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What is a Concussion/ mTBI
“Concussions are defined as a COMPLEX pathophysiological process affecting the brain induced by traumatic biomechanical forces.” (Zurich, 2008)
Concussion/mTBI denotes the acute neurophysiological event related to blunt impact or other mechanical energy applied to
the head, neck or body (with transmitting forces to the brain), such as from sudden acceleration, deceleration or rotational
forces. Concussion can be sustained from a motor vehicle crash, sport or recreational injury, falls, workplace injury, assault
or incident in the community. (Ontario Neurotrauma Foundation)
A concussion is a type of traumatic brain injury that results from a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth creating a whiplash effect. This sudden movement can cause the brain to bounce around or twist in the skull, stretching and damaging the brain cells (axons) and creating biochemical changes in the brain not due to bleeding, tearing or bruising of the brain. Concussions result in temporary alteration of mental functioning. Furthermore this can include physical, emotional/social, cognitive symptoms and sleep disturbances. Signs and symptoms can be delayed appearing hours or days later. Concussions cannot be seen on X-ray or CT scan. Concussions do not have to be a result of loss of consciousness. When a student is injured and has a second concussion while he/she still has symptoms from a previous concussion which can lead to permanent disability and even death. The second injury may be very mild but can progress and have serious consequences.
Concussions are caused by a sudden shift of the brain in the skull. This quick shifting of the brain causes the brain to have altered function and metabolic properties resulting in a variety of symptoms that can range from mild to severe. Even blows to the body, face or head can result in shearing effects leading to rotation injuries as well as flexion/extension injuries. Note: Most gold standard imaging techniques such as MRI and CT will also show up as negative.
A multi-disciplinary approach
Our approach to concussion care offers safe, drug-free treatments and has been proven to be highly effective. Our concussion care team is a multi-disciplinary group of highly trained professionals. Our team works together and with doctors and other specialists (with your consent) to ensure you receive the right treatment.
We can help address the various symptoms related to concussions, including headache, fatigue, poor concentration, light and noise sensitivities, vision issues and more.
How can a concussion care treatment plan help me?
By taking an active role and with guidance from a qualified concussion team, you can take back your life. Every concussion is unique and we tailor our care to meet your needs. A comprehensive assessment and treatment approach is taken to provide focused treatment for all systems involved.
How does it work?
Concussions are complicated and therefore treatment needs to be individualized, multi-disciplinary and progressive. Your treatment plan may include a combination of approaches such as active exercise, manual therapy, vestibular therapy, cognitive behavioral therapy, education and more.
What can I expect at my initial appointment?
At your initial appointment we will discuss any medical history that relates to your condition, so please bring details of any health problems and past treatments. We will discuss your customized treatment plan and explain when you can expect to see results.
Diagnostic Criteria
Concussion/mTBI is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces. Several common features that incorporate clinical, pathologic, and biomechanical injury constructs that may be utilized in defining the nature of a concussion/mTBI include:
1. Concussion/mTBI may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an‘‘impulsive’ force transmitted to the head.
2. Concussion/mTBI typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, symptoms and signs may evolve over a number of minutes to hours.
3. Concussion/mTBI may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.
4. Concussion/mTBI results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course. However, it is important to note that in some cases symptoms may be prolonged. (MTBI guidelines).
Clinical Sub-types of Concussion
Cognitive-Fatigue
Fatigue, tiring more easily,” “forgetfulness, poor memory,” “poor concentration,” and
“taking longer to think,” as being associated with the cognitive fatigue
profile.
Vestibular
We identified the two items, “feeling of dizziness” and “balance
problems,” as being associated with the vestibular profile.
Oculomotor
We identified the two items, “blurred vision” and “double vision,”
as being associated with the oculomotor profile.
Anxiety/Mood
We identified the four items, “being irritable, easily angered,”
“feeling depressed or tearful,” “feeling frustrated or impatient,”
and “restlessness,” as being associated with the anxiety/mood
profile.
Migraine
We identified the four items, “headaches,” “noise sensitivity, easily upset by loud noise,” “nausea and/or vomiting,” and “light sensitivity, easily upset by bright light,” as being associated with
the migraine profile.
Cervical
Typically associated with whiplash or direct trauma
Sleep
Lack of sleep, disturbance ” or “drowsiness throughout the day.
Our promise to you
To improve and provide the best evidenced based practices in the treatment of Concussion and Traumatic Brain Injury. To help reduce the severity of concussions in the local school boards, and surrounding areas. To educate the community, coaches and parents about concussions including the signs and symptoms, treatment, rehabilitation and progressions.