Humpty Dumpty Had a Great Fall
In almost every football game you watch on TV there is at least one pileup of bodies that, when the bodies untangle themselves, there is one player left lying on the ground, inert. Coaches, refs, trainers, EMT’s, team doc all rush out and huddle around. Then one of two things happen. 1) Someone brings a stretcher and the player is loaded and carried off the field or 2) the player’s bent leg/knee starts to move back and forth and within a couple of minutes he is assisted to his feet and helped off the field to sit on the bench for awhile. My husband always used to say,”He’s alright. His leg is moving” and sure enough within minutes he was “ok”. Or was he?
Closed head trauma – especially repeated closed head trauma is starting to get the attention it should have had years ago. Sports figures who have sustained repeated thumps on the head, hard tackles, and other blows to the bony protective covering over the brain we call the skull are now, years later, showing neurological deficits. These problems are ranging from anger management to poor memory to cognition problems to something called “pugilistic Parkinson’s disease.” (See Upright-Health.com). Blows that cause whiplash, trauma to the base of the skull or cervical spin may not initially appear serious. But they are or can be and the damage may go undetected for years.
Before you quit reading this because 1) you don’t play football 2) you aren’t interested in football players or their injuries or 3) this couldn’t possibly impact you or your life – keep reading – car accidents happen every day. People fall down steps. You slip on ice and hit your head on the sidewalk. This article is about concussions – post concussion syndrome and mild traumatic brain injury. It could contain valuable information for you or someone you love.
Now excuse me while I go back to football for just another minute. As far back as 1994 there was some awareness among sports medicine professionals that maybe a concussion is MORE than just a concussion. The NFL formed a Post Traumatic Brain Syndrome commission but little attention was paid to their findings as they were inconclusive and it was thought that the bigger problems were knee injuries, drug and steroid use. In 1997 some rules were changed in regards to how soon a player who was knocked unconscious could return to play….at least until the next game.
Along with the American Academy of Neurology’s report in 1999 that “repeated concussions can cause accumulative brain injury over months and years”, came the first disability claim against the NFL, filed by Mike Webster of the Steelers. He filed for permanent disability. The Academy’s findings were never made public.
Now, almost 15 years later many more football players have become the focus in the study of Post Concussion Syndrome or mild Traumatic Brain injury. Several players have died or had severe dementia at a very early age. Several have committed suicide after experiencing radical personality and behavioral changes. Studies of the brains of the deceased has shown what is now known as Chronic Brain Encephalopathy (can only be diagnosed after death.) Apparently the cumulative effect of head trauma causes changes in behavior such as aggressiveness, depression, amnesia, that can degenerate into dementia.
HOWEVER – It doesn’t take multiple blows to the head to suffer some form of Post Concussion Syndrome. Once is enough. You may not lose consciousness. You may not have amnesia. According to neurologists the symptoms vary from person to person. Memory loss; headaches; hormonal problems such as development of hypothyroidism; cognitive thinking,concentration, reasoning, verbal expression and understanding of communication changes, can all occur days or weeks after the injury is sustained. Emotional problems can range from irritability, apathy, depression,anxiety, restlessness to problems with sleep, nightmares.
Some of these issues can become life changing. If there is a loss of some of the higher level mental functioning skills job performance may become an issue. It may become difficult to resume or retain pre-injury work related activities. If your job requires abstract reasoning, organizational skills, problem solving, or judgement related tasks you may not perform at your previous level.
In the past concussions have been treated as a relatively minor injury. Advice has been “Go home, take something for the pain, don’t fall asleep, watch for increasing symptoms of drowsiness, etc,” especially in children. Not necessarily so. The new awareness that even one blow to the head can show up weeks after the trauma has doctors changing the recommendations.
If you sustain a head injury, even if it seems insignificant, see your physician if you experience any of the symptoms I’ve mentioned above. Your family doctor may refer you to a neurologist, a doctor who specializes in the brain and spinal cord, the nervous system and it’s pathology. The neurologist uses various tools and tests for assessment including EEG’s, MRI and CAT scan imaging, and physical assessment. Specialized treatment may be recommended.
If you feel you may have some of the symptoms related to an old injury there is still treatment available. Neuropsychologists are doctors who work with patients with the aftereffects of head injuries,neurological disorders such as Parkinson’s disease, Alzheimer’s or stroke victims. They help maximize skills for coping with cognitive, memory and other functional disorders.
The first step for the Neuropsychologist is to evaluate function. This is done by a series of tests, verbal, spatial, numeric, personality. Some of the tests are written exercises, others are reading comprehension, drawing and verbal repetition tests. There are multiple choice questions on some, true/false questions for history and personality assessment on others. It’s a lengthy process. A report is then compiled and diagnosis made from the data collected.
Once the evaluation is complete and a diagnosis made a course of treatment can be recommended. This can also be followed with counseling sessions that give further insight to the doctor and to the patient on the prognosis, treatment and expected recovery.
The brain is still the least understood organ in the human body. However scientists and new studies are giving us more insight everyday into the effects of disease and injury of the brain. With more information comes new treatments and advances that can help people already experiencing symptoms, like memory loss and other cognitive deficits, new hope and, in some cases, a return to a higher level of functioning.
My injury was 3 years ago. For the first time in 3 years I feel there may be some constructive ways for me to deal with some of the aftermath of that injury.
Think about it !