Concussion
What we can improve
A concussion is a brain injury caused by an impact to the head, an acceleration, sudden deceleration or torsion of the cranial box. The symptoms can vary greatly from person to person.
When an individual suffers an impact to the head or any of the other mechanical phenomena mentioned, it is important for the person to report to the hospital if they have symptoms. In many cases, the emergency physician will decide to perform a scan or magnetic resonance to ensure that there is no bleeding or damage to the brain structures. That being said, these tests do not make it possible to analyze brain activity. In more than 85% of cases, these tests stand out as normal, even in the presence of severe damage, according to neurologist Jonathan Walker.1.
Several symptoms are related to brain activity such as difficulty with attention, concentration, memory, anxiety, depressed mood, fatigue, headaches, and problems with sleep. In such cases, a qEEG will often make a clear link between the symptoms and brain activity that is deviant from the norm.
When an individual suffers brain trauma, neurons will die and the electrical activity of the brain will be affected. Depending on where the damage has occurred, the symptoms may be different.
At the Neuroperforma Clinic, during the evaluation, we will perform a quantitative electroencephalogram (qEEG), which measures the electrical activity of the brain at 2400 locations at a time, in 3 dimensions. This reading will allow us to see areas of the brain that are hypoactive or hyperactive, which could explain the emergence, for example, of attention difficulties, anxiety, irritability or sleep difficulties).
The neuropsychologist will then interpret the results of the qEEG so as to make the links between the difficulties experienced and the deviations of brain activity. This will help set up a Neurofeedback training program that will aim to bring brain activity back to normal functioning.
Neurofeedback training will target areas or networks that have significant deviations and for which there are symptoms or difficulties. For example, if the individual has difficulties in attention or memory, we will train these networks. If he has more difficulties with sleep, mood or anxiety, we will target them, and so on.
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According to a study by Dale Foster, presented at the ISNR annual conference in September 20132, Neurofeedback is the most effective approach to treat many persistent symptoms following head trauma and post-traumatic stress disorder.
Did you know that the US Army uses the same devices and software as Neuroperforma to help their soldiers suffering from concussion and post-traumatic stress?
1. Walker, J. E. (2007). A neurologist’s experience with QEEG-guided Neurofeedback following brain injury. Chapter in J. R. Evans (Ed.), Handbook of Neurofeedback. Binghampton, NY: Haworth Medical Press, pp. 353-361.
2. LORETA Z Score Neurofeedback in the treatment of Veterans with PTSD and TBI
Thursday, September 19, 2013, 10:50 AM – 11:20 AM
Dale Foster, Memphis Integral Neurofeedback Institute
Katherine Veazey-Morris, Veterans Administration Medical Center, Memphis, TN
Le trouble du déficit de l’attention avec ou sans hyperactivité (TDA/TDAH) est une condition neurodéveloppementale complexe qui toucherait 5 à 8 % des enfants. Il peut être décrit par une panoplie de symptômes liés à des dysfonctions ou à une pauvre maturation des lobes frontaux.
A concussion is a disruption of brain function following a head injury. The injury can be caused by direct or indirect impact to the head, face, neck, or body. It can also result from sudden acceleration or deceleration.
During a concussion, clinical manifestations can vary and evolve differently depending on several factors, including the patient’s age, the number of concussions suffered in the past, certain genetic predispositions, etc. Many signs can initially alert that a person has experienced a head injury. Following a concussion during physical activity, you may have difficulty maintaining your balance, feel drowsy, have a vacant stare, or start vomiting. As for the symptoms experienced, they include:
- headaches,
- dizziness,
- trouble concentrating, confusion, and disorientation,
- balance problems,
- memory impairment,
- sleep disturbances,
- drowsiness,
- blurred vision and sensitivity to light.
Several studies report that the majority of people who have suffered a concussion have manifested the first three symptoms. They can be transient or persist throughout life. Severe concussion is characterized by prolonged and profound loss of consciousness (coma). Upon regaining consciousness, other symptoms such as vomiting, speech difficulties, and balance problems may occur.
Diagnostic evaluation
In Canada, concussions related to sports practice are considered a public health problem. During physical activity, the number of head injuries reported by athletes suggests that the concussion rate is, on average 5 to 15%. However, this figure may increase in teams with established concussion management protocols. The practice of several contact sports, such as ice hockey, skiing, and football, can lead to this head injury.
Other activities, such as socce,r also favor concussions. It is indeed a fast sport that differs from other disciplines where the use of the head is a fundamental part of aerial play. Accidents with impact on the playing surface or in aerial duels are also common.
Athletes are not the only patients to suffer from this brain injury. Apart from hockey and other contact sports presenting a risk of concussions, car accidents or falls are risk factors.
Any collision causing a sudden movement of the neck or head can lead to a concussion. Symptoms of a head injury may appear up to 48-72 hours after an impact. Concussions may therefore sometimes not be detected by the doctor if a clinic consultation is completed in the early moments following a car accident.
Many children and adolescents also suffer injuries during sports activities as a result of falls, collisions, or accidents in the schoolyard. School professionals can facilitate healing and the gradual return to learning after the incident.
To diagnose a concussion, the healthcare professional performs a clinical examination and prescribes specific tests:
- medical imaging tests,
- blood tests,
- neurological examinations,
- electroencephalogram.
- A doctor or a neuropsychologist can make the diagnosis.
Neuroperforma clinics do not make diagnoses. Through neurofeedback, we target brain regions with significant deviations that may be related to concussion symptoms. Our approach is very effective and offers rapid and lasting results. Visit our clinics to address persisting symptoms and return to your activities more quickly.
Treatments for a concussion can vary from patient to patient, depending on the severity of the injury. Your neuropsychologist or neurologist is best placed to advise you on the appropriate treatment for your case. Physiotherapy and occupational therapy sessions are common treatments. However, vestibular rehabilitation may be necessary if dizziness persists.
In some cases, patients may resort to osteopathy. Whatever the treatment, it generally begins with total rest for the patient for at least 48 hours. Prompt management of a concussion can significantly reduce the risk of long-term sequelae.
The consequences of a concussion vary in severity and require close monitoring in the 48 hours following the fall or impact. Several neurological effects can be observed, including:
- brain tissue lesions,
- imbalances in brain oxygenation,
- chemical and metabolic imbalances,
- and glucose level variation.
In the long term, repeated concussions can lead to lifelong neurological problems. For example, chronic traumatic encephalopathy, which is a degenerative brain condition, is well-known among athletes.
Some sports activities are particularly at risk. These include contact sports (such as ice hockey and rugby) and sports with potential falls.
In the days following the impact, consult a doctor and be accompanied for at least the first 24 hours. Complete rest in a quiet environment is recommended. You should also avoid, as much as possible, loud noises, lights, screen exposure, and any other activity that may exacerbate symptoms.
You can protect your head and that of your children with a suitable helmet during two-wheeled trips or during sports activities with a risk of falling (hockey, football, soccer…).