Concussion and TBI

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Expert management of traumatic brain injury

What is a traumatic brain injury?

 

Trauma causing any severity of brain dysfunction would be considered a traumatic brain injury (TBI).  TBI is common condition, accounting for approximately 2.5 million emergency visits in the US annually.  A vast majority TBIs are mild in severity, and complete recovery happens for greater than 90% of patients.

 

What are the typical symptoms after traumatic brain injury?

 

Traumatic brain injury results in a semi-predictable pattern of symptoms that each require management:

  • Headache.  Headache is nearly ubiquitous after head injury and often the most debilitating symptom, and treatments specific for post-traumatic migraines, cervical neck pain, occipital neuralgia, and generalized post-traumatic headaches are tailered to each patient.

  • Dizziness.  Imbalance and dizziness are very common after head trauma, affecting up to 80% of patients. In up to 20% of cases, sustained post-taumatic dizziness can occur.  Specific treatments, including physical therapy, inner ear therapies, and cognitive therapies may be needed to resolve lingering balance issues.

  • Cognitive impairment.  Not surprisingly, cognitive impairment is a common symptom after traumatic brain injury consider the effects on the frontal lobe circuits involving memory, focus, concentration, and executive functions such as planning.  Cognitive training, medications, brain stimulation, and other interventions are used to address cognitive symptoms.

  • Mood effects.  The psychiatric and mood effects of traumatic brain injury are often overlooked.  Frontal lobe circuits regulating anxiety, depression, motivation, and frustration are often direct recipients of the concussive forces that result from TBI, and these circuits become dysfunctional as they require the same type of repair that other circuits in the brain do.  Brain stimulation, medications, and cognitive therapies may be necessary steps to address lingering mood symptoms.

  • Sleep disturbances.  Impaired sleep is very common after TBI, and since we spend 1/3 of our life sleeping, it is no wonder that sleep impairment can dramatically affect memory, mood, cognition, pain, and balance after TBI.  Accurate diagnosis and treatment of insomnia is necessary for healing after traumatic brain injury.

  • Fatigue.  Fatigue is a very common symptom after TBI.  During the recovery and repair phase of TBI, the brain's resources are diverted from normal brain functions and toward repair of damaged circuits.  Medications, rest, and cognitive therapies are necessary to address post-concussive fatigue.

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