Concussions / mild Traumatic Brain Injury

What is a concussion?

A concussion is a mild form of traumatic brain injury. When the head receives a blow or intense shaking (e.g., during a fall, or knocking heads with someone, or a Blast Injury), the brain moves back and forth hitting the front and back of the skull. This can cause damage to the connective tissues in the brain, and cause problems with cognitive functioning.

Should I seek treatment for my concussion?

If you think that you or someone else may have a concussion, you should seek medical attention. Receiving medical attention is important for any type of brain injury to determine severity. Undiagnosed moderate to severe brain injuries that do not receive proper treatment can lead to long-term impairment.

How to treat a concussion

The appropriate way to treat a concussion is to engage in total cognitive rest for at least one week: no texting, emailing, TV, cinema, school or work, and definitively no sport. If the symptoms have disappeared great! If you notice that symptoms are not diminishing over time further evaluation is advised. In most cases, recovery will take place with physical and mental rest within a week to 10 days. However, in some cases, people experience symptoms and problems that are not going away. In these cases, a neuropsychologist can help.

How can neuropsychology help?

An assessment will be conducted including a review of medical history (including any prior concussions or falls), testing to assess cognitive skills such as memory, attention, and reasoning. The results of the assessment will indicate present cognitive impairments and determine what skills have been most impacted by the concussion. A repeat of testing can be useful to track changes over time. If you ever underwent neuropsychological testing in the past, these results can also be compared to current results to determine what deficits are present.

The results will be reviewed with you, and information will be provided about symptoms and typical recovery patterns. Recommendations will also be made, including any accommodations that would be appropriate for school or work, while you are still recovering. Rest is the most important in terms of recovery for a concussion. Recommendations will be provided about when it would be appropriate for you to return to regular daily activities, school, work, and sports. In more severe cases, rehabilitation may be recommended.

Sports-related concussions

Sports-related concussions are mild traumatic brain injuries (mTBI) that take place while someone is participating in a sport event.  Not all concussions-mTBIs lead to a loss of consciousness. Because of the cognitive deficits associated with a concussion, some athletes find that they are not able to focus and comprehend new information presented in class or at work. 

Most of the symptoms of concussion improve within one to two-weeks. Other concussions take up to one month of physical rest before the athlete is able to return to their pre-concussion level of functioning. Yet some athletes, although diagnosed with an mTBI, take longer to recuperate (months or years); sometimes people get depressed because of their mental and physical limitations.

How to treat a sports-related concussion

The appropriate way to treat a concussion is to engage in total cognitive rest for at least one week: no texting, emailing, TV, cinema, school or work, and definitively no sport.  If the symptoms have disappeared great!  If not, the rest period must be prolonged; sleeping and relaxing are very important in recovery. Often returning too soon to a sport will prevent the brain from healing and the symptoms could persist for a longer duration. When the athlete feels better, light physical activity can resume a few times per week. The athlete must be encouraged by the coach to come back only once the symptoms have totally resolved.

Although the athlete can, over a one-to-two-month period, return to active play, he/she should perhaps, not engage in tournaments or competition at the time to prevent an additional concussion.

Additional time to rest will be necessary if the athlete is re-injured within months of the initial concussion.  The general rule is that if the athlete sustained three concussions within the same year, he/she should not compete for at least one year.

In real life though, about one third of concussed players will return to play during the same game. The optimal rest period is not often respected, and athletes are asked to return to play before they are symptom-free thereby increasing the risk of additional brain injury.