Hello, this is Dr. Paul Deglmann at Restorative Health Solutions! This month we will be talking about the hot topic of concussions. Here are some common questions and answers about Concussions:
What is a concussion? Can you get a concussion without hitting your head?
Most concussions are the result of trauma to the head, but many people have the mindset that you have to directly hit your head in order to have a concussion. This couldn’t be further from the truth. Concussions are suffered by a blow to the head or any force – such as a fall – that can cause the brain to strike the inside of the skull.
Your brain basically floats inside a bony vault called the skull. Think of a yolk inside of an egg shell; If someone suffers a fall (like slipping on the ice or repetitive falling to the ground in a sport) or is in a car accident, their head goes from a still position to moving in another direction at a high velocity. If their head does not strike the ground or anything inside a vehicle (in the case of an accident), the brain will move along with the head.
When the head comes to a halt, the brain will continue to move inside of the skull because it is a free-floating mass. If the force is strong enough, the brain will move until it strikes the inside of the skull. Since the brain is oval-shaped and not perfectly round, there are also sheering/rotational forces that happen throughout parts of the brain and brainstem – especially the areas highly involved with the vestibular system. This can lead to a bruising/contusion of the brain and altered brain function.
You have to have immediate symptoms if you suffer a concussion, right?
Absolutely not. I have seen a lot of patients that have delayed symptoms several weeks after a concussion. This is a big reason why it is so important to have baseline testing, especially if you are an athlete. Baseline testing is typically done prior to starting a sport. The testing is important because we can see how your brain and nervous system function before the season begins.
In the event of a concussion, we can retest you and compare how you are functioning after the injury to how you were functioning prior to the injury (baseline), which gives us a reference point. These results, in combination with an extensive history, gives us important information on when to return an athlete to play a sport.
Baseline testing is used to assess the patient’s reaction time, memory, learning skills, ability to multitask, ability to pay attention or concentrate, how quickly the individual thinks and can solve problems, etc. The standard testing used today by most schools and athletic programs is called ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). It is the most widely used and most scientifically validated computerized concussion evaluation system.
There are other ways to do baseline testing that involve videonystagmography (VNG) and posturography as well. The VNG is an advanced test that evaluates the speed, accuracy, latency, and smoothness or eye movements along with your ability to focus or fixate on a target. The posturography is a computerized program that evaluates balance and proprioception – your brain’s awareness of where your body is in space. This also gives us great information on how well the brain is functioning.
Once my concussion symptoms go away, does that mean I am fully recovered? What if I don’t have any symptoms initially?
Common symptoms that occur after suffering a concussion are a headache, brain fog/lack of mental clarity, personality changes, anger, sadness, nausea, lack of balance, lightheadedness/dizziness, difficulty concentrating, difficulty with memory, poor sleep, eye movement problems, light/sound sensitivity and more. Once your symptoms lessen and eventually go away, most people think they are recovered. Even though the symptoms may not be present, it doesn’t necessarily mean that the concussion has completely resolved and that the brain can withstand certain amounts of stimulation or impact.
Depending on the health of the individual, the severity of the impact/details of the concussion, along with many other factors, that person may or may not have symptoms until weeks after the trauma, if at all.
The only way to fully assess the recovery or the findings of a concussion is to see a well-trained medical physician (neurologist, DO, NP, PA, etc) who can perform a detailed neurological evaluation, or to see someone that is well-versed in functional neurology or chiropractic neurology. A comprehensive functional neurological examination tests the function of the different parts of the brain, brainstem, vestibular systems, along with other parts of nervous system, in addition to the standard neurological examination.
What is the typical recovery time for Concussions? Are there any other factors that influence your recovery?
The amount of time it takes to recover from a concussion varies greatly because everyone is different and every concussion is different. Evaluations are personalized and no two cases are the same. Some people recover extremely fast (7-10 days) and others seem to have symptoms for an extended period of time (several months or longer).
Why? The possibilities are many, but here are some of the common underlying mechanisms that seem to make a concussion more complex: inflammation, immune dysregulation/dysfunction, anemia, excessive stress response/too much cortisol, dysglycemia (problems with blood sugar metabolism), hormone imbalances and many more.
When working with patients that have suffered a concussion, it is important that we look at all of the possibilities. How do you know if you have any of those underlying issues? At Restorative Health Solutions, we like to order our standard blood panel in addition to our comprehensive functional neurological examination. The blood panel is a very valuable set of tests we use to detect any additional underlying factor such as the some of the mechanisms mentioned above. These factors can influence how quickly you recover, how well you recover and if you may be prone to flare-ups through immune activation, overstimulation, inflammation, etc.
It is extremely important to get evaluated by a knowledgeable health care practitioner if you’ve suffered a concussion. There is no substitute for good testing and a thorough examination. At Restorative Health Solutions, we utilize functional neurology, functional medicine and chiropractic to help our patients achieve better health. If you are suffering from a concussion or any of the post-concussive symptoms listed in this blog, contact us online or give us a call for a free 15-minute consultation at 952-479-7801.