From the Mind of Joe Valencia: Hey Mom, I Have a Headache (or maybe a concussion)

“It’s Just A Headache, Mom.” ~ Or, is it?

Disclaimer: I am not a medical professional and have no formal medical education or training. I am a layperson who did research and am presenting my findings here. This information should be used as a guide but should certainly not be used in place of professional evaluation and treatment.

To paraphrase Sigmund Freud, “sometimes a headache is just a headache.” Sometimes it’s not. Sometimes it is a sign of a concussion and though the headache goes away, the effects of the concussion can last forever. Have you ever gotten your “bell rung?” What did you do? Unless you were knocked out, you undoubtedly got up, shook away the cobwebs and resumed doing whatever it was you were doing. It’s only natural and we’ve all done it. There’s no blood, no broken bones, only a headache and you’ve had plenty of headaches before. This headache is different, this headache could be due to a concussion. Merriam-Webster defines a concussion as “a condition resulting from the stunning, damaging, or shattering effects of a hard blow ; especially : a jarring injury of the brain resulting in disturbance of cerebral function and sometimes marked by permanent damage”. If you continue to play after sustaining a concussion you are at a high risk of “second-impact syndrome” which can occur if you suffer a second concussion before the symptoms of the first one have subsided. Student athletes suffering an initial concussion are 3 to 6 times more likely to sustain a second one than an athlete who has never had one. Subsequent concussions are even more dangerous. High school athletes who suffer 3 or more concussions are at increased risk of experiencing loss of consciousness (8-fold greater risk), anterograde/post-traumatic amnesia/PTA (reduced ability to form new memories after a brain injury) (5.5-fold greater risk), and confusion (5.1-fold greater risk) after a subsequent concussion. If you hit your head and get a headache, leave the game. If the headache doesn’t go away, see a doctor.

Statistics

• Almost 50 percent of head injuries sustained in sports or recreational activities occur during bicycling, skateboarding, or skating incidents.

• Female soccer players the third most likely high school athletes to get concussions. They suffered more than 6 percent of the mild head injuries recorded in a study published today in the Journal of the American Medical Association. Football ranked first with 63 percent of concussions, followed by wrestling at 10 percent. Research found incidents of head injuries in all 10 sports they studied.

Symptoms/prevention

The most common symptom of a concussion is a headache that just won’t go away. You may also experience migraine-like symptoms such as nausea and sensitivity to light and/or noise along with the headache. Some of the physical signals of a concussion would be dizziness, trouble balancing, double or fuzzy vision. You may also feel tired all the time, have trouble concentrating, forgetfulness, confusion and feeling like you’re in a fog. If you experience any of these symptoms, tell your parents right away!

What is a guaranteed, fool-proof way of preventing concussions? Short of living in a bubble, there is none! You can, however minimize your risks.

 Always wear a helmet while riding a bicycle, rock climbing, skiing, skating or skateboarding.

 Wear a seat belt when riding in a car.

 When playing any sport, wear appropriate protection equipment (such as helmets). It should fit properly and keep it well maintained. Most importantly - wear it at all times!

Diagnosis

The most common diagnosis methods currently being used include symptomatology, MRI and CAT scan. Symtomatology relies on the patients’ understanding of, and responding to, questions and the doctors’ interpretation of the answers – this is purely subjective. The MRI and CAT scan can show certain types of damage to the brain and are objective representations but typically do not tell the whole story. The CAT scan will show the doctor if there is bleeding or damage to the brain tissue or gray matter. The MRI is also good for identifying gray matter damage. Many times these scans will show minimal or no damage but don’t give a true indication of what damage may have occurred. There is a relatively new scan available called “Diffusion Tensor Imaging” or DTI. This scan shows the white matter of the brain. The white matter is the covering of the nerves in the brain – if these are damaged the signals cannot flow to the different areas of the brain and communication breaks down. It’s like the water pipes in your house, if the pipe gets dented the flow of water isn’t as efficient – if it breaks completely the flow of water stops. New technology, “Eye Tracker” , is being developed by a team lead by Dr. Jamshid Ghajar at The Brain Trauma Foundation and Weill Cornell Medical Center. “Eye Tracker” tracks eye movement to quickly assess the severity of damage to the brain. It uses cameras to record eye movement by taking a picture of the eye every 1/1000th of a second. It detects minute fluctuations in the eyes tracking capability. The goal is to one day have this technology portable, and affordable, enough to be on the sidelines for instant evaluation.

In the 1990’s, Drs. Mark Lovell and Joseph Maroon developed Windows-based software called ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) that measures attention span, working memory, sustained and selective attention time, response variability, non-verbal problem solving and reaction time. The test provides objective information about the extent of injury to the brain. Ideally it should be administered prior to participation in athletics so that a baseline reading can be recorded. This will provide better information to the doctor trying to evaluate the severity of the concussion and post-concussion recovery progress.

Short-term/long-term effects

What are the short-term and long-term effects of concussions? The short answer is – no one really knows for certain and everyone is different. We do know that concussions are cumulative and with each concussion the likelihood of another increases. Some long-term effects include loss of coordination, difficulty with memory, vision impairment and persistent headaches. These symptoms may lessen over time for some but for many they are a daily, and sometimes debilitating, reminder of their injuries.

Treatment

There isn’t much you can do for concussions. The best medicine is time. In the hours (or days) immediately following the concussion, the best treatment is to minimize or eliminate outside stimulation as much as possible. This means no television, no music, avoid crowds and loud noises and certainly no computer or video games! The brain needs time to rest and begin the healing process. When you begin exercise after a long period, your muscles get sore. When this happens you take two aspirin and rest as much as possible. The brain, an organ, is very much like your muscles – it needs a rest period to begin healing after an injury. This is, of course, after you have been to see your doctor.

You may heard that you must never allow someone with a concussion to go to sleep – they will never wake up. Don’t believe it. Unless you doctor has concerns and states otherwise, sleep is actually a good thing. Remember what you read earlier about minimizing stimulation? What better way than to sleep?

From the Mind of Joe Valencia

Thursday, March 23, 2017

Hey Mom, I Have a Headache (or maybe a concussion)

“It’s Just A Headache, Mom.” ~ Or, is it?

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