The New Science of “Mild” to Moderate Head Injury
As a former high school athlete and sport spectator I have witnessed the occurrence of many head injuries. Some mild, some severe. Back in my day (now I am sounding ancient), the management approach of mild head injuries was thought to be “much ado about nothing”. Coaches followed a Shake it off and get back in the game! sort of protocol. If your head trauma rendered you a bit loopy or if, in fact, you happened to lose consciousness for a moment…or a minute, then you could rest on the bench for a while. That is, until you were feeling better or were needed out on the field—whichever came first!
Thanks to scientific research, times, they are a-changin’! Today, no head trauma is taken lightly—or should be. It is now understood that, indeed, deleterious, long-term effects from concussions can absolutely occur, but they stem primarily from poorly managed injuries.
Ninety percent of the time, potentially brain-damaging concussions occur without loss of consciousness. They can often lead to post-concussive syndrome (PCS) in which the affected person can experience one or more of the following symptoms:
- Headache, migraine
- Neck pain
- Nausea, vomiting
- Memory loss, difficulty concentrating, mental fatigue
- Dizziness, difficulty with balance, motion and/or coordination
- Blurred or double vision
- Emotional lability (e.g. anxious, depressed)
- Sleep disturbances
Typically, these symptoms peak at 4-6 weeks following the injury. On occasion, the symptoms of PCS last for a year or longer.
Active intervention for today’s concussive patient has replaced the “lie in a dark room and rest” recommendation. Such treatment will mix and match vestibular, visual, and exertion therapies, as well as prescription medication (if need be) to target the areas of defect present.
Experts in the field are now asking parents of athletes to take a pro-active approach to head injury by getting a baseline neurocognitive (computerized) test done annually for children 6-12 and every other year for those 13 and older. This way, if a head injury does occur, the intervening healthcare professional can know exactly how much injury has taken place and when your child has recovered sufficiently to be returned to school and extracurricular activities.