In episode 17, we discussed how and when symptoms of concussion present, addressing some of the challenges in connecting with athletes and injury tracking, and some new research on CTE – also known as chronic traumatic encephalopathy.
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Concussion Symptoms: How, When and Why?
Concussion symptoms can take some time to manifest after injury. The initial impact creates an electrical storm inside the brain. That electrical storm – neuronal discharge and firing inside the brain or the ‘excitation phase’ – can cause symptoms to be immediately apparent.
This massive discharge of brain cells generally calms down in a very short period of time. A patient may even feel better after a few minutes to hours after injury. This is known as ‘spreading depression.’
The initial brain cell discharge creates an imbalance within the cells of the brain, leading to an energy deficit as the cells use up all of their energy stores to reset the normal balance. These stores continue to decline for up to 7 days, potentially causing symptoms such as extreme fatigue, irritability and more emotional. This is because energy levels are depleting.
Dr. Marshall explains these concepts in detail in this episode. For more information, check out our concussion education resources.
Connecting with Athletes and Injury Tracking
Concussion management requires a team approach. Everyone involved has a role to play, particularly in sport. This remains a challenge for many sports organizations as well as their healthcare providers.
- How to educate players, parents, coaches and trainers?
- How to connect with athletes on and off the field?
- How to provide communication to coaching staff?
- How to communicate return to play status?
- How to determine level of recovery?
Good concussion management needs communication to report the injury to the right person as soon as possible after injury. Proper recognition and reporting is often the first step to appropriate care.
Dr. Marshall explains his point of view as well as novel technology that can help streamline these processes.
As of this post, there is no causal link between concussions (or head trauma) and chronic traumatic encephalopathy (or CTE). There is also no evidence that the pathological findings of CTE lead to any type of cognitive impairment.
Of note, researchers have found CTE in people with no concussion history and no history of contact sports.
There’s a lot we still do not know about CTE. Listen or watch the full episode below for Dr. Marshall’s analysis of the current research around CTE.
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 B. Willer et al. A Preliminary Study of Early-Onset Dementia of Former Professional Football and Hockey Players. J Head Trauma Rehabil. 2018 Aug 3. Available at: https://www.ncbi.nlm.nih.gov/pubmed/30080796.