DR. ALEX VALADKA: Today's topic is how to treat a concussion. Now, before we talk about treatment, it's important to make sure you actually understand what a concussion is. A concussion is any sort of disturbance in brain function that's almost always caused by a trauma. Those common symptoms are confusion and amnesia. Now, it's important to note that being knocked out or passing out is not necessary to be diagnosed with a concussion. We used to think that, but now some people think that as many as 90% of all concussions take place without the patient ever passing out. So we got a typical scenario, someone gets a blow to the head. It may even be what appears to be a relatively minor bump on the head, you know, hitting your head on a kitchen cabinet or while you're working under the hood of your car, hitting your head against the hood. Confusion, amnesia, maybe associated later with things like irritability to light, just grouchiness, headache, things like that, in most cases, the symptoms resolve pretty quickly. And it's very common for an athlete who has an injury early in a football or a basketball game to be completely normal by halftime. However, warning signs or things like a headache that is very severe or worsening, persistent vomiting, perhaps the worst and most dangerous symptom is loss of consciousness. If someone seems to be getting sleepier and harder to wake up, you have to assume that they have a surgical emergency, like a blood clot that's enlarging, so they need to get straight to an emergency room and get a CAT scan. But again, those are very, very unusual and a minority of cases. Most patients do fine. The problem is that there is no specific drug or medicine to make some of these longer symptoms go away, so people may be bothered for a while with headaches and irritability and things like that. And Tylenol or ibuprofen is the best thing, probably not aspirin because that may increase your risk of bleeding which is something you don't want shortly after a head injury. Down the line, patients may develop something called a post-concussive syndrome characterized by, again, problems with memory, concentration, judgement, maybe problems with balance, dizziness, things like that. If that doesn't get better then perhaps a neuropsychological evaluation and counselling may help; but again, most of those people do fine. The goal is to identify the minority with significant persistent symptoms so we can intervene and treat them before those symptoms become chronic.
