Concussion rates among the general population continue to rise from contact sports, motor-vehicle accidents and the fall-risk of an ever-growing elderly population.
At the Concussion Program, we treat concussions in people of all ages, resulting from all-causes; including head injuries due to motor vehicle accidents, falls, and sports injuries, just to name a few. Many of our patients are referred to the program from area emergency rooms, doctors’ offices, rehabilitation centers, and high schools and colleges.
Integrated, Multidisciplinary Team Approach
Our Concussion Program provides an integrated, multidisciplinary evaluation and rehabilitation for people with persistent problems following a concussion. This program offers a team of experts who are trained in the assessment and management of concussion. Our team includes physiatrists (certified in traumatic brain injury), neuropsychologists, and multiple therapeutic disciplines. Our program is unique in that it combines a comprehensive evaluation with an individualized treatment plan. We also have in-depth experience in neuro-cognitive recovery and brain plasticity.
Comprehensive Concussion Treatment
For many people, there are challenges in getting an accurate diagnosis following a brain injury, especially when there is no observed or documented loss of consciousness. The constellation of symptoms following a concussion may result in post-concussion syndrome. If the symptoms do not resolve within three months, they may require specialized intervention.
In athletes, to reduce the risk of re-concussion, second impact syndrome, or other complications, and safely returning athletes to play — the specialists in our program offer concussion protocols and safety guidance for the athlete, as well as parents, coaches, teachers, and administrators.
As a part of your condition and recommended treatment, our team may evaluate you as soon as one week post-injury. A brain-injury certified physician, who is trained in concussion management, will perform a clinical interview, physical (including neurological) examination, and balance testing. You will be provided with an educational overview on the nature of concussions, how to avoid a subsequent concussion, and medications and supplements that are either recommended or advised against, during the period of neurological recovery. The physician may recommend the use of medications to enhance cognitive function, or recommend further medical evaluations.
Once a more serious condition has been excluded, an extension of the evaluation may include neurocognitive testing by a neuropsychologist, particularly if the symptoms are persistent.
Poor concentration, taking longer to think, difficulty with multitasking, finding the right way to express oneself, and forgetfulness are among the most common symptoms after a concussion. A neuropsychological evaluation is recommended for people whose cognitive difficulties do not resolve after three months, to gain an accurate understanding of potential cognitive impairments, and guide treatment. Treatment to remediate cognitive problems, usually provided by a neuropsychologist or speech and language pathologist, include direct attention training, time pressure management, active listening, and compensatory memory strategies – all of which are individualized according to each person’s needs.
Our Concussion Program offers comprehensive neuropsychological evaluations for children and adolescents, ages 5 to 18 years. The neuropsychological evaluation provides an in-depth evaluation of cognitive functions, including the ability to pay attention, remember instructions and conversations, remember tasks that have to be performed, making plans, and thinking before acting. The pediatric neuropsychological evaluation often focuses on how these factors influence a return to learning and performance of schoolwork, and provides detailed feedback and recommendations.
Specialized neurologic evaluation and physical therapy can address problems with dizziness, vertigo and in balance after a concussion.
Specialized evaluations by a neuro- ophthalmologist and treatment with an occupational therapist can address problems with visual diagnostic focusing and depth perception, difficulties getting information, or reading. A Brain Certified Physician will evaluate the need for a neuro-optometrist or ENT (ear, nose, and throat) specialist.
Specialized assessment by a physiatrist or a neurologist, are essential to understanding the causes of post-traumatic headaches, neck pain, or other causes of pain after a concussion. Once diagnosed, treatment can be provided through prescription medications, nonpharmacological medical interventions, physical and occupational therapies, and psychological methods of pain management.
Fatigue may be a consequence of poor sleep, or a direct neurologic effect of the concussion. Post-concussion fatigue is a type of neurogenic fatigue characterized by the inability to tolerate sustained mental or physical activity and prolonged recovery after mental effort. Cognitive – behavioral therapies and pharmacologic treatment can both help to manage fatigue after concussion.
Emotional Regulation Therapies
Problems controlling emotional reactions and feelings of irritability or inpatients can be a direct consequence of a concussion, or a result of other chronic symptoms such as pain, fatigue, and being overwhelmed by too much information. Learning to recognize and manage signs of emotional dys-regulation can reduce these feelings; in some cases the use of medications can improve symptoms of irritability, depression or anxiety.
Mindful attention is training is a specialized form of medication meditation and stress management that helps people focus their attention and improve cognitive physical and emotional symptoms that can occur after a concussion.