Dr. Cirelle K. Rosenblatt
BIO : Orthopedics Now
Dr. Rosenblatt has been working in the field of neuropsychology for more than 25 years, and has trained and worked in leading Rehabilitation Medicine hospitals in the United States. From the Traumatic Brain Injury Unit at Mount Sinai Medical Center, to Kessler Institute for Rehabilitation Medicine, and New York University’s Rusk Institute for Rehabilitation Medicine, Dr. Rosenblatt has worked on both inpatient and outpatient rehabilitation and neuropsychology services. Dr. Rosenblatt’s work in the spectrum of rehabilitation medicine settings, including closed head injury units, has honed her skills in the areas of neuropsychological evaluation, individual and group cognitive rehabilitation, individual psychotherapy, family interventions, group counseling, and interdisciplinary team management. Dr. Rosenblatt also maintained a successful private practice in New York City where she treated neuropsychology patients and their families. After her move to BC with her family in 2003, Dr. Rosenblatt worked in private practice and provided medico-legal evaluations, before founding the Brain Health service and working as VP and Corporate Director for Copeman Healthcare Centers.
Dr. Rosenblatt has applied her expertise in concussion as neuropsychologist and consultant to National and Olympic snow athletes and teams, NFL, NHL and CHL, National Lacrosse and other professional and competitive athletes. She has been an invited speaker to physician groups, hospitals and medical institutions, schools, sports academies, athletic organizations, as well as print, radio, and television news outlets
A concussion occurs when a force or there’s a hit to the head or body that is sufficient to cause the brain to shake violently within the skull. And the skull is hard, it has bony protrusions, and so the brain’s delicate material hitting those parts of the skull can cause some damage.
The damage can also be caused by shearing, or stretching that happens in the long neurons inside the brain, and all of those disruptions cause a disturbance to systems or functions that are then perceived as symptoms by the individual who suffered the concussion.
One of the biggest misconceptions in concussion diagnosis is the notion that a loss of consciousness has to have occurred in order for a concussion to have occurred. We know that this is not the case, concussion can occur, a mild traumatic brain injury can be sustained in the absence of any loss of consciousness.
Diagnosis of concussion can be challenging, since concussion or mild traumatic brain injury doesn’t typically include the kinds of findings on imaging that might be offered in an emergency room assessment. What usually happens is that symptoms are reported by a person, and identified by a qualified healthcare professional, who have to determine whether or not those symptoms would best be assigned to concussion.
This is especially important because symptoms of concussion can overlap with many other conditions. So, the individual who’s making that assessment, that healthcare professional, really needs to understand the mechanism of injury, the evolution of symptoms that have occurred after that injury, and then assess those symptoms to determine if they most appropriately fit a concussion diagnosis.
Otherwise, the only way the concussion is diagnosed in the community would be based on symptom report by that individual, which again can be better grasped by a person who’s qualified and has experience in concussion, because they can help to identify those symptoms and assign that diagnosis where most appropriate.
When it comes to diagnosing concussion in the community, one of the best ways to get a handle on what has actually happened for this individual is with an interdisciplinary team. This is because the symptoms of concussion manifest in so many different areas of a person’s function, that if you don’t have that interdisciplinary team assessing those different functions, you might not see them.
So for instance, a physiotherapist with experience in concussion can look at the visual system, at the balance system, make sure those two systems are working in tandem. Those two systems rely on neck function and also exertion tolerance, energy levels that need to be managed or coordinated by the brain. If any of these are off, those speak to diagnosis and can help support a concussion diagnosis, or rule it out in some instances.
And of course, beyond those symptoms there are emotional symptoms, which can come from many arenas, but again might be assigned to concussion when that mechanism of injury and evolution of symptoms best fits.
So, all those symptoms need to be considered and included in making that determination of diagnosis, and this is why it’s so difficult for a physician to make that diagnosis all by himself, because you really need a good understanding of all the different systems that could be affected by concussion and how they’re functioning. So that assessment by an interdisciplinary team can really inform that diagnosis and help to rule out others.
Local Practitioners: Psychologist