CentraState - Healthy Directions

www.centrastate.com Summer 2014 7 When most people think of concussions, sports injuries usually spring to mind. In reality, only approximately five to 10 percent of concussion cases are sports related, with the large majority of concussions actually resulting from falls and air bags, according to Brian Mason, PT, DPT, clinical director of rehabilitation services at CentraState. Too often, these concussions go undetected. "What the public doesn't understand is that a lot of times when people are concussed, they go to the emergency department and appear symptom-free," Dr. Mason says. "They are not aware of the need for full brain rest, and their symptoms get worse." Concussions often go undetected because it's commonly believed that you must hit your head in order to suffer a concussion, which is untrue. "Concussion is an acceleration/deceleration injury where the brain bounces back and forth, hitting the inside of the skull," says CentraState speech-language pathologist Marilyn Abrahamson, MA, CCC-SP. "It can occur from any fall or blow that results in jarring to the head or body." Abrahamson explains that many concussion patients ignore their symptoms because they believe they can just "shake it off" and don't want to miss work. "They are unaware of the significance of their symptoms. They also do not know about the need to rest their brain after concussion or their recovery time will be delayed, and symptoms may worsen," she says. "The time needed for brain rest should be determined by both the patient's physician and by the brain itself. Only the patient can really determine when recovery is taking place." Abrahamson also points out that diagnostic imaging such as CT scan is not effective for diagnosis of concussion, so doctors diagnose based on symptoms being presented. "Concussion results in a metabolic change within the brain, which cannot be seen on X-ray" Abrahamson says. "Just because you have a negative CT scan doesn't mean you're in the clear." So what are the major symptoms of concussion? • Headache or head pressure • Temporary loss of consciousness • Nausea or vomiting • Confusion/fogginess • Dizziness • Ringing in the ears • Fatigue • Slurred speech • Memory impairment • Light and noise sensitivity • Sleep disturbances • Impairment of taste or smell • Irritability, depression, or other personality changes • Patients often complain "I just don't feel right." If you or someone you know experiences a concussion, you should visit your nearest emergency department immediately and then contact the CSMC Neuro-Rehabilitation Concussion Program at 732-637-6316. HD Understanding Concussions about her ability to focus on her studies and retain any new knowledge that she acquired while trying to study," says Marilyn Abrahamson, MA, CCC-SLP. Kristen's speech-language pathologist at CentraState. "We take these complaints very seriously. By creating functional therapy goals that targeted the issues that Kristen was experiencing, we were able to help her to improve those skills so she could ultimately achieve her goal of graduation from nursing school." Kristen was provided with a computerized neurocognitive assessment to determine which cognitive domains of her brain were affected. "She needed to successfully graduate and then be able to function as a nurse, so I felt it was important to focus on attention, memory, and reading comprehension," Abrahamson says. "We started out by using small reading passages and math problems to target attention, then gradually introduced longer and more complex paper-pencil tasks. We then introduced distraction, such as familiar music with words and other types of ambient noise (such as working with the door open). Before adding the distractions, she did very well but had a lot of difficulty after distraction was introduced because, in a sense, she had acquired a temporary attention deficit disorder from her injury." Abrahamson taught Kristen to focus by consciously blocking out distractions and to target only the primary task. "It took practice and persistence, but she was able to do it," Abrahamson says. After a few weeks of therapy, Kristen started to feel like herself again, and small tasks, such as math problems and playing cards, weren't difficult for her anymore. "As I regained more confidence in my mental abilities, I also gained more confidence in my ability to drive again," Kristen says. Kristen believes that without this treatment, it would have taken a much longer time for her to recover from her concussion symptoms. "I remember after seeing how much I struggled during my therapy evaluation, my parents were worried about my abilities to continue with my bachelor's degree in nursing, as scheduled," she says. "The rehabilitation team at CentraState, especially Marilyn, my therapist, was amazing. She encouraged me at every session, gave me homework and helped me get through many difficult and frustrating sessions." Thanks to cognitive therapy, Kristen was able to complete all of her finals, just in time to start her senior year. Now fully recovered, Kristen has been working as a nurse in CentraState's Emergency Department for the past several months. "After completing my cognitive therapy, I experienced firsthand the professionalism and compassion of the staff, combined with the excellent training I received as a nurse extern in CentraState's Emergency Department, I knew I couldn't pass up an opportunity to work at an organization as great as CentraState," she says. The neuroscience programs at CentraState offer comprehensive care for brain, spine and nervous system conditions. For more information, visit www.centrastate.com/neuroscience or call 866-CENTRA7 (866-236-8727). HD

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