Caring for Concussions

Getting your bell rung. A blow to the head. Seeing stars. They’re all ways of describing what can be a very serious threat to your brain health — a concussion.

If you suffer one of these injuries, you may be able to “shake it off,” or you may experience symptoms that linger, depending on the severity. Regardless, a concussion can have long-term effects that can threaten your well-being, memory and life.

The new Enloe Health Concussion Services clinic offers specialized treatment and support for folks who suffer from one of these brain injuries. Viktor Gabriel, M.D., and Maya Armenta, a nurse practitioner, lead the roster of the brain injury specialists at the clinic, which opened in September.

A Closer Look

A concussion occurs when the brain shifts inside the skull and results in temporary loss of brain function. Sometimes, just moving your neck rapidly can cause one. Other times, participating in contact sports like soccer or football can lead to one.

Concussions are common. According to the Centers for Disease Control and Prevention, an estimated 1.6 million to 3.8 million concussions occur every year nationwide, though that figure may be higher. The CDC reports that many of them go unreported.

Dr. Gabriel said that’s typical. “A lot of people with brain trauma don’t seek medical care for it, even if they have symptoms,” he explained. “There are a lot of teenagers who sustain significant concussions who participate in sports, especially football.”

Armenta said she estimates 40% of people who go to the Enloe Health Emergency Department for concussions have fallen, 40% have been in motor vehicle accidents and 20% have suffered brain trauma from sports.

An injured person may or may not lose consciousness, but he or she will likely experience headache, confusion, dizziness, nausea, vomiting, double vision, ringing in the ears, or inappropriate crying or laughter, Dr. Gabriel said.

If you think someone may have suffered a concussion, take action if the person shows signs of drowsiness, lethargy, vomiting, difficulty balancing or irritability, or if the person sleeps longer than usual or has trouble falling asleep, he added.

It’s critical that anyone who suffers a blow to the head gets pulled aside and assessed, especially if the person is not acting normally. If the victim loses consciousness, or if a mild headache worsens or comes with vomiting, take that person to the Emergency Department right away, Dr. Gabriel said.

Those who have mild symptoms can head home with a responsible adult, but loved ones should check in and awaken individuals periodically to make sure they’re OK, he added.

Getting Back to Normal

“People often get better in 30 days,” Armenta said. “Our clinic is meant for those whose conditions linger beyond that. It is not the place to go after the game. It’s the place to go once you’ve received the education you need and need to get back into participating in a safe way.”

Armenta added that most people who sustain concussions seek care from primary-care providers, Enloe Health Prompt Care or the Emergency Department, and they receive education about their injuries. However, those still having symptoms 30 days later “can self-refer or go back to the ER,” she said. “We also take referrals from athletic coaches or trainers.”

A month may seem like plenty of time for most brain traumas to resolve themselves, but Dr. Gabriel said there’s “a pretty significant number” for whom symptoms last six months or longer.

“We see it in the young adults, teens, young professionals,” he said. “It affects a person’s ability to concentrate. If you’re in school, you won’t be able to do your homework or pay attention in class. You won’t be the same as before the injury.”

California Interscholastic Federation regulations, which govern high school sports in the state, prohibit athletes from returning to competition until they’ve been medically cleared to do so. The Concussion Services clinic can provide this clearance, assuming the athlete meets the criteria.

“We run a thorough history,” Armenta explained. “It covers everything cognition — a basic neurological exam, memory, balance. We flood the patients with education, offer ideas for headache management, and for sleep, hygiene, diet and exercise.”

To learn more about the clinic, visit www.enloe.org/concussion.