A Modern View On Concussions: Part 2

By: Dr. Mark Gallant and Dr. Colin Bartoe

In the last post we discussed the basic definition of what a concussion is. In this post, we will explore more about what happens to the brain during a concussion.   

We said before that a force can be applied to the body and translated through the body to the head.  With the force travelling like that, it is most likely going to affect the central portions of the brain.  It’s kind of like wringing out a towel, where the central portions receive more stress.  This force leads to microscopic damage that doesn’t show up on conventional brain scans but still creates changes in how a person can function.  This can be frustrating to the individual that has a concussion, because doctors can’t find anything wrong through standard MRI or CT scans.  Current research and patient care are showing that a functional approach to diagnosing concussions is much more valuable in determining how to help patients recover after an injury to the brain.

The current model for treating concussion is telling the patient to rest until they are not experiencing any more symptoms.  The problem with this is that even after symptoms go away, there is still healing to be done.  This can lead to what is referred to as second impact syndrome.  The term second impact syndrome is what is used when it appears that an individual sustains another concussion more easily and with more severe symptoms than the first concussion.  What is happening here is that the initial concussion wasn’t fully healed.  Think of it like a cut on your finger.  At first it bleeds, but you put a bandage it and the cut closes up.  You’re not bleeding anymore (the symptoms are gone), but it’s not healed up all the way.  Now you bang your hand on something, and the cut opens back up (it’s easier to reinjure something that isn’t fully healed). 

With concussion being a very hot topic, more and more research is coming out, which has pointed us in new directions in identifying and treating the areas of the brain that are injured during a concussion.  As we said before, the central areas of the brain are more susceptible to this kind of injury.  Two systems in these areas are the visual system and the vestibular system.  Your vestibular system is your sense of balance.  This is one of the reasons why people with concussions can feel dizzy and have blurry vision.  The majority of people will have these symptoms go away after a week or two, but that doesn’t mean that they are completely healed.  We mentioned in our first blog how it is important for people suffering from a concussion to see a doctor with extensive training in this area.  These trained doctors know how to look at person’s eye movements and sense of balance and decide if they have completely healed. 

I just mentioned that the majority of people feel better after a week or two (up to a month really), but that means that there are people who don’t feel better.  This is what is called post concussion syndrome.  All that means is that the person’s brain is not healing on its own.  Doctors trained in this kind of work can now use the evaluations of the eyes and balance to devise treatments. 

In the next segment, I will talk about persistent symptoms and treatment, as well as baselines and sports. If you enjoy our blog, please share it with others or like our Facebook page: www.facebook.com/backnbalance.