Q&A with National Dizzy and Balance Center: Concussions- Causes, Treatment and Myths

This summer AKA has been partnering with National Dizzy and Balance Center to learn more about their approach to sport injury treatment. Lauren Kijewski, Certified Athletic Trainer, works with patients of all ages and abilities on dizzy and balance disorders. Her specialty, however, is youth athletes. She is currently the Athletic Trainer at several metro schools and represents NDBC at events such as the MN Hockey tournament.

We asked Lauren to share information on concussions with us so we can understand the symptoms and treatments if a concussion should occur.  Here are some common questions that Lauren and her team receive about concussion prevention, treatment and common myths.

 

What is a concussion?

A concussion is a mild traumatic brain injury.  

 Source: Scienceleadership.org

Source: Scienceleadership.org

What is the most common cause of concussion?

Any type of fall. That includes kids falling off playground equipment, while running or during sports games. They don't always occur during high impact activities- concussions can really happen at any time and can occur with any movement or jostling of the head as in whiplash injuries (front to back) or rotational force (side to side).

 

Which sports have the highest rates of concussions in athletes?

There are different statistics available that can vary by age group and location, but Football, Soccer and Hockey rank among the highest because an athlete can sustain injury from collisions with other players, impact or falls.

What is the best way to prevent a concussion?

There is really no way to prevent all concussions. It is important to wear proper gear when playing a sport, but because a concussion can result from any type of impact to the brain, injuries can still occur.

What are the most common symptoms of concussion?

Symptoms usually fall into four categories:

  1. Thinking/Remembering (difficulty thinking clearly or concentrating, difficulty remembering new information)

  2. Physical (headache, blurred vision, nausea/vomiting, dizziness, balance problems, sensitivity to light or noise, having no energy)
  3. Emotional/Mood (Irritability, sadness, nervousness or anxiety)
  4. Sleep (More or less than usual, difficulty falling asleep)

 

How is a concussion diagnosed?

There isn't a "test" for concussions, but typically an evaluation at an emergency room will include basic neurological tests and may include neuroimaging tests such as an MRI or CT scan. A concussion does not cause structural injury to the brain, so these scans are used primarily to rule out a more serious injury, especially bleeding inside the skull. An evaluation done immediately following a potential concussion would include an interview of the athlete to check for loss of memory or consciousness, an evaluation using a SCAT (Sideline Concussion Assessment Tool) to check symptoms, attention, memory, balance and coordination. Finally there may be an examination to test strength, reflexes, coordination, mental status and other neurological functions.

 

There is a lot of information about concussions that some claim to be myths. Can you tell us if this information is true?

- A concussion only occurs when a person is knocked unconscious.

False. The American Academy of Neurology defines concussion as a "trauma- induced alteration in mental status that may or may not involve a loss of consciousness". Only about 10% of concussions involve loss of consciousness.

- If someone has a concussion, do not let them sleep.

False. If the person is tired, let them rest! Their brain needs to heal. The exception to this rule is if the person is showing other signs- extreme fatigue, vomiting, not acting like themselves. In that case, it is best to seek emergency care to ensure there are no other internal injuries.

- A concussion takes two weeks to heal.

True and False. All concussions are different so there is not one time frame to know you have healed properly. Most concussions do resolve in 7-10 days with proper treatment. When symptoms do not resolve within 30 days, post concussive syndrome is usually diagnosed, and in most cases a specialty concussion clinic like NDBC is needed to properly evaluate and design an appropriate treatment plan. Untreated post concussive syndrome can affect memory, physical and emotional functioning for many months to years post injury. Children and teenagers actually recover more slowly due to their developing brain. They are also more prone to complications from concussion.

- It is not safe to give a person that may have a concussion over the counter headache medicine.

True and False. After a concussion is sustained, you do not want to give your athlete any OTC medication that is a blood thinner, such as Advil or Ibuprofen. Parents ask “Can I just give him Advil to make his headache go away?” The answer is NO. These medications will restrict the blood flow to the brain and hide the true symptoms of the concussion. There are a few OTC medications that are acceptable to give your athlete after 24-48 hours of sustained concussion if his/her headache is intolerable. In this case, taking your athlete in for an evaluation is highly recommended.  It is very important to consult your physician on proper recommendations before administering any medication.

- An athlete who has had one concussion is more likely to have another than an athlete who hasn't been concussed.

True. Once a person has had one concussion, the threshold for sustaining another concussion is lowered. Also, if a player sustains another blow before he or she is fully recovered the symptoms can be worse and it may take longer to recover.

 

Source: ImPact

NDBC recommends Baseline Concussion Testing for youth athletes. Why is this?

All Concussions are unique and need to be treated differently. Baseline Concussion Testing allows us to test multiple aspects of cognitive functioning in athletes including attention span, working memory, attention time, reaction time, and problem solving. Impact testing helps providers make better return to play decisions, helping to prevent secondary impact syndrome and post concussive syndrome. NDBC uses these Baseline tests if an injury occurs to effectively plan individualized rehabilitation programs post injury to ensure health return to activity.

Think of Baseline testing like insurance for your brain. You hope you don't need it (that means an accident has occurred), but if you do need it, the recovery process is much easier. Then think that this is your brain- you can't get a new one and a traumatic injury can really impact your quality of life. It's our goal to get you back to normal as quickly and safely as possible.

Baseline Concussion Testing Opportunities

If you are interested in baseline concussion testing there are two upcoming opportunities for AKA families at a reduced rate of $10 for children age 10 and up (regularly $50).

  • Saturday, August 13th, 9am-12pm: Edina NDBC Clinic (6700 France Ave S Suite 300 Edina MN 55435)
  • Saturday, Sept.10, 9am-12pm: Edina NDBC Clinic (6700 France Ave S Suite 300 Edina MN 55435)

Email Lauren at laurenk@stopdizziness.com for more information and to sign up!  

Learn more about NDBC and baseline concussion testing