QUICK LINKS ABOUT CONCUSSIONS
What is a concussion?
Concussion is a very common event that in itself does not constitute a significant injury. In 80-90% of concussions, spontaneous healing is observed after 10-14 days in adults, and after 2-4 weeks in children and adolescents. In only 10-15% of cases, the concussion is followed by persistent neuropathological/functional late damage. There are, of course, many factors that influence the outcome of this condition, but if the most important ones are to be highlighted, they often point to both the physical and psychological condition of the patient, as well as the amount of energy involved in the collision. To form an understanding of how to treat late injuries after a high-energy cerebral trauma, it is important to have knowledge of what takes place intracranially both at impact and in the subsequent healing process.
What causes concussion?
Concussion can be caused by a direct blow to the head, face, neck or other parts of the body with an impulsive force that is displaced to the head (no need to hit the head). This typically results in short-term impairment of neurological function that resolves spontaneously. However, in some cases, signs and symptoms develop over a few minutes to hours. Concussion can lead to neuropathologic changes, but the acute clinical signs and symptoms largely reflect a functional disturbance, rather than a structural injury. Therefore, nothing abnormal is seen in standard structural neuroimaging studies. (No findings on MRI.) Concussion results in a range of clinical signs and symptoms that may or may not involve loss of consciousness (fainting is not required). Changes in clinical and cognitive features typically follow a sequential course. However, in some cases the symptoms may be long-lasting.
Symptoms
If these neuropathological changes/functional disturbances last longer than 10-14 days in adults or 3-4 weeks in children, the diagnosis will change to post-concussion. The most prominent symptoms after a concussion are somatic complaints such as headache, nausea and vomiting, as well as cognitive disorders such as weakness, sensory deficits, reduced reaction time, balance problems, loss of consciousness, memory loss and neurological instabilities. In addition dizziness, impaired eye motor function (visual disturbances) and stiff neck may also occur.
As mentioned above, it is very rare for CT or MRI to show any clinical findings after a concussion. Both CT and MRI have different sensitivity and specificity depending on the pathological condition to be assessed and the tissue and organ being examined. This is why these two imaging modalities are not always equally informative. Mild traumatic head injuries such as concussions are a good example of this, but this does not mean that an injury or change may not have occurred in the brain or nearby structures.
- Somatic (e.g. headache), cognitive (e.g. feeling like in a fog) and/or emotional symptoms (e.g. lability)
- Physical signs (e.g. loss of consciousness, memory loss, neurological instability)
- Impaired balance (e.g. unsteady walking)
- Behavioral changes (e.g. irritability)
- Cognitive impairment (e.g. reduced reaction times)
- Disturbances in sleep/wakefulness (e.g. sleepiness, drowsiness)
- Dizziness
- Impaired eye motor function (e.g. visual disturbances).
- Neck stiffness
Late damage
The most common changes that follow a concussion are impaired cerebral blood circulation, changes in ATP production, diffuse axonal damage, changes in the blood-brain barrier and local neuroinflammatory response. In addition to these changes, it is common to see changes in eye motor function, the vestibulo-ocular reflex, as well as the cervical-ocular reflex. Even with sub-concussive strokes, changes in eye motor function are seen. As a result of these changes and the patient's physical and psychological starting point before the concussion, it is impossible to predict which of the patients will develop late effects or what these will entail. Therefore, the literature states that it is necessary to carry out clinical examinations and look at the patient's symptoms and individual level of function. This is highly necessary in order to tailor and adapt a rehabilitation program for the individual patient.
Does everyone suffer late effects after a concussion?
No, 80-90% of all concussions resolve on their own after 10-14 days in adults and 3-4 weeks in children and adolescents. Only 10-15% suffer late effects.
How to minimize the chance of getting late effects?
A history of previous concussions or poor physical or mental health before a concussion increases the chances of late effects. After a suspected or confirmed concussion, you should reduce or avoid physical and cognitive activity, exertion and screen use (TV, mobile phone, computers, etc.) for the first 72 hours. After 72 hours, you can try light physical activity, such as going for a walk for 15-20 minutes. Then you can move on to interval training, walking for 10 minutes, running for 5 minutes, etc. It is important to start with light physical activity to keep your body moving. Studies show that resting too long after a concussion can lead to late effects.
If symptoms last longer than 10-14 days in adults and 3-4 weeks in children and adolescents, you should contact a doctor or other healthcare professional with experience in neurological rehabilitation.
What to do with concussions?
One of the most important factors in neurological rehabilitation is the frequency of stimulation. In many ways, neurological rehabilitation can be compared to endurance training. Endurance is not achieved by training with heavy weights with few repetitions, it is done with somewhat lighter weights and more repetitions. The goal of neurological rehabilitation is to create plasticity. Plasticity is defined as the brain's ability to undergo change on its own. This is achieved by forming new neural pathways, connections and increasing the efficiency of the remaining systems. In other words, neurological endurance.
The Quantum Clinic offers treatment that includes different variations of specific eye-hand coordination, balance exercises, motor eye exercises, low-level electrostimulation and vestibular rehabilitation. In addition, low-level laser therapy (cold laser), manipulation of the spine and various exercises that contribute to cognitive training. A combination of the above methods and exercises is adapted to the individual patient. This is based on clinical findings and symptoms observed and recorded at the initial consultation.
Please contact us for further information.