What is a concussions?

What is a concussion? A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth.

Quiz: Do You Understand Concussion?

Test your knowledge by answering the following questions:

Questions
True
False
1

Mild concussions aren't serious.

Explanation:
Concussion causes immediate, but usually temporary, brain dysfunction. Concussions can be mild or severe, but they’re always serious.
2

It’s common for patients to have permanent injury from a single concussion.

Explanation:
Most people will recover from a concussion, and it’s rare for patients to have permanent injury from at least a single concussion. But patients can be disabled by concussion symptoms for many weeks or months after the initial concussion.
3

Changes in mood can be a symptom of concussion.

Explanation:
Common symptoms of concussion include headache, poor sleep, neck pain, dizziness, ringing in the ears, blurred vision, nausea and vomiting and changes in mood.
4

The primary concussion treatment centers around rest.

Explanation:
Although research is progressing around concussion, there remain very few proven treatments. The primary treatment centers around rest - not just physical rest, but also intellectual or cognitive rest.
5

Concussion causes physical symptoms but not emotional ones.

Explanation:
Treatment of the emotional symptoms associated with concussion is often neglected, and there is some evidence that psychological therapy, like cognitive restructuring and reattribution can be quite effective in treating patients’ emotional symptoms.
(Answer all questions to activate)

Melissa Hansen, BA, MScOT, OT Reg (BC), discusses how an occupational therapist can help patients recovering from a concussion.

Hilary Johannsen, MPT, Physiotherapist, talks about what brain systems are affected in concussion.

Larissa Roux, MD FRCP Dip Sport Med, MPH, PhD, discusses How do Hockey Concussions Effect You

Audrey Spielmann, MD FRCP(C), discusses head MRI scans.

The Patient's Role in Recovery from Concussion

A key component of treating concussion has to do with a patient’s engagement in rehabilitation. That active engagement in rehabilitation is crucial to achieving the successful outcomes that absolutely can be achieved in concussion rehabilitation.

Some of the barriers to that active engagement can often be mood, and those mood-related issues can come about because of challenges that have come up for an individual, a sense that they should be able to handle the things that are their norm in their day-to-day function. Sometimes it’s loss or grief at what things they’re missing out on with this injury in play.

But bottom line is that active engagement in rehabilitation is crucial, and if needed that’s a key component of the interdisciplinary treatment model, in order to make sure that mood is not overlooked as a component of the rehabilitation plan, but also to make sure that it’s not assigned outside the injury, where it doesn’t belong. That is a symptom of concussion, it is a treatable part of concussion, and part of actively engaging in your rehabilitation and achieving what you can in your recovery. Local Orthopedic Surgeons 

The science of concussion treatment has moved far beyond cocoon therapy, or the passive watchful waiting that’s gone on for weeks at a time. If you’re not getting better and you’ve been doing one thing or doing nothing waiting for your concussion to recover, it’s time to seek interdisciplinary care with a treatment team that can address all the component parts of concussion and help you get better. Local Orthopedic Surgeon.

Presenter: Dr. Cirelle K. Rosenblatt, Psychologist, Vancouver, BC

Local Practitioners: Psychologist

What Are Your Concussion Treatment Options?

Although research is progressing our understanding of concussion, there remain very few proven treatments for concussion.

The primary treatment centers around rest, as well as avoidance of reinjury and treatment of symptoms. Rest as a treatment for concussion needs to involve not just physical rest, but also intellectual or cognitive rest.

Patients must avoid excessive stimulation from overuse of computers, for example. Returning to work too quickly can slow the recovery of concussion, just like returning to sports too quickly can slow recovery.

Treatment of the emotional symptoms associated with concussion is often neglected, and there is some evidence that psychological therapy, like cognitive restructuring and reattribution can be quite effective in treating patients’ emotional symptoms.

Therapy for concussion often needs to be tailored to an individual patient. Patients who require more psychological therapy, for example, may benefit by treatment from a psychologist.

If you have further questions about concussion treatment, you should discuss that with your doctor. Local Orthopedic Surgeon.

Presenter: Dr. Dean Johnston, Neurologist, Vancouver, BC

Local Practitioners: Neurologist

MRI Technology for Head Injuries and Concussions Scans

The most common type of injury in sport is a concussion as far as head injury goes.

What we can see is bruising to the brain, we can see blood within the brain, or blood around the brain basically. This typically occurs with impact and there are many sports where we see impact such as hockey, football, or if a patient has – a person – has fallen during skiing for example or skating.

And what we can see is this is an example of a normal brain and MRI shows us in great detail the brain matter and what MRI illustrates the best is subtle areas of hemorrhage within the brain that might not be identified on CT scan.

And the benefit of brain MRI is that we can see evidence of injury even if it was remote. This is an example of a normal brain, and we see the grey matter and the white matter, and no evidence of hemorrhage.

What we look for in the setting of trauma is little areas of hemorrhage at the grey white junction, something called diffuse accidental injury, which can be very subtle and only seen on MRI but result in severe brain injury.

I just want to show you an example of another brain; I just want to show you an abnormal brain. This is a patient who has sustained injury to the brain and there is a large hemorrhage or blood collection around the brain which is compressing and pushing the brain tissue. This is called a subdural hematoma.

With MRI we can image in multiple planes, and also MRI allows us to determine whether there is fresh blood on old blood, so we can determine the age of the hemorrhage as well with MRI.

It is extremely important to determine the extent of injury for concussion and other brain trauma, and obviously the clinical examination is very important in that assessment. But brain MRI is the best technique to look for subtle injury of the brain, if any are present.

If you have any questions on brain MRI, contact your family doctor, your sports medicine physician or an imaging centre.

Presenter: Dr. Audrey Spielmann, Radiologist, Vancouver, BC

Local Practitioners: Radiologist

Local Sports Medicine Physcians

Dr. Ellen Smith

Dr. Ellen Smith

MD, FACEP
Sports Medicine Physician
Gaithersburg, MD
Dr. Vinay Chopra

Dr. Vinay Chopra

MD
Sports Medicine Physician
Freehold, NJ
Dr. Naresh Rao

Dr. Naresh Rao

Sports Medicine Physician
New York, NY
Dr. Mark Harary

Dr. Mark Harary

Sports Medicine Physician
Setauket- East Setauket, NY

Orthopedics Now

Orthopedics Now

QA Chat
Ask us a health question on
diagnosis/treatment options...