Concussion

Each year 1.6 to 3.8 million concussions occur in recreational and sports-related activities.  This number is believed to be much lower than the true amount of concussions each year. The number is only the amount who seek care, but there are many who do not lose consciousness or who feel dazed that do not seek care.  For this reason, it is important to understand that one does not need to lose consciousness to have a concussion.  
A Concussion is a form of traumatic brain injury (TBI) but is considered mild form.  Traumatic brain injury results in changes in the brain during MRI.  Concussions, which are a form of mTBI are not visible on traditional imaging such as MRI or CT scan. Changes occur at the cellular level that results in symptoms.  Depending upon the area in the brain that has the changes, one may report different symptoms such as headaches, difficulty focusing, anxiety, insomnia, light sensitivity, and much more.    

Concussions can occur from sports, recreational activities, falls, and motor vehicle accidents.  While a concussion is a single event; symptoms of a concussion can occur following repetitive hits to the head as seen in football, hockey, soccer, rugby, or boxing.  

Sports-related concussions are a growing concern among all school, college, and professional athletes.  Football is the sport with the greatest number of concussions.  It is followed by hockey, soccer, lacrosse, rugby, basketball, and cheerleading.  Females are more likely to have concussions than males in comparative sports.  Females are also more likely to have prolonged recovery time compared to males.    

Falls are the leading cause of traumatic brain injury with many of these being considered mild and resulting in concussions.  Falls impact predominantly infants, toddlers, children and the elderly.



Concussion: An Invisible Injury

Nearly 15-20% of concussions do not resolve in 30 days.  Following this time frame the individual has post-concussive syndrome.  Headaches that have developed following a concussion are the main predictor of prolonged recovery.  Post-concussive syndrome does not have a time frame for resolving.  The lack of routine imaging to diagnose concussions creates a sense of frustration for the patient and caregivers.  It impacts the patient physically, cognitively, psychologically, and socially.  

Below is a map highlighting common post-concussive symptoms, this is not an all inclusive list.





















Physical symptoms can impact balance, dizziness (vertigo), eye tracking, headaches, coordination, light sensitivity, sound sensitivity, blurry vision, energy, and gut health.  

Cognitive symptoms result in difficulty: concentrating, focusing, academics, job performance, memory, brain fog, and multitasking.

Psychological symptoms: anxiety, depression, irritability, sadness, and emotional swings.

Socially it is hard for these patients to hang out with family and friends due to the increase of their symptoms.  Activities that can impact symptoms are physical exertion, watching movies, bright screens, loud noise, and length of time performing activities.

The physical and cognitive symptoms play a big role in the psychological and social challenges these patients face.  Sleep is difficult for these patients as they either sleep more or less, but the usual result is fatigue.  For this reason, many concussion patients report chronic fatigue.  


Revive Concussion Treatment

At Revive we treat the underlying cause of your symptoms: the brain.  Following a concussion, the brain no longer efficiently communicates.  Your symptoms are a result of this inefficiency.  We utilize comprehensive diagnostics to evaluate how your brain functions.

Videonystagmography (VNG)
VNG is a diagnostic test that has the patient perform different eye movements.  Eye movements are controlled by different parts of the brain.  Difficulty performing any of these movements allows us to specifically and accurately identify the part of the brain that is not communicating efficiently.

Computer Assessment of Postural Stability (CAPS)
CAPS is a diagnostic test that looks at balance.  The ability to balance comes from visual, joint, muscle, and vestibular input.  The vestibular system controls reflexive balance and eye movements based off of gravity and movement.  This system is impacted during most concussions.  

Physical Exam and History
Each patient receives a comprehensive physical exam to assess reflexes, cranial nerves, motor and sensory systems.  The history allows us to identify factors that have contributed to your post-concussive state and are preventing you from healing.  

The information gathered from the VNG, CAPS, history and physical exams are used to create a treatment plan to allow you to participate in life again.  

This is a plan created specifically for you as each patient has unique circumstances that have prevented them from healing.

Treatment Plan:
The goal of the therapies used is to help the damaged areas of your brain to communicate efficiently again.  Your therapy may include brain stimulation using repetitive transcranial magnetic stimulation (rTMS), eye movements, balance therapy, gyrostim, sensory stimulation, gait training, and hand-eye coordination.

The use of hyperbaric oxygen, nutrition, and supplements is to create a favorable environment for healing to occur.  Brain stimulation has the ability to improve function, but it cannot have the long-lasting results stimulation combined with nutrition and oxygenation provide.         


Baseline Testing

Research is showing the need for additional baseline testing in addition to ImPACT.  The VNG and CAPS complement the ImPACT to provide a comprehensive insight to the functionality of the brain.  If an injury, suspected injury, or repetitive hits occur; we are able to compare follow-up testing to the baseline results.  

Pre and post testing comparison will allow your athlete to return to sports not only when their symptoms have resolved, but when the brain has healed.  Allowing the brain to heal is critical.  Research shows that changes in the brain persist longer than reported symptoms.  

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