Concussions: What you need to know about this type of traumatic brain injury
Editor’s note: This is the first of a two-part series on concussions, causes and treatments.
By Kristine Porter
The common belief when someone gets hit on the head is to watch and wait to see if he feels fine.
Daniele Shollenberger, a nurse practitioner and director of the Concussion and Head Trauma Program at Lehigh Valley Health Network, said concussions are not a watch and wait situation, but are actually an active rehabilitation plan.
“Concussion is a traumatic brain injury,” she said. “This blow to the head actually alters the way that the brain functions.”
She said concussion is defined as a blow or jolt to the head, and professionals consider how the blow occurred. Did something impact the head or did the head impact something?
Officially though, the medical diagnosis of a concussion is that it is a pathophysiologic process affecting the brain induced by traumatic biomechanical forces, she added.
“Concussions are serious and need appropriate treatment. Unfortunately, they are also invisible, so diagnosing a concussion can be tricky,” she said. “There are no specific blood tests or scans that diagnose concussions.
“Rather, a detailed and focused evaluation performed by concussion specialists will assess for concussion.”
Screening for a concussion
Shollenberger said medical professionals look at the symptoms reported by the patient and the signs observed by the provider to assess the concussion. Together, symptoms and signs give the provider much information.
They use a post-concussion symptom checklist that was developed by researchers of the most common symptoms. The symptoms are placed into four categories. These categories and some of their symptoms include:
• Physical - headaches, dizziness, nausea, sensitivity to noise and light, imbalance, and others;
• Thinking or cognitive - feeling mentally foggy or slowed down, difficulty concentrating, and difficulty remembering information;
• Sleep pattern changes - sleeping less than usual or more than usual, trouble falling asleep or staying asleep;
• Emotional - feeling irritable, sad, nervous, feeling different emotionally from how the person usually feels.
From there, the medical provider discusses more than 20 symptoms with the patient and has him rate the symptoms, Shollenberger said.
Every time the patient comes in for therapy, he completes this list, which helps the provider to monitor his progress.
“Concussions are diagnosed with the second part - the assessment,” she said.
Treating a concussion
The Concussion and Head Trauma Program at LVHN uses a multidisciplinary approach that includes a physical, vision, speech and cognitive therapists and a neuro-optometrists. They use a list of assessments that includes, but is not limited to:
• Neurologic evaluation
• Ocular motor function or eye movement tests
• Stimular function - evaluates balance and dizziness.
Although it is best to be evaluated for a concussion soon after a blow to the head occurs, medical professionals can diagnose and treat concussions years later.
“With proper diagnosis and treatment, you can begin your journey to recovery,” she said.
LVHN’s Concussion and Head Trauma Program is offered in both the Lehigh Valley and the Pocono region. The program treats concussions caused by sports injuries, auto accidents, falls at home and in the workplace. In the Poconos, it is available at 447 Plaza Court, Building 200, Suite B, East Stroudsburg. To make an appointment, call 484-862-3011.