Seeing Stars: When a Bump On The Head May Be More Serious
ITHACA, NY — You don’t have to play in the NFL to get a concussion. During the course of a normal day, a person can slip on a sidewalk, fall in a bathtub, or bump a head on a playground or construction site. According to the U.S. Centers on Disease Control and Prevention, an estimated 1.7 million Americans sustain a traumatic brain injury each year — most of them children, adolescents and adults over 65.
The recent research that has refocused some of the ways athletic trainers and sports medicine physicians manage concussions also applies to nonathletes. For example, if you bring home a family member who has just been treated for a concussion in the emergency room and he or she wants to go to sleep, do you allow it?
“There was a time when it was considered life-threatening to let a person suffering from a concussion fall asleep,” said Chris Hummel, a certified athletic trainer and clinical associate professor in Ithaca College’s Department of Exercise and Sport Sciences. “But current research shows otherwise. Sleeping is actually the best thing for a concussed individual. Getting physical and mental rest helps someone recover from a concussion. But those individuals should not be left alone the first night and should be seen by a qualified medical person the next day.”
Concussion management, Hummel added, is very complicated and should be undertaken only by people with specialized concussion training. Still, it’s important for parents, friends, coworkers and loved ones to know the difference between fact and fiction when applied to concussion basics.
- A normal CT scan rules out a concussion.
“A concussion results from a neuro-metabolic event brought on by the trauma,” Hummel said. “Simply put, there is an imbalance of the needed chemicals or fuel that helps the brain function when someone is concussed. That’s not a structural injury, so a CT scan won’t pick it up. CT scans can only view structural damage.”
- An individual who has been knocked unconscious will suffer a worse concussion than someone who didn’t lose consciousness.
“A person doesn’t have to be knocked out to sustain a serious concussion,” Hummel said. “In some cases, people who are knocked out may suffer less severe trauma. In either case, the severity of the concussion might not be known for days or weeks.”
- A grade-one concussion is less serious than one that’s a grade-three.
“We used to grade concussions during the initial diagnosis, but we no longer do that because we now know it’s difficult to accurately assess the severity of a concussion right away,” Hummel said. “We have to wait and see how the symptoms resolve over time before we can determine how significant the concussion is or is not.”
- The harder someone is hit, the worse the concussion.
“It doesn’t always take a big impact to produce a concussion,” Hummel said. “Any contact to the head or body that causes rapid head movement can cause a concussion.”
- A person can soldier through a concussion.
“No,” Hummel said. “Typically, it takes one to two weeks for concussion symptoms to resolve and for the brain to begin operating back at full capacity. Just because someone states his or her head has cleared is no indication that he or she should resume normal activities. That would not be safe.”
- Helmets prevent concussions.
“Helmets for cyclists, snowboarders and construction workers are designed to prevent skull fractures, not concussions,” Hummel said. “If a helmet is fitted properly, it might reduce the risk or severity of concussions, but no one helmet is capable of preventing a concussion, yet!”
- An individual who has had one concussion is more likely to have another than a person who hasn’t been concussed.
“Once someone has experienced one concussion, the threshold for sustaining another concussion can be diminished. Also, if a person sustains another blow before he or she is fully recovered, the resultant symptoms can be worsened and result in a prolonged recovery. There is also a rare phenomenon called Second Impact Syndrome that can cause impaired brain blood flow or even death if an individual suffers another trauma before fully recovering.”
- Concussions should be treated and managed on an individual basis.
“The brain is an incredibly complex organ, and so are the neurochemical processes that govern it,” Hummel said. “No two concussions are exactly alike anymore than the brains of any two individuals are identical.”
- If you suspect someone of having a concussion, assume it’s a concussion.
“If a person describes having a headache or dizziness, shows signs of balance problems, or difficulty remembering, assume that individual is concussed and have him or her evaluated by qualified medical person,” Hummel said.
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