Treating Concussions Quickly Key to Better Outcomes
Dec 31, 2019 11:30AM
● By Kathleen Ganster
Allegheny Health Network
Danielle Fagan of Cranberry didn’t even know she had a concussion—until the next day.
“I fell on the ice, but I did not realize I had hit my head or knocked myself out,” she explained. “Originally, I just thought I fell, but when I went to the doctor the next day, we found a large lump on the back of my head. There was a big gap in my story, too, so they were able to figure out that I had knocked myself out when I hit my head.”
While in Fagan’s case it was a fall, it is a common myth that you have to hit your head to suffer a concussion.
“It is sudden deceleration that causes the brain to hit against a skull, and this can come from simply falling on your tailbone causing a sudden shake of the head, such as when you fall on ice,” explained Marco Alcala, MD, sports medicine and concussion specialist, Concussion Center, Allegheny Health Network. “One can also get a whiplash-like injury from getting into a car accident from your head shaking from side to side, or from front to back.”
The Centers for Disease Control and Prevention states that the most common causes of concussions are major falls, motor vehicle-related injuries, unintentionally being struck by or against an obstacle, assaults and playing sports.
According to Dr. Alcala, concussions—or the brain hitting the inside of the skull—can be caused by a number of factors which may not even seem serious at the time. “It does not have to be a severe blow to the head, it can be light,” he explained. “Many people tend to brush it off thinking they just got their ‘bell rung.’ But then they start to feel the symptoms either hours or a couple of days later.”
Symptoms of concussions are varied and can be different for everyone, but some of the basic signs that someone has a concussion may include headaches, dizziness, confusion, sensitivity to light and noises, eye strain, feeling off balance, fogginess, difficulty focusing and problems with memory, nausea, irritability, moodiness, and fatigue. Anyone who suspects that they may have suffered a concussion should immediately seek medical attention.
For Fagan, it was a combination of factors that sent her to the doctor.
“My immediate symptoms were fuzzy eyesight and confusion, and I had trouble with words. Then my symptoms progressed; I had trouble in bright settings and certain types of lights hurt my head,” she said. “The sounds on television were horrible and I was overstimulated very easily. Plus, my sense of time was affected—what seemed liked minutes could be an hour.”
The good news is that there are better and more comprehensive treatments available to treat concussions than ever before. At the Allegheny Health Network Concussion Center, doctors take a team approach to better diagnosis and prescribe treatment.
According to Dr. Alcala, the first step for anyone with a concussion is relative brain rest, along with other treatments prescribed according to their individual injury and diagnosis. “The brain rest that’s involved still allows a person to be active, but they have to understand what symptoms they have and stop at the right time in order not to have symptoms flare up, which will then prolong their recovery,” he explained.
Neuropsychology is used to assist doctors with more information about patients’ conditions so that the medical team can determine more specific treatments. “We have vestibular and ocular therapies available, speech therapy to help with the cognitive deficits, and vision therapy,” said Dr. Alcala. “At times, psychology and psychiatry may be necessary.”
Just as symptoms of concussions vary with each person, so does recovery time. While Dr. Alcala said that most patients should recover from a concussion within about four weeks, some people can actually take several months, and a few people even take years to improve.
Fagan still suffers from symptoms from her fall in February of 2015.
“I get severe headaches and weather changes affect my well-being, causing me to have an extreme pressure feeling in my head. I still get blurred vision, lose my balance easily, and have trouble remembering things,” she said.
Fagan has been treated by numerous healthcare professionals. “I saw a general practitioner, a concussion specialist, a neurologist, and a psychologist. I also did chiropractic and nutritional treatments and had physical therapy,” she said.
The important thing is to not delay receiving treatment.
According to Dr. Alcala, ongoing studies at AHN’s Concussion Center are correlating symptoms to patient activity and show an association with the way patients feel with what they are doing. “If that’s the case, then it is all controllable by behavior,” he explained. “This could limit someone’s symptoms when they have a concussion and allow them to get through the day successfully without feeling miserable while they heal from a concussion.
“Every individual is unique and needs a tailored treatment program just for them,” he added.