Our Approach to Concussion Management
October 6, 2013
No two concussions are exactly identical so the care of each athlete is tailored to them. Generally our management is a conservative one yet with the goal to recover the patient as quickly, comfortably and safely as possible. We generally believe that customized early cognitive rest is important for faster recuperation with less symptoms, meaning that we tend to hold the student athlete out of all academics the first few days of their management. We restrict as much sensory stimulus as possible such as limiting the use of technology, with a gradual return to normal activity as symptoms tolerate. The symptoms are managed medically on a case by case basis. At this time we do recommend supplementation with Omega-3 fatty Acids in every patient as there is some evidence they may be beneficial and are not thought to cause any harm by the FDA.
Our management routinely relies on a combination of a careful history of the event, assessment of risk factors for prolonged recovery, the symptoms reported, detailed neurologic exam as well as balance testing. This is often followed by formal neurocognitive testing in most but not all cases. The tool we use is ImPACT, a proven computerized form of neurocognitive testing that our providers have training and experience with. Once we determine the student athlete has returned to their baseline function, we send them to begin the return to play process. We work very closely with the local schools and athletic trainers to make the process as smooth and seamless as possible. In the vast majority of cases we do not do imaging unless there are emergent or unusual indications for it.