Brain Concussion (cont.)
What is the treatment for concussion?
Time is the ally in concussion treatment since most symptoms resolve within a
week to 10 days. Treatment is directed at symptom control for headaches, nausea,
dizziness, and insomnia. Discussion with employers may be needed to alert them
to issues of poor work performance due to difficulty with concentration and
comprehension.
How can concussion prevented?
As with most accidents, injury prevention is the first consideration. The
following are all important steps to prevent concussion and severe head
injuries:
- workplace safety using helmets where required or recommended;
- using seatbelts in motor vehicles;
- wearing helmets while bicycling and motorcycle riding; and
- recreational athletes should use head protection appropriate for their
sport.
What is the future of concussion?
Newer computer-based testing products, like ImPACT™, may be able to predict
when athletes can return safely to the field of play. The test requires a
baseline measurement of the athlete's mental function and after injury can
determine when the athlete's brain has returned to normal. It may be able to
replace neuropsychologic testing, which is time intensive and not always
available to the general population.
There are certain genes that predispose to poor outcome after minor head
injury. Genetic issues that may presdispose to poor outcome involve abnormal
swelling of the brain in the early stages of concussion, while late
complications may be related to chronic destruction of brain tissue.
References:
Summary and Agreement Statement of the 2nd International Conference on
Concussion in Sport, Prague 2004. Clin J Sport Med. Volume 15, Number 2, March
2005
Stiell IG, et al. The Canadian CT head rule for patients with minor head
injury. Lancet May 5, 2001;357:1391-6.
ImPACT™ (http://www.impacttest.com/index.php)
Kors E, Terwindt G, Vermeulen F, et al. Delayed cerebral edema and fatal coma
after minor head trauma: Role of the CACNA1A calcium channel subunit gene and
relationship with familial hemiplegic migraine. AnnNeurol. 2001;49:753-760.
Teasdale G, Nicol J, Murray G. Association of Apolipoprotein E polymorphism
with outcome after head injury. Lancet. 1997;350:1069-1071.
Last Editorial Review: 1/4/2008
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