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More Than Just a Headache: CKHS Offers Specialized Concussion Management Care

In Brief

  • A concussion is a brain injury. Most of the time, concussions are caused by sports injury, but they can also happen at work or home — anytime there is trauma to the head or neck.
  • Symptoms of concussion include headache; nausea; vomiting; sensitivity to light or noise; weakness or other neurological change (memory problems, confusion, dizziness, etc.).
  • It’s important to seek immediate medical treatment for a concussion. Go to the ER if there is head trauma, otherwise see a sports medicine physician.
  • Ideally, your sports medicine physician should be trained and credentialed in the ImPACT neuropsychological testing system — which measures physical and cognitive symptoms to evaluate and manage sports concussions.
  • Concussions usually resolve within two weeks, but it could take longer — as much as six months.

Lately, news outlets across the nation have focused a great deal of attention on concussion — especially in high school and college athletes. As more research is completed, medical professionals are discovering that concussions can have far-reaching and, sometimes, life-limiting effects on people. Crozer-Keystone Health System offers specialized services to help diagnose and treat concussion — whether from a fall, sports injury or trauma to the head.

We use almost funny-sounding phrases to describe a concussion, such as, “Getting your bell rung,” or “Having a ‘dinger.’” But a concussion is not a laughing matter. It is a brain injury; and the sooner it is diagnosed and treated, the better the patient’s outcome.

“A concussion is any type of trauma to the head or neck from an athletic injury or injury sustained at work or home (head trauma),” says Joseph Stellabotte, M.D., a sports medicine physician with Premier Orthopaedics and Sports Medicine, and team physician for Haverford High School. “You can get a concussion with or without loss of consciousness. If you have a headache, nausea, vomiting, sensitivity to light or sound, or decreased exercise tolerance, you should visit a physician who is trained in the diagnosis and management of concussion — such as a sports medicine physician.”

Stellabotte maintains that head trauma injuries, such as weakness or other neurological change after sustaining a head injury, are much more serious and should be seen immediately by an ER physician.

Once you get to the doctor’s office, the first thing he or she will do is a complete physical along with a medical history. Steven Collina, M.D., medical director of the Crozer-Keystone Sports Medicine Fellowship Program and chief of the Division of Sports Medicine for CKHS, says that in the case of a sports injury, doctors identify and treat concussions by getting a thorough history of the event and previous concussions. “This may include getting history from the patient, parents, coaches and certified athletic trainer,” he says. “We then perform a thorough physical exam with a focus on the neurological exam. We look for deficits in memory, concentration and balance. When appropriate, we use ImPACT to evaluate the athlete’s memory, concentration and reaction time. ImPACT allows us to better stratify their symptoms and compare their performance to either preseason (baseline) testing or age-matched controls.”

ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is a specialized neuropsychological computer system that is used to evaluate and manage sports concussions. It measures physical and cognitive symptoms, including visual and verbal memory, reaction time and processing speed. The athlete must pass both the physical and cognitive parts of the test in order to be cleared. Anyone who plays sports — specifically youth or college athletes — should have a baseline ImPACT test done.

“It can take a long time to heal from a concussion,” Stellabotte says, “and treatment plans are divided into physical and cognitive (mental/thinking) components. For example, the patient may have to rest from things like schoolwork, work duties or physical activity. They have to ‘pass’ both the physical and cognitive parts and be asymptomatic in school or physical activities. Ninety-nine percent of people recover and do well with the appropriate treatment, and time to heal and rest.” Concussions usually resolve within two weeks, but it could take longer — as much as six months.

Collina, who is also one of the team physicians for The Philadelphia Union, says that he has treated a few players for concussion, as soccer is a high-risk sport for concussion (along with football and hockey). “We know that more mature brains can heal faster from concussion, and the athletes that we treated were over 25 years old. Once they were asymptomatic and had normal ImPACT scores we instituted our return-to-play protocol and they were cleared without difficulty. Adolescent athletes sometimes take longer to recover from concussion and should not expect return to play as quickly as adult athletes.”

Only physicians who are certified and credentialed in ImPACT testing can use the system, so when looking for a sports medicine physician make sure they have this important level of experience. Both the sports medicine physicians of Premier Orthopaedics and Sports Medicine, and the Healthplex Sports Medicine Institute (which also offers the Concussion Management Center) are certified and credentialed ImPACT consultants.

To find a Premier/Crozer-Keystone sports medicine specialist who is right for you, call 1-877-CK-MOTION (1-877-256-6846). To learn more about the Concussion Management Center at the Healthplex Sports Medicine Institute, visit www.sportsmed.crozer.org.

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