Diagnose and Adios…

This weekend our staff is attending the first of a three part seminar on concussion health and treatment. The class, which is taught by Mary McMains-Beck O.D. FCOVD and Brigette Wallace PT, DPT, is entitled Visual Vestibular Functional Integration Training and is Part One of the V2 FIT Certification. As most seminars go, our class was opened with a historical perspective on the treatment of concussions, which included a humorous reference to the method of 30 years ago – diagnose and adios!

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Here’s some interesting points from Day One in a bulleted format:

  • In adolescence (specifically 12-17 years of age), a concussion with less than 15 minutes of symptoms at time of injury required 7 days for cognition to return to baseline symptoms to resolve
  • Over 35% of reported concussions are the result of falls
  • In the past, a loss of consciousness was necessary criteria in the diagnosis of a concussion.  In recent years, research has proven that major concussions can occur with or without a loss of consciousness.
  • Second Impact Syndrome occurs when a second concussion is sustained while  recovery from the first is still in process
  • In patients less than 23 years of age, the occurrence of Second Impact Syndrome is on the rise
  • Second Impact Syndrome currently carries a 100% morbidity rate and a 50% mortality rate. This is due to a rapid onset of cerebral swelling which leads to brainstem failure within 2-5 minutes
  • The Remove From Play protocol has provided both education and path of treatment to coaches and athletic directors on the sidelines of all sports
  • The most serious symptoms may take up to 72 hours to manifest. This is because the prevalence of swelling and interruptions in the flow of cerebral spinal fluid
  • Concussion symptoms may impact visual, vestibular, and cognitive function
  • Dizziness is often the most prevalent symptom. Dizziness within the first 3 minutes is associated with a 6.4 times greater risk for protracted recovery (greater than 21 days)
  • Visual – Vestibular intervention facilitates recovery because both systems contribute to our inner gyroscope of where we are in space
  • The mechanism of injury (better known as the area and direction of the impact) should ALWAYS be considered in examination and treatment. As an example, a football player who experiences a helmet to helmet impact usually will present differently than someone suffering whiplash as the result of being rear-ended
  • Treatment of concussion should always include VOR, and possible suppression of the VOR should be examined

Looking forward to day two! 🙂

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Posted on August 15, 2015, in From My Perspective.... Bookmark the permalink. 3 Comments.

  1. Robert – pardon my ignorance, but what is “V2 FIT” certification?

    Liked by 1 person

  2. Robert,
    Thank you. I will forward to you comments about a very famous head injury written by David McCullough. The book is not that old and, while McCullough is an historian, I am certain that he had medical advice about what he wrote. Fortunately, awareness is changing.
    gjw

    Like

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