Scoping for Concussion
Concussion
A concussion is a mild form of traumatic brain injury (TBI) that causes a disturbance in brain function. The Centers for Disease Control and Prevention estimates about 1.7 million Americans sustain a TBI each year. About 75 percent of these cases are classified as a concussion.
Signs of a potential concussion include headache, nausea, vomiting, sensitivity to light or noise, double or blurred vision, trouble with balance, confusion, difficulty with concentration, memory problems, extreme fatigue, irritability and sleep disturbances. Unlike severe head trauma, a concussion may or may not cause a loss of consciousness. In addition, in some patients, not all signs appear immediately.
Sports and recreational activities account for up to 3.8 million concussions annually in the U.S. Children 5 to 18 make up 6 percent of these cases. The sports most commonly associated with concussion include bicycling, football, basketball and soccer.
Diagnosing Concussions
It's important for an athlete who has had a concussion to temporarily refrain from playing sports or other activities that could lead to another head injury. Research shows that the effects of successive or multiple head injuries can be cumulative and cause potentially serious, permanent brain damage.
Coaches and trainers should know how to spot signs of a concussion in an athlete and, if necessary, send the player for an evaluation and medical clearance before allowing him/her to return to play. However, Jeffrey Bazarian, M.D., M.P.H., Emergency Physician with the University of Rochester Medical Center in Rochester, NY, says it's often difficult to determine the extent of brain injury because some patients appear to be fine, but still have impaired function.
One of the unseen risks associated with concussion is bleeding in the brain, which can cause more serious neurological problems, like a stroke. Bazarian says bleeding only occurs in 5 percent of patients with a concussion. However, since the effects of a bleed are so serious, doctors often err on the side of caution and perform CT brain scans on many concussion patients.
Scoping Out a Better Way to Diagnose Concussion
Bazarian is undertaking a study to test a concussion-detecting device from a company called, BrainScope. The BrainScope device uses EEG technology to study brain waves of patients suspected of having a concussion. A headband with eight electrodes is placed over the forehead and temples. The electrodes detect and record brain wave activity and send the information to a handheld computer device. The computer analyzes the data and lets the physician know if the brain wave activity is within normal parameters. Bazarian says the auto-evaluation is important because emergency room physicians are not trained to read the results of an EEG and finding a neurologist to translate the readings takes extra time.
A study published last year from high school and college athletes found the BrainScope device could effectively determine if an injured athlete had abnormal changes in brain activity (indicating a concussion). In fact, the study found some affected athletes showed impaired brain activity for several days after they were presumed to be "recovered".
Bazarian says the BrainScope device is still under study. Researchers are still trying to validate the computer program used to assess normal vs. abnormal brain activity. In addition, the investigators hope to see if the technology can help doctors determine which patients are likely to have a brain bleed. If that part of the technology works out, fewer athletes would need a brain CT scan. Bazarian is hopeful that the BrainScope technology will one day be incorporated into a portable device that can be used on the field.
Research compiled and edited by Barbara J. Fister
Brain Injury Association of America, http://www.biausa.org
Centers for Disease Control and Prevention, http://www.cdc.gov/Concussion
For information on the company, BrainScope, go to http://www.brainscope.com/index1.shtml
