Not All Concussion Recoveries are Created Equal

Not All Concussion Recoveries are Created Equal

Posted By Vernon B. Williams, MD || 30-Nov-2015

There is so much about the concussion process that isn’t yet fully understood by science. How can one athlete seemingly return to “normal” hours after what looks like a knockout blow to the head during a big game, while another takes weeks to fully recover from what seemed to only be a slight ‘ding’ during practice? Though I am pleased to say we’re no longer in the traumatic brain injury ‘Dark Ages,’ there is still so much research yet to be done and information from it to be learned about how individuals recover from concussive trauma. This can understandably create confusion among a public that often hears of the serious health implications of concussion and wants concrete answers about how to best minimize the life-altering consequences that can be associated with them for some people. But one thing we do know to be true today, is that not all people are the same with how their brains and neurological processes recover from traumatic brain injuries, even the mild ones.

With concussion such a hot and controversial topic in the news media, especially as it relates to professional athletics, (namely NFL football players,) I had the opportunity recently to provide some sports neurology perspective in an interview with a major newspaper. The story focused on the return-to-play of an athlete who had suffered a concussion just a few days earlier, only to sustain another just hours after being cleared to play by an independent neurologist. It is understandable that the public at large gasps in alarm when an athlete suffers a second concussion shortly after having been cleared to return to play post-concussion. They point to that “other” professional athlete (insert name of any high profile athlete who has sustained a concussion here,) and cite his or her two or three week hiatus from sport after just one concussion. They think the medical team should have known better. The truth however is that this isn’t intentional medical negligence or the putting the lives of players at risk just for a chance to win the next game. It really has to do with how each person, individually and regardless of their status, recovers from a concussion.

What we know to be true about professional football players is this: it is clinically believed that there is some increased risk of chronic or long-term neurological impairment after repeated concussions, sometimes after just one. But what that risk looks like 20, 30 or 40 years down the road, we really don’t know. Because we don’t have a one-size-fits-all roadmap to concussion risk or recovery, we do the best we can with the proven tools we have. That includes expert neurological evaluation, management and monitoring – and we make individual recommendations based on the results of each of these encounters, not necessarily on the collective number of concussions sustained over an arbitrary period of time.

And while it is true that we may not yet know EVERYTHING there is to know about concussion’s effects on the brain, it doesn’t mean we know NOTHING. Quite the contrary, actually. Neurological researchers today are making incredible inroads when it comes to how we evaluate and treat traumatic brain injuries that were nothing more than a mere “hunch” just a decade or so ago. While we have a ways to go, we are heading in the right direction. The more collaboration we neurologists can do together, while simultaneously accurately and effectively educating our patients and the public, the better equipped we all will be in the future to diagnose, treat and hopefully one day prevent concussions.

Categories: Blogs & Updates

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