December 19, 2017
Concussions have gained a lot of attention in recent years, yet the repercussions of mTBIs are still not well understood. With insights from leading concussion experts, let’s look at a few effects of concussions that you might find surprising.
The brain is a highly complex organ. Damage from head impacts can affect any part of the brain, disrupting cognitive processes in myriads of ways. Dr. Charles Shidlofsky, a leading concussion specialist who heads Neuro-Vision Associates of North Texas, explains:
“When you’ve seen one brain injury…you’ve seen one brain injury. It’s pivotal to recognize that there are many different dynamics to concussion, both in the functional effects and in the symptoms.”
Most people are aware of headaches, nausea, and perhaps light sensitivity, but psychological symptoms can include anxiety, depression, insomnia, irritability, and basic ability to focus or concentrate. Post-Concussion Syndrome can also have physical effects through influences on the central nervous system. For example making balance difficult, both in terms of vestibular effects (ear based), and proprioceptive effects (body feedback), as well as impair movement coordination.
Dr. Keith Smithson, a sports vision concussion specialist and Director of Visual Performance for the Washington Nationals, outlined some of the specific ways mTBIs can change brain function:
“Symptoms can involve optic distortions, ocular-muscular problems, multiple object tracking deficiencies, as well as sensory integration and overload issues.”
For this reason, he states that a range of recovery interventions need to be used specialized for dealing with each of these effects.
For specialists managing concussion recovery, it’s not unusual to have patients in treatment for six months or longer. For example, Dr. Smithson finds that severe cases of mTBI require up to eight months of recovery treatment. Somewhat surprisingly, this is not necessarily down to the severity of the actual head injury. Dr. Shidlofsky gave examples of this phenomenon:
“There are often very different recovery trajectories from one person to another. For example, sometimes we have patients who’ve been hit in the head really hard and they come in for six sessions and they’ve actually recovered. But then you can have someone else who’s had a minor fender bender, and they have such debilitating symptoms that just a slight rotation of their chair triggers severe dizziness.”
Dr. Michael Matter, President of the Geneva Medical Doctor Association and Director of Neurovision Consulting, provides cognitive rehabilitation for professional athletes and highlighted how difficult the recovery process can be for athletes:
“We had hockey players with no ice for 5 or 6 months with no return to play. It’s a reality, they are unable to focus, to have attention”.
As concussions can affect almost all aspects of daily life, therapy is usually needed to monitor effects all the way to the end point of recovery.
According to a new study published in The Journal of the American Osteopathic Association, recovery from concussions can take twice as long for young female athletes compared to young males. This is believed to be due to underlying cognitive conditions that are more common in girls, including as headaches, depression, anxiety, and stress.
As these are common mTBI symptoms, the effects can overlap and lengthen the recovery process when already existent. In this study with 212 male and female young athletes, 58% of the girls still had concussion symptoms after 3 weeks of injury, compared to 25% of the boys.
This means that any person, with any kind of pre-existing cognitive condition, is likely to have both increased susceptibility to concussion symptoms, and more difficulty recovering from them. John Neidecker, an orthopedic specialist in concussion treatment, highlights the fact that student-athletes with concussions often become stressed about not being able to play sports.
This is common because athletics are also a key activity that normally allows them to burn off stress, and the primary treatment for concussions is simply resting. Stress compounds many of the hallmark symptoms of mTBI, making recovery more challenging than for non-sports children.
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