Let's get smart on what a concussion is.

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Let's get smart on what a concussion is.

Postby LostPenguin on Sat Apr 06, 2013 7:29 am

"Are you an expert?" -- Andy Sutton

Lots of discussion overnight as to whether James Neal suffered a concussion after the elbow by Whatshisname.

"Can you be knocked out without suffering a concussion?"
"I believe so."
"Sure can"
"Absolutely. There is actually a nerve in the area of your chin/mouth that can be hit just right and turn everything off for just a second."
"I was attacked with metal pipe to the back of my head. Knocked me out for 10 seconds, got up said what the hell happened. Got checked out and had no concussion. Sure is possible."

Purpose of this post, is to say that all of the above is incorrect.

From MayoClinic.com:

If a blow to your head, neck or upper body has caused symptoms such as a headache, dizziness, nausea or loss of consciousness, you've had a concussion.

If you pass out, you've had a concussion!

If Neal lost consciousness (and I believe he did, due to his 'Whaaa happennn?' shortly afterward), he had a concussion.

Mister 'I Was Attacked With A Metal Pipe' ... had a concussion.

Also, I asked a bona fide medical doctor about this nerve around the mouth that can turn everything off for just a second. Doc said 'We don't have an off switch! There's no such thing!'
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Re: Let's get smart on what a concussion is.

Postby tikidoc on Sat Apr 06, 2013 8:18 am

I'm not sure if Neal actually lost consciousness, but he was obviously disoriented and confused. Again, concussion, by definition. His brain function was temporarily interrupted by a blow to the head. Probably a mild concussion, but a concussion nonetheless.

There are multiple grading systems for concussions, and no consensus on which one is the best, but in all of them that I have seen, loss of consciousness moves you up to at least a grade 2 concussion. And NONE of them say that anyone who has had a blow to the head and loss of consciousness, even a very briefly, could be considered to have not suffered a concussion.
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Re: Let's get smart on what a concussion is.

Postby Pensfan4life27 on Sat Apr 06, 2013 8:24 am

I feel Neal will be back by Tuesday which is our next game. We have a luxury now of only having 4 games in the next two weeks so guys can rest and get healthy. I think Neal and Letang play Tuesday. Leaving only Martin and Crosby to get healthy.

Go Pens!
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Re: Let's get smart on what a concussion is.

Postby marek on Sat Apr 06, 2013 10:41 am

My ex wife had an off switch.
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Re: Let's get smart on what a concussion is.

Postby LostPenguin on Sat Apr 06, 2013 2:56 pm

marek wrote:My ex wife had an off switch.


Aaaah ... was it activated by an elbow to her chops?
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Re: Let's get smart on what a concussion is.

Postby Rylan on Sat Apr 06, 2013 3:53 pm

uhoh...last time a thread like this happened....
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Re: Let's get smart on what a concussion is.

Postby ExPatriatePen on Sat Apr 06, 2013 3:58 pm

marek wrote:My ex wife had an off switch.


Mine didn't, that's why we aren't together anymore. :)
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Re: Let's get smart on what a concussion is.

Postby pensfan1989 on Sat Apr 06, 2013 5:02 pm

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Re: Let's get smart on what a concussion is.

Postby torartc on Sat Apr 06, 2013 5:22 pm

I recently came back with a 6 month recovery from a concussion. I saw a sports neurologist for months monitoring my recovery. I'd love to answer any questions anyone has about concussion related injury. It's been a year and 1 month since my concussion and I'm still on meds for my symptoms, and I'll most likely have bad migraines, loud tinnitus (ear ringing) for life. I was 25 when I suffered my injury.
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Re: Let's get smart on what a concussion is.

Postby Gaucho on Sat Apr 06, 2013 5:29 pm

What happened to nastystang? I sure hope moondart didn't chase him off for good.
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Re: Let's get smart on what a concussion is.

Postby Gaucho on Sat Apr 06, 2013 5:30 pm

torartc wrote:I recently came back with a 6 month recovery from a concussion. I saw a sports neurologist for months monitoring my recovery. I'd love to answer any questions anyone has about concussion related injury. It's been a year and 1 month since my concussion and I'm still on meds for my symptoms, and I'll most likely have bad migraines, loud tinnitus (ear ringing) for life. I was 25 when I suffered my injury.


Here's wishing for a full recovery.
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Re: Let's get smart on what a concussion is.

