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Concussion – Traumatic Brain Injury

Having Concussion (mTBI) Symptoms that don’t go away is scary and stressful.

Concussion, a form of mild traumatic brain injury (TBI), is a leading public health problem, with an estimated 1.6 to 3.8 million sport-related concussions each year in the United States.  The majority of patients with sport-related concussion recover within a 7- to 10-day period. Persistence of symptoms beyond the generally accepted time frame for recovery may represent a prolonged concussion or may herald the development of post-concussion syndrome (PCS).

If you have been having symptoms for more than a few weeks, it is smart to be proactive.  Research recommends initial cognitive rest, but you need to actively treat the problem at this point.  It is a stressful time and you need answers.  This is when you need to be working with someone who specializes in concussion rehabilitation.

We Use a Biomedical Approach

Acute emergency situations of head injury should only be managed by the hospital emergency room. Many times these injuries require a CT scan. Once a more serious situation is ruled out, the best approach in the first 30 days after a concussion is physical and mental rest until symptom resolution as well as proper nutrition to reduce brain inflammation. We recommend a strict 7-day total rest period immediately following the injury. This means, no school, work, TV, homework, exercise or video games. We are expertly trained in the best nutritional approach to take after a person suffers a concussion and can provide specific nutritional recommendations that can aid in decreasing brain inflammation in the acute period following the concussion.

If a concussion sufferer is still having symptoms after the initial rest period, they have post-concussion syndrome (PCS) and are best cared for using specific functional neurological care. Many times these patients DO NOT improve with more time; they need an intensive rehabilitative approach.

We See Post-Concussion Syndrome Patients

As Functional Neurologists, we see post-concussion syndrome patients who do not achieve full neurological recovery both objectively and symptomatically through rest within the initial 30 days post injury. It is important to understand the majority of concussion sufferers that do feel better with rest may not really be recovered neurologically. It’s essential that they have the proper testing done to evaluate all the potential areas of their brain that may be affected by the concussion. These areas are not limited to the cognitive areas of the brain tested by a neurocognitive test such as IMPACT, but also the areas that affect balance, equilibrium, blood flow to the brain itself and other vital functions. Very often a concussion sufferer will pass a neurocognitive test such as IMPACT, meaning the cognitive areas of the brain are functioning well, but they may still have serious deficits in other areas causing their symptoms. If a player goes back to play with these deficits and functioning at less than 100% there is a greater chance that they will get hurt again.

We Do Not Look To Treat With Medication

Medications affect the brain as a whole and are not specific or able to bias certain neurological areas. It is not possible for a chemical to only affect the specific areas of the brain injured by the concussion and not the non-injured areas. For example, if only the left side of a person’s brain stem is affected causing dizziness and poor balance, how could the chemical action of the medication only affect one side and not the other? It is for that reason we do not use medication and instead use specific brain stimulation to train and repair the specific areas affected by the concussion. The most current research is supporting this approach.

In order to better understand this methodology, it’s important to understand how a Functional Neurologist differs from conventional medical neurology. The key difference between a Functional Neurologist and a conventional medical neurologist lies primarily in their approaches to treatment.

A Functional Neurologist views the nervous system as a moldable, changeable entity that can be affected in its function through many types of environmental stimulation and specific therapies. This concept of the brain being able to change its function throughout life via environmental stimulation is termed neuroplasticity and is at the very core of a Functional Neurologist’s clinical methodology.

We Look at Overall Brain Function

We look at each specific brain region affected by the concussion in addition to the individual’s specific functional capabilities and the neurochemical effects of the concussion as well. This is different than just passing a computerized test or vague, generalized batteries of tests that do not look at various things from a functional model.

Traumatic Brain Injury (TBI) is a mechanical injury to the brain from accidents, falls, assaults, sports injuries and other traumatic forces. Another form of brain injury is called Anoxia, which is caused by a lack of oxygen to the brain. This occurs with heart attacks, stroke, asthma attacks and carbon monoxide poisoning. Our group of experts perform careful neurological examinations and use special functional testing such as videonystagmography (VNG), brain mapping (EEG/QEEG/ERP) and computerized balance testing. Once this assessment is complete, our team can better characterize the extent and level of injury.

Once a follow-up visit is scheduled, we will report all of the clinical information with the patient and lay out a personalized treatment strategy. The protocols can include specific nutrition programs, vestibular therapy, physical therapy, cold laser therapy, chiropractic, hyperbaric oxygen, neurofeedback and intravenous nutritional supplementation. In select cases, we can employ transcranial magnetic stimulation (TMS).

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