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Natural Awakenings Tucson

Thinking Twice About Return to Play After Sports Concussion

May 30, 2020 12:55AM ● By Carol L. Henricks
It has become clear in the neurological literature that symptom resolution after a concussion does not equal brain recovery. This is concerning in children because it affects future brain health and development. Deciding when a child can play a contact sport again is not a trivial decision. Current screening misses many of the less severe concussions. Recovery of the ability to function in our life does not guarantee that there has been biological healing of our brain.
   
A concussion injury is caused by violent shaking of the brain and is a complex injury causing injury to blood vessels, structural intra-neuronal microtubules and the myelin (the fatty coating around brain cells) and other changes.
   
Imaging that depends on the MRI changes seen in myelin (diffusivity of water which reflects post-traumatic changes) are the most useful in demonstrating post-concussion changes. A brain MRI-DTI with tractograms is a good choice. Supportive diagnostic data/functional testing can come from the RightEye test of visual information processing and objective balance assessment can be done with sophisticated vestibular balance testing.
   
Residual injury to the frontal lobe of the brain may cause the person to make poor decisions or have emotional instability. Residual injury to the temporal lobe of the brain can affect memory. Parietal lobe damage can cause problems with reality testing. Occipital lobe injury affects visual information processing. Concussion in children and adults carries a risk for future dementia, Parkinson’s disease and other neurodegenerative conditions. A neurologist is trained to ask all patients, “Have you ever had a concussion?” rather than “Have you recently had a concussion?”
   
Hyperbaric oxygen therapy is the only treatment that has ever been demonstrated to create healing of a brain injury condition. Nutrient optimization, energy therapies and retraining exercises are all supportive adjunctive modalities.
   
Return to play is a serious decision; the long-term consequences can be life changing.

Carol L. Henricks, MD practices at NorthStar Hyperbarics, located at 7598 N. La Cholla Blvd., Tucson. Connect at 520-229-1238 or NorthStarHBOT.com.
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