Postby torartc on Sat Apr 06, 2013 5:37 pm

Gaucho wrote:
torartc wrote:I recently came back with a 6 month recovery from a concussion. I saw a sports neurologist for months monitoring my recovery. I'd love to answer any questions anyone has about concussion related injury. It's been a year and 1 month since my concussion and I'm still on meds for my symptoms, and I'll most likely have bad migraines, loud tinnitus (ear ringing) for life. I was 25 when I suffered my injury.


Here's wishing for a full recovery.



Thanks! I've been practicing at full strength since Sept and only had a minor setback with a headbump this March. I'm a bboy (breakdancer) so my sport almost constantly involves the head making contact with things. I've found that Yoga has been the best workout / recovery.
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Re: Let's get smart on what a concussion is.

Postby ExPatriatePen on Sat Apr 06, 2013 5:40 pm

torartc wrote:
Gaucho wrote:
torartc wrote:I recently came back with a 6 month recovery from a concussion. I saw a sports neurologist for months monitoring my recovery. I'd love to answer any questions anyone has about concussion related injury. It's been a year and 1 month since my concussion and I'm still on meds for my symptoms, and I'll most likely have bad migraines, loud tinnitus (ear ringing) for life. I was 25 when I suffered my injury.


Here's wishing for a full recovery.



Thanks! I've been practicing at full strength since Sept and only had a minor setback with a headbump this March. I'm a bboy (breakdancer) so my sport almost constantly involves the head making contact with things. I've found that Yoga has been the best workout / recovery.


torartc dances! Start the thread now! :) j/k torartc, wishing you the best!
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Re: Let's get smart on what a concussion is.

Postby no name on Sat Apr 06, 2013 6:52 pm

torartc wrote:I recently came back with a 6 month recovery from a concussion. I saw a sports neurologist for months monitoring my recovery. I'd love to answer any questions anyone has about concussion related injury. It's been a year and 1 month since my concussion and I'm still on meds for my symptoms, and I'll most likely have bad migraines, loud tinnitus (ear ringing) for life. I was 25 when I suffered my injury.


Any suggestions for the Tinnitus have you done anything for this, Doctor told me there is nothing they can do for that. I got it also. I use a white noise maker at night, it helps to fall asleep.
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Re: Let's get smart on what a concussion is.

Postby Scott on Sun Apr 07, 2013 2:55 am

I have been through a massive head trauma so I can speak all about it. As a matter of fact my Doctor told me I'm now half a terminator. The left side of my head and face is the Terminator.

Currently I coach contact sports and have for the last dozen years so I am educated top to bottom on the concussion.

This is one statement that IS NOT TRUE...if you get a headache then you had a concussion. If you have a concussion legit like, you very well may get a headache. However just because you got a headache DOES NOT mean you had a concussion.

Over the years in sports people were ignorant to the "C" word. It just never surfaced. 2013 is here and people have gone the other way to an extreme level that if you bang your head on your car roof you might be concussed.

Mayo clinic or not, I can assure you that a headache, and some dizziness to some degree does not AUTOMATICALLY mean concussion.

Also if anyone cares, the Doctor who rebuilt me and educated me was the same DOC who fixed Ben Roethlisberger after his cycle accident and he would have been the one who just rebuilt Sid's lower face/jaw.

YES INDEED you can be knocked out and NOT have a concussion. They are NOT one in the same. They are two different animals. You could be knocked out and have a concussion too, however just because you got knocked out is not a guarantee concussion.

Anyone with any questions feel free to ask.


P.S.

Please know how the mayo clinic operates. If they say something then could be held liable. Do you realize the ramification that would ensue. So better safe than sorry. A lot of Doctors fall into this as well...they are terrified to say something ISN'T a concussion. If they diagnose something all the way to the top they have nothing to lose if someone takes the steps to deal with a concussion. On the other hand if they say no to a concussion and it turns out he has one...again the ramification from that is crazy.

Until someone comes out with a magical machine to say concussion or not instantly....everyone will continue to diagnose everything from an overly safe attitude.
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Re: Let's get smart on what a concussion is.

Postby headh on Sun Apr 07, 2013 7:46 am

There is no such thing as "overly safe" when it comes to head trauma.
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Re: Let's get smart on what a concussion is.

Postby tikidoc on Sun Apr 07, 2013 8:22 am

OK, forget Mayo Clinic's definition (although it is correct). The American Association Of Neurological Surgeons defines a concussion as "an injury to the brain that results in temporary loss of normal brain function." This is the accepted definition of "concussion" in the medical community. It's actually quite simple. It is also what I was taught in medical school.

A blow to the head associated with a loss of consciousness fits that definition. If you black out, you have injured your brain. It might be a mild injury, it may be 100% reversible, but that is a concussion, by definition.

