Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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:
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.
Stiell IG, et al. The Canadian CT head rule for patients with minor head
injury. Lancet May 5, 2001;357:1391-6.
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
Teasdale G, Nicol J, Murray G. Association of Apolipoprotein E polymorphism
with outcome after head injury. Lancet. 1997;350:1069-1071.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Internal bleeding occurs when an artery or vein is damaged and blood to escapes the circulatory system and collects inside the body. Internal bleeding can be caused by a variety of situations such as blunt trauma, deceleration trauma, medications, fractures, and spontaneous bleeding. Treatment of internal bleeding depends on the cause of the bleeding.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Hydrocephalus is an abnormal buildup of cerebrospinal fluid (CSF) in the ventricles of the brain. The fluid is often under increased pressure and can compress and damage the brain. Symptoms of hydrocephalus vary with age, progression of the disease, and individual tolerance to the condition. Hydrocephalus is most often treated by surgery in which a shunt system is inserted.
Hypothermia is having a body core temperature of less than 35 C or 95 F. Most causes of hypothermia are preventable. Risk factors for hypothermia include age, mental status, medical conditions, and medications. Symptoms of hypothermia generally depend upon the severity of the condition. Treatment depends upon the severity of hypothermia. If not treated early, hypothermia can lead to cardiac arrest, coma, or death.
Coma is the inability to waken or react to the surrounding environment. The Glasgow Coma Scale is frequently used to measure the depth of coma. Causes of coma include trauma, bleeding, edema, lack of oxygen, poisoning, or hypoglycemia. Prognosis for a patient in a coma depends on the cause of the coma.
In the United States, head injuries are one of the most common causes of death and disability. Head injuries due to bleeding are generally classified by the location of the blood within the scull, these include: epidural hematoma, subdural hematoma, subarachnoid bleed, intracranial bleed, sheer injury, edema, and skull fracture. Some common symptoms of a head injury include: vomiting, bleeding from the ear, speech difficulties, paralysis, difficulty swallowing, and body numbness. Treatment of a head injury depends on the type and severity of the injury.
Brain lesions (lesions on the brain) are caused by trauma, inflammation, autoimmune diseases, cancers, other diseases, stroke, bleeding, pituitary adenomas, and cerebral palsy. Symptoms of brain lesions include headache, nausea, fever, neck pain and stiffness, affected vision and speech, weakness or paralysis to one side of the body. Diagnosis of brain lesions is generally with imaging studies like CT or MRI scans. Treatment and prognosis of brain lesions depends on the cause of the lesion.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
First aid is a complicated subject and it is situation-specific. First aid is the help and medical assistance that someone gives, not only to an injured person, but to a person who is sick. Preparedness is a key element of first aid, like having basic medical emergency kits in your home, car, boat, or RV. Cuts, puncture wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart attacks, strokes, seizures, and heat stroke are examples of more critical first aid emergencies.
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