based programs (ImPACT™) are being used as screening tests to measure reaction times and emotional changes. Once a patient “passes” these tests, repeat evaluation by a care professional is usually required before return to full activity.

Patients with severe head trauma may have genetic factors that affect their prognosis. A variety of hormones and chemicals may affect brain function and recovery. The impact of this research on patients with minor head injury and concussion is as yet uncertain.

ImPACT™ (http://www.impacttest.com/index.php)

Kors, E. E., et al. "Delayed cerebral edema and fatal coma after minor head trauma: Role of the CACNA1A calcium channel subunit gene and relationship with familial hemiplegic migraine." Annals of Neurology 49.6 (2001): 753-760.

Stiell, I. G., et al. "The Canadian CT Head Rule for patients with minor head injury." Lancet 357.9266 (2001): 1391-1396.

McCrory, P., et al. "Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004." British Journal of Sports Medicine 39.4 (2005): 196-204.

Teasdale, G., et al. "Association of apolipoprotein E polymorphism with outcome after head injury." Lancet 350.9084 (1997): 1069-1071.

Source: MedicineNet.com
http://www.medicinenet.com/brain_concussion/article.htm