Concussions

And mild traumatic

brain injuries
Cause
A Concussion or (mTBI) is caused by trauma
(direct and indirect) to the head that

Prevention

The best way to prevent a concussion from

happening is to make sure the activities you
participate in are as safe as possible. Here are a
few ways to help prevent and minimize your risk of
head injury:
- Wear appropriate protective equipment
during recreational activity and sport.
- Buckle up
- Keep floors around your house clean and
free from clutter, to reduce risk of falls
- Wear sensible shoes, to reduce risk of falls

immediately disrupts normal brain function.

Concussions are a common result in car
accidents, falls, assaults and sports injuries.
Each individual may experience a concussion
differently and no two cases are the same.
A common misconception about concussions
is that a person losses consciousness after
they sustain their injury, but this is not the case.
Only about 10% of people who receive a
concussion will lose consciousness. In reality
amnesia or confussion after an injury is the
main indicator of concussion. Amnesia is also
the main indicator of severity and the best
predictor in post-injury recovery

Wearing a custom mouthguard could decrease the

severity of a concussion by absorbing some of the
force caused by the blow and not allowing it to
damage the brain. However, the use of
mouthgaurds do not completely protect against
concussions, and not all mouthgaurds are created
equal. Typically the order from least to greatest
protection follows this order: stock mouthgaurds,
boil and bite mouthgaurds, and custom
mouthgaurds. A mouthgaurd will not eliminate
concussions and brain injuries completely but they
help have been shown to have a protective effect.

Diagnosis

A Sport Concussion
Assessment Tool or SCAT2 is
one evaluation to determine if
a person suffers from a
concussion. It evaluates and
scores 8 elements: Symptom
score, physical signs score,
Glasgow coma scale (GCS),
Sideline Assessment
Maddox Score, Cognitive
assessment Standardized
Assessment of Concussion
(SAC), Balance examination,
Coordination examination and
Cognitive assessment Standardized Assessment of
Concussion (SAC). These test
and scores can determine the
presence of a concussion. It
can also be used to determine
if the concussion has
subsided. Another similar test ,
a computerized test, widely
used is called Immediate Postconcussion Assessment and
TM
Cognitive Testing (ImPACT ).
CT and MRI scans are also
sometimes used to determine
if there is any brain bleeding.

Its part of
the game
Until its
you. -

Mario
Manningham

Symptoms

Treatment

Physiotherapy

It is common for
concussion symptoms to
appear immediately.
However, symptoms can
also appear several days
after injury. Symptoms
present in physical,
cognitive, emotional or
sleep-related in nature.

Immediate
Rest is the best treatment plan. Resting and
avioding strenuous activity is the first step in the
road to recovery. Alcohol, sleeping pills, aspirin
anti-inflammatory medication should not be taken.
Driving should be avoided until medically cleared.
Training and participating in sport should also be
suspended until medically cleared.

Physical headache,
nausea, vomiting, balance
problems, dizziness, visual
problems, fatigue,
sensitivity to light,
sensitivity to noise,
numbness and tingling

Long Term
The best way to manage a concussion is rest and
limitation on mental and physical exertion.
Recovery differs from person to person and with
severity. Rest must be continued until a person is
asymptomatic. Being asymptommatic refers to
the physical, cognitive and emotional symptoms of
concussions. Once the symptoms are gone at rest
a gradual increase to normal activity can begin. It is
a general rule of thumb that if a person has
symptoms for two weeks the must rest for a further
two weeks without any symptoms before their
gradual return.

An often overlooked injury

associated with concussions is
cervical spine injury. The cervical
spine is closely linked to structures
that can cause many of the same
symptoms of concussions.
Cervicogenic headache usually coexist with complaints of dizziness,
tinnitus, nausea, imbalance,
hearing complaints and ear/eye
pain. If this is left untreated it could
lead to post-concussion syndrome
and further discomfort and pain. A
few treatment options are availible
for people with cervico pain and
dysfunction which include:
1) Range of Motion unidirectional
and/or combined movements
2) Mobilizations as per
assessment findings
3) Deep Neck Flexor (DNF) training
- Can be performed in multiple
positions:
- Can progress to DNF recruitment
with extremity movement, addition
of resistance or change in position
4) Deep Neck Extensor (DNE)
training
- Can also be performed in multiple
position and in combination with
DNF Recruitment
5) Muscle Extensibility Exercises
- Stretching
- Muscle energy techniques
6) Postural correction
7) Cervical Proprioception
- Ex. head repositioning exercises,
vestibular exercises
8) Acupuncture

Cognitive feeling
mentally foggy, feeling
slowed down, difficulty
concentrating, difficulty
remembering, forgetful of
recent events or
conversations, confused
about recent events,
repeats questions
Emotional irritability,
sadness, more emotional,
nervousness or anxiety
Sleep-related
drowsiness, sleeping more
than usual, sleeping less
than usual, trouble falling
asleep

Medication
In some cases medications can be prescribed to
alleviate some of the more debilitating symptoms.
There is no set prescription for concussion but your
doctor will treat the symptoms you are
experiencing. Pain killers are the more common
medication prescribed. Another common
medication is associated with the emotional
symptoms and alleviates irritability, dizziness and
depression.