The understanding and treatment of concussions – mild traumatic brain injuries that can damage cells, cause chemical imbalances and disrupt the brain’s normal functioning in various ways – has moved on apace in recent years.
Cognitive and physical rest has been the primary treatment for people experiencing concussions, whether from sport, falls or other accidents. Patients have been advised to darken rooms, turn off screens, limit movement and cut out activities that require attention or concentration, particularly in the first few days after injury. Such steps have been driven by experts’ concerns about worsening the damage or re-injuring the brain rather than strong evidence.
However attention is turning to managing patients differently, intervening earlier to pinpoint problems and prescribe targeted therapies to help young people to recover more quickly, with physicians across America involved in various studies.
Small observational studies have shown positive effects of single therapies — such as exercise, or vestibular therapies — in patients who have had symptoms for a long time. Research looking at multiple therapies, and therapies started early on, is underway.
“We’re taking active, individualized approaches, rather than just having them rest and waiting for the brain to right itself on its own,” said Brooke Pengel, medical director of youth sports medicine at Denver’s Rocky Mountain Hospital for Children, which is known for its guidelines on helping students gradually resume their schoolwork.
Most young athletes see their symptoms go away within two to three weeks. However between 10 and 20% are affected for weeks, months or longer, according to a 2014 Institute of Medicine report.
There is growing appreciation for the ways concussions can affect the vestibular system, a network involving sensory organs in the inner ear and connections to various areas of the brain, the eyes and muscles throughout the body. Some concussions affect the vestibular-ocular system, which allows us to maintain stable vision while moving our heads. Injury to this system causes dizziness, nausea and other symptoms. Other concussion-induced impairments involve the vision system. Injuries to this part of the brain can cause blurred vision, headaches, difficulty reading and navigating busy environments.
Carefully monitored exercise may help promote recovery, experts say, while prolonged and complete rest can lead to depression, fatigue and deconditioning that lowers tolerance for physical activity.
Identifying the causes of headaches — and targeting therapy accordingly — is another part of the new approach. Some concussion-induced headaches reflect vision-system impairment and will respond to vision therapy. Others are migraine-like or cervicogenic (relating to neck injury) and may be treated with medication or physical therapy, respectively.
The Concussion Program at the University of Pittsburgh Medical Center, hopes to establish a consortium to conduct the controlled research that would provide evidence to support individualized active treatment. The research would consider issues such as:
When should treatments be initiated — right after injury, or as symptoms begin improving? At what dose or what pace? How much can active treatments shorten recovery time? And can these approaches guarantee a more complete recovery?
Source article : The Washington Post
The Brain Injury Group brain injury directory
https://www.braininjurygroup.co.uk/brain-injury-group-directory/
How can Brain Injury Group help you?
If you would like advice about bringing a brain injury claim, capacity, deputyships, managing the award of compensation or any other aspect of brain injury welfare, legal or financial advice, we have specialist brain injury solicitors and Court of Protection solicitors who can assist.
You can find full details of Brain Injury Group members on our website or there are several ways to get in touch:
