Concussion: Frequently Asked Questions
Suspected Concussion | Testing | Baseline vs. Post-Injury Testing | Sleeping | Headaches | MRI/CT Scans | Driving | Neuropsychological Tests | Mood Swings | Preparing for Appointments | Baseline Testing | Long Term Effects | CTE (Chronic Traumatic Encephalopathy) | Prevention
Immediately remove the athlete from all contact sports and physical activity. Athletes should be evaluated by a concussion trained health care professional. Do not resume physical activities/sports until a health care professional, experienced in evaluating concussions determines it is safe for the athlete to return to play.
One of the more common tests used in post-concussion assessment is the ImPACT™ test (Immediate Post-Concussion Assessment Cognitive Test). It is a web-based, scientifically validated computerized concussion evaluation test used to test your cognitive ability. It is a measure of verbal and visual memory, processing speed and reaction time. In addition to ImPACT, other traditional (paper-pencil) neuropsychological tests may be administered by a neuropsychologist to provide more comprehensive information about an individual's cognitive abilities.
ImPACT Baseline tests are usually administered prior to an injury. An ImPACT Post-injury test is given after an injury or suspected injury occurs and can be compared to the pre-injury baseline to determine changes in the athlete's cognition that may be attributable to the concussion.
Yes, this is normal. Rest is very important in order for the brain to heal. It is not necessary to wake the athlete/patient every hour, although careful monitoring of any changes in mental status or deteriorating symptoms is highly recommended.
For headaches, you can take acetaminophen, such as Tylenol, but avoid aspirin, blood thinners, and any drug that causes drowsiness unless prescribed by a concussion trained physician. To date, there has been no medication scientifically proven to enhance recovery from concussion. A majority of concussion symptoms resolve spontaneously within a few days with plenty of mental and physical rest.
A concussion cannot be seen on a CT scan or MRI. Occasionally, imaging of the brain is needed to rule out other problems, like a skull fracture or bleeding in the brain. A normal CT or MRI scan may not mean the athlete is okay to return to sport competition. A formal evaluation with a concussion specialist is still recommended.
Many patients will experience impairments in their reaction time and hand-eye coordination following a concussion. In addition, a concussed patient may be prescribed medications following their injury in which driving may not be safe. Therefore, an assessment of cognitive abilities and medical clearance is recommended before driving can be resumed.
There are many tests that can be included in a full battery of neuropsychological testing. ImPACT™ may be one resource test and is cognitive screening, but usually manual paper-pencil testing performed by a neuropsychologist with concussion training is the preferred method of assessment. Information from this type of evaluation can help assist clinicians in what types of treatments (i.e., medications, cognitive rehabilitation, and supportive psychotherapy) may be necessary to help facilitate recovery.
It is common to experience emotional changes following a concussion. For example, a blow to the frontal portion of the head may result in changes in personality or the ability to control one's emotions. A concussion hurts and because of symptoms, you may not feel like doing daily activities or interacting with others. Athletes that have suffered a concussion may also feel very stressed not being able to participate in their sport and fearful of letting their team down or even losing their position on the team. There can also be a great deal of stress over missing school and falling behind in coursework. Athletes and their families should be provided assistance with these issues during the recovery period.
Get plenty of rest and limit TV time, cell phone usage and texting. You should get as much physical and cognitive rest as possible. Come prepared with questions to address with your provider. Our concussion team wants to help expedite your recovery in an effort to return you back to sports and normal activity as safely as possible.
A baseline is an assessment that is performed prior to an injury to determine an individual's abilities and functions prior to an injury or change in health status. In the context of sports concussion, baseline assessments of cognitive function (i.e., Immediate Post-Concussion Assessment Test; ImPACT) and balance (Balance Error Scoring System; BESS) are highly recommended to help clinicians in the interpretation of tests performed after a concussion occurs. Please contact our Concussion Program to obtain more specific information on how to undergo pre injury baseline assessments. Baseline Assessments are offered from ages 6 and up and may be most effective for post injury comparisons if re-administered at every level of play (i.e., middle school, junior high, high school, collegiate, professional)
What if I get injured and don't have an ImPACT™ baseline?
You can still take a post-injury test and the results will be compared to the norms (expected performance) for your age group and gender. This gives your concussion specialist an idea of where you are supposed to be cognitively and the cognitive deficits that you may be experiencing following your injury. From this information, an academic plan as you recover can also be determined.
Please note that that not all physicians are trained to interpret the ImPACT™ data and may not be able to administer a post-injury test. ImPACT™ is only one valuable resource used to test cognitive response following a concussion and should not be the only tool utilized to diagnose and manage concussions.
Factors that have been identified to influence the potential for persistent effects include repeated concussions occurring over a short period of time, age when concussion occurred, and co-existing conditions (i.e., psychological illness, neurological disorders, learning disabilities, attentional disorders, and sleep disorders). Individuals who are not properly managed from their injury and continue to play while symptomatic have been found to have more severe symptoms and mental status changes and become concussed more easily with less physical force.
CTE is a neurodegenerative disease in the brain thought to be associated with repetitive brain trauma. CTE can currently only be diagnosed at autopsy. The prevalence and incidence of CTE in sports concussions is unclear. It likely various per sport, position, duration of exposure, and age of initial exposure. Not every athlete that suffers a concussion develops CTE and research to date has included a biased sample. Continued research needs are required in order to learn more about this disease and potential therapies that may slow or reverse its course.
There is no consistent scientific evidence to suggest that protective equipment will prevent concussions. Helmets have been shown to reduce impact forces to the brain and may help reduce the occurrence of a skull fracture or bleed. THERE IS NO CONCUSSION PROOF HELMET. Although mouth guards have an important role in preventing dental or oral facial injury, concussions can still occur while wearing a mouth guard. Some concussion experts have recommended neck strength training exercises, education and enforcement of proper tackling techniques, and reduction in the number of contact practices as means to help reduce the number of concussions in sports.
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