What Can Be Involved When You Hit Your Head?

 

Concussion is a hot topic at the moment, with increasing pressure to review sports, especially for adolescents, where a concussion could occur. I think that it is important that awareness is raised of both the short-term and long-term effects of concussion, as well as cumulative concussions. This especially true if we want to continue to stay active and encourage the next generation to have an active lifestyle.

However, a sports-related concussion is only one cause of concussion. I see as many patients who have concussion from falling off a bike, road traffic accidents, or a trip or a fall as those with concussion from playing sport. Even if we can minimize the exposure to head injuries in sport, concussion is not going to go away.

I see many patients with concussion and especially post-concussion syndrome. These are people who still three, four, or five years down the line are suffering from ongoing debilitating symptoms. In many cases this impacts their ability to live a normal life, affecting their work, relationships, mental health, and ability to be active and play sport.

The common symptoms of concussion can be broken down into 6 general categories, and in many cases, it is a combination of these.

Vestibular

This is the system that provides you with most of the information about where you are in space. Typically this refers to the inner ear structures that feed into the vestibular nucleus in the brain stem. The vestibular nucleus is like a central processor for your balance and also receives information from the visual system as well as the body, especially the neck. Typical symptoms include brain fog, dizziness/vertigo, headaches, poor balance and coordination, ringing in the ears

Visual

The visual system integrates many different structures and pathways in the brain. It’s not just about vision, it is also about how the muscles that move the eyes are working. Typical symptoms here can cause blurry vision, brain fog, dizziness, double vision, light sensitivity, nausea, poor spatial awareness, and sensitivity to motion.

Cognitive

Cognitive function relates to the overall speed and connectivity of the different parts of the brain. This often results in confusion, difficulty concentrating, memory loss, mental fog, repeating questions, slow processing, and understanding of information.

Somatosensory

This is often a heightened and altered sense of awareness of information from the body and can lead to balance problems, changes in smell, metallic taste, neck pain, numbness and tingling, feeling overwhelmed in crowds, and poor body awareness.

Emotional

The emotional side of concussion can be due to the initial trauma as well as the secondary effects of the often radical changes to lifestyle that occur secondary to concussion. Commonly this can result in a feeling of anxiety, confusion, depression, stress, irritability, more emotional, nervousness, restlessness and sadness.

Dysautonomia

The balance system in your body is very closely related to the autonomic nervous system, as a result, this can lead to dizziness, lightheadedness, fainting or passing out, chest pain, heart palpitations, heart racing, headaches, brain fog, fatigue, sleep disorders, stomach pain, diarrhoea, constipation, nausea, vomiting, muscle/joint pain, unstable joints in the body, and discolouration of hands and feet.

 

The way that I like to work with patients is to complete an assessment of these different areas in order to develop an individualized rehabilitation programme. Although it’s possible to generalize symptoms into the above categories, it’s rarely quite so black and white. For each patient, the nature of each injury is different, their previous medical history is different, especially in relation to previous head injuries and whether they have fully recovered from those. As a result, a rehabilitation programme may follow similar themes, but it is tailored to the individual.

Drop me a line if you’d like to know more.