Concussions have been have been making headlines across the country in the sports world and in Hollywood with actor Will Smith starring in the new movie “Concussion.” The Centers for Disease Control and Prevention estimates that there are as many as 3.9 million sports-related and recreation-related concussions that occur in the United States annually. According to renowned Mayo Clinic neurologist, Dr. Amaal Starling concussions are not only caused by blows to the head, but also blows to the body. Dr. Starling was kind enough to join me for an interview yesterday to discuss what a concussion is, the most common symptoms, myths and misconceptions, treatment options and much more.
Candace Rose: What is a concussion?
Dr. Amaal Starling: “A concussion is abnormal brain function as a result of a blow to the head. It can cause a variety of symptoms. I like to categorize the symptoms in specific categories – one being physical symptoms such as headache, dizziness or lightheadedness, sensitivity to light, sensitivity to sound, as well as problems with thinking skills such as concentration, memory or attention.
There can also be emotional symptoms of a concussion which I definitely like to highlight because sometimes they’re overlooked. Those things are like depression, anxiety, difficulty controlling emotions, irritability or simply a change in personality, as well as difficulties with sleep where individuals are sleeping too much or sleeping too little, so a concussion is abnormal brain function causing those variety of symptoms.”
Candace Rose: How are concussions typically caused?
Dr. Amaal Starling: “Concussions are typically caused by some sort of blow to the head or it can be caused by even a blow to the body because the brain itself is floating inside of spinal fluid inside of the skull which is a hard box. Even if there is a blow to the body, the brain can hit the front and the back of the skull and can become injured. But the most common way a concussion occurs is when there is a blow to the head causing brain disfunction.”
Candace Rose: How long do symptoms typically last?
Dr. Amaal Starling: “That is a great question, and I’m so glad that you’ve asked it. Concussion symptoms can last several days or even longer periods of time. It varies greatly amongst individuals. Amongst concussion experts, one of the things that we say is that when you’ve seen one concussion, you’ve seen one concussion, meaning that each individual has a varied course with a variety of symptoms. Although oftentimes you will hear that people will say that a concussion and the symptoms of a concussion can only last seven to 10 days, I’m here to tell you and educate you and your listeners that sometimes it can take much longer than that and that it can require us to evaluate all of the different risk factors that may cause there to be a longer recovery.
The other important thing that I want to highlight here is that we know from our scientific data that the brain disfunction can actually outlast the symptoms that are present, which is why it is so important for individuals that have had a concussion to be involved with a medical professional so that they not only monitor the resolution of symptoms, but also objectively monitor brain disfunction which the individual themselves may not be aware of.”
Candace Rose: Can a concussion cause permanent damage?
Dr. Amaal Starling: “The majority of concussions will recover and improve. However, we do think (and based on our research available right now) that repetitive hits to the head can potentially cause longer term issues and that is something that is an active area of research. The National Institute of Health has recently funded a number of grants including one to the Mayo Clinic here so that we can evaluate what is the risk of having repetitive hits to the head.
Another study that we’re doing here at Mayo Clinic is with our youth athletes and looking at what is the risk of being involved with contact sports from the age of five all the way up to adulthood. We’re going to be monitoring and researching these individuals over time so that we can answer that question in a better and more productive way.”
Candace Rose: Do you think parents should limit the amount of time that their kids play contact sports or have them start playing contact sports at a later age?
Dr. Amaal Starling: “What I think is important for parents to know is that the benefits of playing sports and being physically active undeniably are important from a physical, from a mental and social skills perspective. We know that kids that play sports have lower risks of obesity, have better grades in school, have a lower risk of having risk taking behaviors and do better in college and adulthood, so sports are a crucial part of childhood development.
At the same time when an individual and when your child is considering playing sports, the parent should be educated about concussions, should make sure that their child has had preseason neurological or brain function assessments, and make sure that the organization that the child is playing with has appropriate concussion protocols – remove from play protocols; as well as once there has been a concussion, what is the process for returning to play.”
Candace Rose: What are some of the most common treatment options?
Dr. Amaal Starling: “At this time one of our most common treatment options is that we allow for the brain to rest with mental and physical rest, but at the same time we identify all of those symptoms and we treat each individual symptom.
We have some initial data specifically for headache that demonstrates that headache is the most common symptom after a concussion and if we can aggressively and proactively treat that headache, we can prevent that headache from becoming persistent or permanent. We identify all of the symptoms and we treat them. We provide physical therapy, occupational therapy, balance therapy, thinking skill therapy to try to speed that recovery. We increase their level of mental and physical activity and we monitor them carefully over time and we also do objective tests to make sure that they’ve returned to their preseason baseline brain function before we then return them to full game play.”
Candace Rose: Do you have any additional tips or information you’d like to share with us?
Dr. Amaal Starling: “What I want for everybody to know is that concussion is a traumatic brain injury, however the majority of concussions are something that improves. What we need to do is increase our awareness and our education at a public level, as well as at a national level with individuals in the National Institute of Health, so that we can increase the funding for concussion research and that we can eventually start to answer many of these unanswered questions.”
Candace Rose: Where can we go for more information, Dr. Starling?