Signs of Concussions and Mild Traumatic Brain Injury

Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Signs of Concussions and Mild Traumatic Brain Injury
Fall season sports are in full swing. Weekends are filled with football and soccer games in all age categories – pee-wee, high school, college, and professional. Hockey season is right around the corner. At some point, the commentary discussion often will turn to the increased number of concussions, and its harmful effects being seen in these athletes. There are at least 3.8 million sports related concussions that occur in the US annually, with many athletes having a history of more than one. The consensus is that multiple concussions and subconcussive injuries prove to be disastrous.

Mild traumatic brain injuries reach beyond athletes who play contact sports. Motorists involved in collisions, armed forces, fire and police personnel, and those in related lines of work or activity also experience a high number of concussions or mild traumatic brain injury. Athletic programs, especially those of college and professional leagues, may have highly skilled athletic trainers or physicians on staff that can evaluate the trauma, but there are many high school programs and other scenarios where there may be limited or no support in identifying symptoms of a concussion. Very mild concussions often heal within several days or a few weeks. However in some cases, it may take time to understand the full extent of brain injury symptoms and understand how well or poorly the brain is healing. Many times it is a parent or a spouse who sees a change in their loved one’s behavior or demeanor that occurs weeks or months after the injury or sports season, and they may wonder if this is a problem related with the concussion. Researchers have identified that even repetitive minor impact known as subconcussive blows can create cumulative subtle changes without concussion symptoms leading to collective damage and neurodegeneration years later. Identifying the problem is fundamental to recovery.

Identification



There are three categories of symptoms that may reflect Mild Traumatic Brain Injury (MTBI). These are symptoms to monitor and discuss with your health care professional. Note that there does not need to be a loss of consciousness with the impact or injury to have a concussion.

Cognitive or Thinking Skills


• Change in concentration or attention, easily distracted
• Trouble with short term memory, forgetfulness
• Difficulty learning new things
• Trouble with remembering old memories
• Trouble with organization, planning, or being on time for appointments
• Trouble processing information, slower at comprehension, or slower rate of thinking
• Feeling dazed
• Confused thinking
• Making more mistakes than usual
• Not catching mistakes
• Not remembering the point of impact
• Not able to complete assignments or other paperwork
• Trouble managing work, school, relationships, home

Emotional Symptoms


• Experiencing new or worsening symptoms of depression, sadness, weepiness
• Change in the intensity of emotional expression, i.e. increased or decreased
• Poor motivation
• Decreased or increased appetite
• Decreased or increased libido
• Decreased interest in previous activities
• Increased feelings of fear, anxiety, frustration
• Irritability

Physical Symptoms


• Ringing in the ears
• Double or blurry vision
• Dizziness
• Headaches
• Neck pain
• Nausea and vomiting
• Fatigue
• Trouble sleeping
• Increased sensitivity to bright lights and/or loud noises
• Numbness or tingling in arms or legs
• Periods of black outs or seizures
Altered heart rate

The goal is to identify first and foremost if there is a problem. The earlier the concern is identified, the better the outcome as treatment can be instigated immediately. Mild concussion symptoms often resolve without long term complications. However, just because the symptoms have abated, doesn’t mean the physical injury changes have been resolved.

Nutritional Support



If you or your loved one has immediate needs with a concussion and brain recovery, focus on these factors to begin. The first line of therapy with a concussion is to reduce inflammation, ensure adequate GABA reserves, boost antioxidants, and rest. The initial trauma of the concussion causes release of excess glutamate, stimulatory calcium ions, substance P, and other pro-inflammatory chemicals. Compounds that help to quench these excitatory compounds include DHA/EPA, vitamin D, NAC, R-alpha lipoic acid, magnesium, coenzyme Q10, resveratrol, and grape seed extract. Additional support may be found at "How to Recover from a Concussion – Athletes Take Note.”

However, repetitive concussions or poor recovery from concussions are a different story. Repetitive concussions can develop into a very serious disorder called Chronic Traumatic Encephalopathy (CTE). This devastating disorder is being reported on with a number of professional football players who have recently been in the news. The disease findings are considered similar to Alzheimer’s disease, i.e. there is a build up of damaged proteins in the brain leading to serious neurodegeneration. Post Concussion Syndrome is far less serious than CTE, but this too may take several months or years to heal.

Why the Increase in Concussions?



Scientists are heavily debating the mechanisms and why there is a major rise in the number of concussions and increased concerns with Post Concussion Syndrome effects diagnosed in the last 10 years. This increased number of concussion is occurring despite decreased sports enrollment and participation along with changes in helmet support and contact rules in sports such as football. Researchers are delving into why the resiliency of the brain to withstand trauma has decreased in modern day with increased concerns of neurodegeneration. Part II of this discussion will delve into an eye opening concept of concussions, brain recovery or resilience related with modern day factors. Identifying the risks making the brain less resilient is the other piece of the puzzle of concussion prevention and management. It should prove to be highly thought provoking and startling, prompting you to make powerful, health-oriented choices.

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