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Concussion, Traumatic Brain Injury…Are They One in the Same?

9/12/2022

 
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A concussion is a type of traumatic brain injury (TBI), but not all TBIs are considered concussions…
Our March 2022 blog post for Brain Injury Awareness Month explored definitions of different types of brain injury, including Traumatic Brain Injury, or TBI. A TBI is a type of acquired brain injury (ABI), meaning that it occurs after birth and is not developmental or hereditary in nature. When a person sustains a TBI, there is an “...alteration in brain function, or other evidence of brain pathology, caused by an external force..” such as from a fall, car accident, or gunshot wound. 

Individuals can experience different levels of severity of TBI, ranging from mild to severe. Severity is often dependent upon many factors, such as: extent of brain injury; duration of loss of consciousness; and presence of signs or symptoms of cognitive disruption (e.g., confusion, loss of memory). However, it should not be assumed that severity always equates to a person’s level of performance or abilities. 

A concussion is defined as a mild TBI (mTBI) in which an individual can lose consciousness for up to 30 minutes, appear disoriented, and exhibit loss of memory. Concussions are the most common type of TBI, making up 75% of such injuries. Children and adults can be diagnosed with a concussion. Typically, imaging results such as a computed tomography (CT) or magnetic resonance imaging (MRI) scans do not depict any structural changes to the brain when a concussion occurs. Rather, there are changes at a cellular or chemical level when the head is struck and moves about within the skull. 

Though termed “mild” TBIs, concussions should be treated as seriously as moderate and severe TBIs, as the accompanying signs of a concussion can be debilitating for some. Changes to appetite, vision, and environmental sensitivity can make it difficult to return to work or school. Individuals may note changes in their ability to find the right words to say, stay focused in conversations, or remember details. 

Most individuals who sustain a concussion will fully recover within days to weeks. A small percentage of people may experience persistent symptoms beyond one to three months after their initial concussion. Post-Concussion Syndrome may be diagnosed at the one year mark of ongoing symptoms, but requires comprehensive testing to determine the role that additional factors may play in exacerbating symptoms (e.g., psychosocial history, sleep disorder, or presence of pain prior to concussion). A history of repeated, prior concussions can also impact long-term recovery. 

Treatment for concussion is multifactorial. Focus is placed on a balance of gradual re-entry to daily routines and management of overall health and wellness. A patient should be followed by a functional neurologist or concussion specialist who can support medication management and ongoing assessment of neurologic presentation following a concussion. Patients may also receive referrals to see:
  • Occupational Therapists (may specialize in vision needs)
  • Neuro-ophthalmologists
  • Physical Therapists (may specialize in vestibular/balance needs)
  • Speech-Language Pathologists (may specialize in cognitive-linguistic needs)
  • Cognitive-Behavioral Therapists
  • Psychologist or Psychiatrists
  • Neuropsychologists

If you or someone you know has recently experienced a concussion, follow up with your doctor to obtain a referral to a functional neurologist or concussion specialist for further assessment and care. Should an in-depth assessment of cognitive abilities be needed to determine a plan for return to work or school, contact Cognition, Speech & Language for a free consultation. 

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    Devon Brunson, MS, CCC-SLP, CBIS

    Welcome to the CSL Blog - musings about treatment, education, care, and advocacy.

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