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Tackle concussions with awareness, no matter the sport

It’s not really a fashion statement, but it can absolutely add that final touch to an outfit. A helmet is one of the most important things you can put on before playing in the snow, on the river, in the dirt, climbing over rocks, riding a road or mountain bike or playing a contact sport.

“While helmets do not prevent serious head injury, they do a great job limiting the severity of injury to our most important body part — our brains,” said Dr. David Miller, neurosurgeon at the High Mountain Brain and Spinal Surgery Center at Valley View and former staff neurosurgeon at the Cleveland Clinic Foundation. Yet despite an increase in helmet use, doctors nationwide are seeing an increase in the number of concussions within their clinics, especially in active individuals and athletes.

A concussion is a traumatic brain injury; it’s defined as an alteration of consciousness as a result of trauma to the brain. “With our active mountain lifestyles and the (sometimes) adrenalin-fueled decisions that accompany them, concussions are very common in our area,” said Dr. Miller. Concussions can temporarily affect the brain and can be very serious — they can cause confusion and problems with memory, speech, vision or balance.



It’s not always easy to see that someone has sustained an injury resulting in a concussion. Of course, when a friend or teammate loses consciousness (gets knocked out) as a result of a head injury, most people typically recognize the severity of the injury. “Unfortunately, many people appear fine immediately after a traumatic brain injury but show symptoms later,” said Dr. Wade Ceola, who is joining Dr. Miller in January 2015 from the Springfield Neurological and Spine Institute in Missouri. This more common and potentially more dangerous scenario — when there is no loss of consciousness and the patient has only mild confusion — may have a severe impact on the brain and can be life-threatening.

Concussions leave a wide spectrum of symptoms; these symptoms are typically reported to be surprisingly severe with even some relatively mild concussions. The most common symptoms of concussion include headache, dizziness and difficulty remembering things.



Some patients report trouble sleeping, concentrating and maintaining a stable emotional state. In some cases, personality changes affect the post-concussive patient.

“Unfortunately, there is no specific evaluation, test or imaging modality to define a concussion or its expected time of recovery,” said Dr. Ceola. “The timeline for these symptoms to resolve is highly variable and hard to predict; symptoms typically last a few weeks but can last for years.” No specific treatments or medications significantly change the recovery process, though some recent small studies show that light aerobic conditioning can expedite recovery. Time and rest are the keys to treatment. This prescription for recovery isn’t always welcomed by active people, but it truly is the best thing to do to ensure a good recovery.

Patients are typically evaluated by primary care physicians, neurologists, pediatricians and/or psychologists/psychiatrists. Recognizing that a patient has suffered a concussion is paramount to preventing a rare condition that can happen in athletes, known as “second impact syndrome.” With this syndrome, a patient suffers a second head injury while symptomatic from an earlier injury. This can cause significant swelling in the brain and commonly causes permanent brain injury; it can be fatal.

Second impact syndrome is more common in teenagers and children, as both groups are at higher risk for head injury as well as for multiple impacts to the head. “If you think you or someone you know has suffered a concussion, it’s important to seek good medical guidance,” said Dr. Miller. “It’s very important to recognize a concussion as quickly as possible, and to be sure a patient has recovered completely before returning to any activity that risks another head injury.” Because there is no perfect definition or guideline proven to determine when a person is safe to return to activity following a concussion, concussion patients must avoid subsequent head injuries.

“We do have consensus on that: The universal recommendation of experts is that a symptomatic person should not return to any activity that has any risk of head injury,” said Dr. Miller. “We also agree that to reduce the severity of potential brain trauma in sports, athletic and outdoor activities that have a potential to knock you on the head — always wear a helmet.”


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