So, Mr. Coach, do you know more than neurological surgeons?
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Re: Let's get smart on what a concussion is.

Postby tikidoc on Sun Apr 07, 2013 8:30 am

I'm also going to cross-post this from what I posted in another thread, because it is relevant here.

The diagnosis of a concussion is a purely clinical diagnosis. What that means is that you go by symptoms, physical exam, and history when making the diagnosis of a concussion. There is no imaging test that can be done to give a definitive answer. This is in contrast to many medical diagnoses which do have tests that establish a diagnosis. Cancer is diagnosed by the finding of abnormal cells on a biopsy. Down Syndrome is diagnosed by the finding of an extra copy of chromosome 21 in the cells. Intracranial hemorrhage can be diagnosed by seeing a bleed on CT or MRI.

With a concussion, certain findings on physical exam can support the diagnosis (such as slurred speech, slowed reaction time, impaired mental status) but the main things used in the establishment of a diagnosis are history (usually a blow to the head, but sometimes a whiplash type injury without any direct head trauma) along with some sort of impairment of brain function. A concussion is a mild traumatic brain injury, by definition. Loss of consciousness (LOC) certainly fits the criteria, and the combination of head trauma with associated LOC ALWAYS indicates concussion, but most concussions occur without LOC. Other symptoms can include (but are not limited to) headache, nausea and/or vomiting, blurred vision, memory loss, cognitive impairment and others.

The longer the symptoms persist, the more severe the concussion. Having a concussion makes you more susceptible to traumatic brain injury in the future, which is why someone who has had more than one concussion is generally told to not resume contact sports for a much longer period of time than someone who has had their first concussion. The likelihood of permanent injury increases with multiple concussions, and this is illustrated by what we are seeing now with retired boxers and football players, many years after their injuries.
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Re: Let's get smart on what a concussion is.

Postby tikidoc on Sun Apr 07, 2013 8:43 am

And if the Mayo Clinic and AANS are not enough for you, Mr. Coach, how about the World Health Organization's Collaborative Center Task Force on Mild Traumatic Brain Injury? Mild Traumatic Brain Injury is the medical term for "concussion".

"MTBI is an acute brain injury resulting from mechanical energy to the head from external physical forces. Operational criteria for clinical
identification include: (i) 1 or more of the following: confusion or disorientation, loss of consciousness for 30 minutes or less, post-traumatic
amnesia for less than 24 hours, and/or other transient neurological abnormalities such as focal signs, seizure, and intracranial lesion not requiring
surgery; (ii) Glasgow Coma Scale score of 13–15 after 30 minutes post-injury or later upon presentation for healthcare. These manifestations of
MTBI must not be due to drugs, alcohol, medications, caused by other injuries or treatment for other injuries (e.g. systemic injuries, facial injuries
or intubation), caused by other problems (e.g. psychological trauma, language barrier or coexisting medical conditions) or caused by penetrating
craniocerebral injury."

This is a slight modification of the American Congress of Rehabilitation Medicine Special Interest Group on Mild Traumatic Brain Injury, which used the following diagnostic criteria:

"A traumatically induced physiological disruption of brain function, as manifested by at least one of the following:
any loss of consciousness
any loss of memory for events immediately before or after the accident
any alteration in mental state at the time of the accident (e.g., feeling dazed, disoriented, or confused) and
focal neurologic deficit(s) that may or may not be transient
But where the severity of the injury does not exceed the following:
loss of consciousness of approximately 30 min or less
after 30 min, an initial Glasgow Coma Scale score of 13–15 and
post-traumatic amnesia not greater than 24 hr

"Anyone with any questions feel free to ask." I would be happy to provide citations.
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Re: Let's get smart on what a concussion is.

Postby Lt. Dish on Sun Apr 07, 2013 1:15 pm

Image
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Re: Let's get smart on what a concussion is.

Postby Lt. Dish on Sun Apr 07, 2013 1:16 pm

torartc wrote:I recently came back with a 6 month recovery from a concussion. I saw a sports neurologist for months monitoring my recovery. I'd love to answer any questions anyone has about concussion related injury. It's been a year and 1 month since my concussion and I'm still on meds for my symptoms, and I'll most likely have bad migraines, loud tinnitus (ear ringing) for life. I was 25 when I suffered my injury.


Good luck to you! Thanks for sharing your experience and welcome to the board.
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Re: Let's get smart on what a concussion is.

Postby Pavel Bure on Sun Apr 07, 2013 1:28 pm

This thread is so smarmy.
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Re: Let's get smart on what a concussion is.

