It’s a common belief that simply allowing the injured brain time to heal is all that’s required in order for a patient to regain full health after a concussion. But there is more to the story when it comes to traumatic brain injury (TBI) recovery—much more. We’ve asked our very own Dr. Vincent Schaller, MD, DABFM, CIC, Medical Director of Mid-Atlantic Concussion Alliance to set the record straight about brain rest for concussions. Find out the facts in this informative Q&A.
True or False:
Concussions Just Need Some Brain Rest Time to Heal.
Dr. Schaller: False! Indeed, brain rest is important following a concussion. But brain rest may not be enough, and if needed additional treatment and care is not given, the patient may suffer from symptoms that can be disruptive, or even debilitating. That’s why it is so important to get head injuries checked out by a doctor, and to monitor people post-concussion for symptoms, in case they need to see a concussion specialist. Sometimes issues can linger, or not show up right away.
Post-Concussion Syndrome Explained
Most concussions, fortunately, do get better soon after a brain injury. But nagging symptoms that may not even be initially attributed to the original bump or jolt to the head can actually take weeks, months or even years to resolve. Neurologists sometimes call concussion symptoms that seem to last long after even a mild concussion post-concussion syndrome, or they reference the issue as “persistent post-concussive symptoms.”
The Mayo Clinic website provides a lengthy list of persistent post-concussion symptoms, including:
- Memory and concentration issues/brain fog
- Low energy/mood or personality changes
- Irritability
- Headaches/migraines
- Dizziness
- Fatigue
- Insomnia/sleep disturbances
- Ringing in the ears
- Blurry vision
- Sensitivity to noise and light
In rare instances, we may even see impulsivity and even decreases in taste and smell as persistent post-concussion symptoms.
True or False:
After an Initial Concussion, Symptoms Can Seem Unrelated or Delayed.
Dr. Schaller: True. The Centers for Disease Control and Prevention (CDC) and other authoritative sources on brain injury tell us that some signs and symptoms of concussion can be difficult to sort out. And some concussion symptoms don’t appear right away. If the medical professional seeing the patient isn’t familiar with traumatic brain injuries, these thing can be overlooked to the detriment of the patient.
Monitoring and Treating Concussion Symptoms
MAC Alliance is a concussion specialty clinic and has advanced testing technologies that can be easily repeated at each visit. So, we can map out a recovery plan and then make sure the patient is having positive results with ocular, vestibular and/or cognitive therapies. We can adjust programs as needed based on objective test results. We can also direct patients to any additional specialists they might need beyond our offices, too.
Dr. Schaller and his team utilize the latest in brain-health and concussion technologies to screen, diagnose, monitor and treat patients, including:
- BrainScope One EEG analysis
- Brain SPECT Scan 3-D metabolic imaging
- Cambridge Brain Sciences neurocognitive testing
- ImPACT neurocognitive testing systems
- RightEye infrared eye-tracking assessment
- Sway Balance System mobile-app-based vestibular screening for cell phones and tablets
True or False:
Ocular Therapy Can Help Correct Concussion-Related Eye Issues.
Dr. Schaller: True. Eye movement is one particular area where we sometimes sees patients exhibiting long-term deficits. Some of my patients in the military, professional sports and even law enforcement who were initially prescribed only brain rest later report ocular issues long after their brain injury happened. Ocular therapy may be prescribed to correct these problems, with each patient’s treatment plan specific to their individual injury.
Signs You May Need Ocular Therapy after a TBI
When TBI patients fail to exhibit what is known as smooth pursuits, which is healthy movement of a pair of eyes when following a moving object, it is cause for concern. Instead of healthy eye movement, these patients exhibit saccadic eye movements, which are irregular eye movements that indicate that the eyes are having a hard time focusing. These patients may still feel disoriented, have headaches and experience numerous other symptoms that might not be as obviously linked back to the initial concussion. Ocular therapy is a treatment to correct the eye-movement deficits causing issues.
LEARN MORE ABOUT MAC'S OCULAR THERAPY PROGRAM
True or False:
If Not Treated Right Away, There Are No Good Therapies to Help Improve Concussion Symptoms.
Dr. Schaller: False! While it is true that cognitive (behavioral), vestibular (balance) and other rehabilitation therapies are optimally initiated soon after a concussion has been diagnosed when symptoms persist, it is possible that treatment many years afterwards may still be beneficial. It’s amazing to see how applying ocular, vestibular and cognitive therapies years later can result in objective improvement with post-concussive deficits. Luckily, brain plasticity—the ability of the brain to rewire itself—has no expiration date!
Concussion Therapies for Those with Long-Haul TBI Symptoms
According to a 2018 article in Military Medicine, researchers found that even with patients with intractable chronic complex mild TBI demonstrated significant improvement in symptoms, cognitive, vestibular, oculomotor and balance function following targeted interventions. The authors noted that with these post-concussion long-haulers “vestibular therapy can be beneficial months or even years after a concussion has occurred.” Growing research shows that chronic post-concussion syndrome patients can benefit from vestibular and ocular therapies even when those treatments are delayed.
Hyperbaric Oxygen Therapy (HBOT) For Patients with Persistent Post-Concussion/TBI Symptoms
Mid-Atlantic Concussion (MAC) Alliance now offers hyperbaric oxygen therapy (HBOT) at our Hockessin, Delaware, location for post-concussion and post-TBI treatment. More and more medical research, and our own experience in our clinic, show evidence that concussion/TBI patients can benefit from properly supervised HBOT treatments. This usually consists 60 one-hour sessions done 2-3 times a week, over the course of several months. These treatments are prescribed in conjunction with (and not in place of) a patient’s individualized recovery program. We can also provide HBOT for any medical conditions for which HBOT is FDA cleared.
MORE ABOUT OUR HYPERBARIC OXYGEN THERAPY CENTER
Find a MAC Concussion Specialist Near You
MAC Alliance certified concussion specialists are able to help traumatic brain injury (TBI) patients in the Mid-Atlantic region through our network of practitioners in:
- Delaware
- Maryland
- New Jersey
- Pennsylvania
- Virginia
To find a MAC Center near you, click here.
