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Wednesday, August 08, 2012 - Proper, Aggressive Treatment of Concussions Is Vital for Positive Outcomes

Proper, Aggressive Treatment of Concussions Is Vital for Positive Outcomes
By Mark R. McLaughlin, M.D., F.A.C.S.

Many people think that only athletes who play contact sports get concussions, but it's important to understand that a concussion can happen to anyone. When a concussion occurs, it must be treated properly so a patient can return to their normal life and avoid long-term problems.

A concussion is the dysfunction that occurs in the brain after a trauma to the head. Even a mild concussion is a brain injury and must be taken very seriously. A concussion exerts severe force upon the brain. To illustrate, a person riding a roller coaster can feel four to five Gs—four to five times the force of gravity on the body—and the impact from a car crash can cause 35Gs. When a person sustains a concussion, their brain is subjected to 80 to 100 times the force of gravity.  

In many instances, a concussion is caused by a direct impact to the head that makes the brain collide with the skull. But a concussion also happens when the head rotates very abruptly, as with the whiplash from a car accident or a bad fall. If the rotation is vigorous enough, it can twist the area deep in the center of the brain that controls consciousness, the sleep/wake cycle and alertness. The twisting causes the brain to "short-circuit" which makes a person lose consciousness.  

Common Risks

We've become more aware of the problem of concussions in organized sports, but some non-sports activities can place people at equal risk. For example, about 75% of the time that children ride bicycles, they don't wear a helmet. This is a major reason for head injuries and it can be completely eliminated by kids wearing a properly fitted helmet every time they ride a bike.   

Elderly people are at risk for concussions too. Often, their balance isn't as sharp as it once was and their eyes don't react as well to changes in light. When an older person gets out of bed at night, household hazards can cause a fall and a concussion. To help prevent this, older people should install night lights, clear hallways of objects they can trip over, and make sure rugs are securely fastened to the floor.  

When a concussion happens, the brain goes into a very "excitable" state—it is more easily activated and a person becomes more sensitive to light and sound. Usually, an effective treatment is to let the brain rest and recover in a quiet environment—no television, video games, reading or even deep concentration.

If the concussion is severe or symptoms persist, treatment can include brain imaging and other neurological testing. A patient is carefully monitored and, as symptoms subside, they are allowed to do more of their usual activities. With proper treatment, a fast and full recovery usually occurs.

Long-Term Effects

Enduring too many concussions can cause long-lasting symptoms and sometimes even post-traumatic encephalopathy—permanent damage to the brain. This type of brain damage can cause depression, memory loss and difficulty managing day-to-day affairs such as work, finances and relationships.

Fortunately, we can take many steps to prevent concussions. In organized sports, athletes should be properly conditioned, have thorough warm-ups and be alert at all times during the activity. People who engage in activities such as bike riding, motorcycle riding and skiing should always wear protective helmets and observe rules of safety for the activity. These preventive steps can dramatically decrease the incidence of concussions.

Dr. Mark R. McLaughlin, a board-certified neurosurgeon on staff at CentraState Medical Center, is also the medical director of Princeton Brain and Spine Care, which has an office located in CentraState’s Star and Barry Tobias Ambulatory Campus, Suite 267, at 901 W. Main Street in Freehold. Nirav K. Shah, MD, FACS is director of the practice's concussion clinic and provides community education on the prevention and treatment of concussions. Doctors McLaughlin and Shah can be reached by calling (732) 333-8702.