Postby Scott on Sun Apr 07, 2013 3:39 pm

tikidoc,
or should I say mr Med Student.

your sarcasm is very inane however I will respond. A concussion is one of those symptoms that isn't identical from one case to the next. Symptoms can vary from one person to the next. One of the reasons they monitor for concussion type symptoms because they may flare up after some time of the incident.

So Mr Med student, since you feel that anyone that experiences those symptoms that you mentioned has a concussion, since its so black and white, then how on earth do the Steelers even field a team every week. If a player has a headache after having played a tough physical game, then according to you
he is concussed. Right? There is no other factors going on there. He is concussed and sit him for a few weeks. Is that what you are saying? If Suzy homemaker hits her head off a cupboard door and gets a headache of any sort from that then she is concussed? Yes? SERIOUSLY.

Obviously if a player has a headache ALONG WITH OTHER SYMPTOMS then alarm bells ring. As they should.

Mr Med Student it appears you are on your way to being the wealthiest doctor in the world since you seem to know exactly when, who, why, and how on the concussion. I, on the other hand, simply understand that when it comes to any form of head injury every case is different and there are zero guarantees. Just because an athlete gets a headache does not mean he is concussed.

Oh and mr med student I would also like for you to come see some of these doctors around here who would never diagnose anything wrong. Please help them because they are as ignorant and paranoid to the injury at best.
Someone posted there is no such thing as being overly cautious with a head trauma. That is true to a point however my use of overly should have been changed to ignorant. Case in point, we had a player who had a headache after football. Went on a couple of days, so off to the Doctor he goes.

The first Doctor said do you play football? He said yes. The Doctor did not ask to see the helmet he was wearing, ask about any specific plays that may have triggered this headache, ask about the temperature. Moreover the Doctor did zero testing. The Doctor asked do you play football? The kid said yes. The Doctor said you have a concussion. After leaving the parents weren't happy with this doctor. Nobody was. It wasn't because he said concussion and it meant the kid couldn't play but rather the ignorance of the doctor to diagnose it in such a simple fashion.
The point? Two other doctors did a much more thorough examination of the player and it was deemed he was fighting a sinus infection.
The bigger point?
Yes I would call that a little overly cautious. In reality this is an example of a doctor not understanding to the best of the medical world's knowledge on a concussion. So right away he just goes right to the top and says concussion. I'm not suggesting that a player doesn't have a concussion rather a sinus infection but do you see just how ignorant the medical field is to this injury? Do you also see how a so called expert like yourself can read the journals and will just determine when in doubt, concussion.

In all Mr med student the only guarantee with a concussion is that there are no guarantees. This injury is different from any other kind. Symptom time and recovery time is even worse because there is no set time. It is different each and every incident.
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Re: Let's get smart on what a concussion is.

Postby torartc on Sun Apr 07, 2013 3:44 pm

ExPatriatePen wrote:
torartc wrote:
Gaucho wrote:
torartc wrote:I recently came back with a 6 month recovery from a concussion. I saw a sports neurologist for months monitoring my recovery. I'd love to answer any questions anyone has about concussion related injury. It's been a year and 1 month since my concussion and I'm still on meds for my symptoms, and I'll most likely have bad migraines, loud tinnitus (ear ringing) for life. I was 25 when I suffered my injury.


Here's wishing for a full recovery.



Thanks! I've been practicing at full strength since Sept and only had a minor setback with a headbump this March. I'm a bboy (breakdancer) so my sport almost constantly involves the head making contact with things. I've found that Yoga has been the best workout / recovery.


torartc dances! Start the thread now! :) j/k torartc, wishing you the best!


Haha yeah, instead of a thread, here is a quick move
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Re: Let's get smart on what a concussion is.

Postby torartc on Sun Apr 07, 2013 3:48 pm

no name wrote:
torartc wrote:I recently came back with a 6 month recovery from a concussion. I saw a sports neurologist for months monitoring my recovery. I'd love to answer any questions anyone has about concussion related injury. It's been a year and 1 month since my concussion and I'm still on meds for my symptoms, and I'll most likely have bad migraines, loud tinnitus (ear ringing) for life. I was 25 when I suffered my injury.


Any suggestions for the Tinnitus have you done anything for this, Doctor told me there is nothing they can do for that. I got it also. I use a white noise maker at night, it helps to fall asleep.



Yeah! I've been using a white noise or a binaural beats app to help while trying to sleep. Other than that, I'm on Nortyptaline which is an antidepressant that has really done wonders for my post concussive symptoms. That's really the only thing that's been able to stop my Tinnitus although I'm trying to slowly get off meds altogether at the moment.
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