Issue link: https://viewer.e-digitaledition.com/i/41086
+++++++++++++++++++++++++++++++++++++++++ SPECIAL SECTION: NEUROSCIENCE +++++++++++++++++++++++++++++++++++++++++ + ++ + ++ + + The Epidemic of Concussions By Ryan J. Lynch, DO, MS, MEd E ACH YEAR AN estimated 1.7 million traumatic brain injury (TBI) or concussion-related emergency room (ER) visits, hospitalizations and deaths occur in the U.S., according to the Centers for Disease Control. Of this number, nearly 1.365 million people are treated and released from an ER, 275,000 are hospitalized and 52,000 die. Concussions may cause many symp- toms, including headaches, vertigo, memory loss, decreased balance, insomnia, hypersomnia, decreased reading endurance, slowed reaction times, decreased attention, decreased concentration, mood changes, slowed thinking or fogginess, visual changes, nausea and vomiting, syncope (initially), photophobia, phonophobia, anxiety, and depression. These symptoms can occur immediately or may develop more slowly over time. Loss of consciousness is not necessary for the diagnosis of concussion or TBI. If you're a first responder to a head injury, don't assume a patient didn't have a concussion simply because he or she appears to be symptom free at the time of examination. Instead, provide the patient with literature about concussions and a list of symptoms that may develop. Charting that the patient didn't have a concussion in the ER may hurt the patient's chances of receiving workman's compensation or insurance assistance if they develop symptoms later. For athletes, return to play can only occur if they are symptom free at rest and at full exertion. Getting another concus- sion before the original one has healed can cause more severe problems. A second MDNEWS.COM SEPTEMBER-OCTOBER 2011 MD NEWS Cleveland-Akron-Canton | 29 concussion may cause the symptoms of the fi rst one to worsen and last longer and can also lead to immediate death on the fi eld due to double impact syndrome. Double impact syndrome is believed to be caused by severe and instantaneous brain swelling, resulting in herniation. All in all, concussions are becoming more commonplace in our culture. While there are still some who view them as a benign injury, they can be very debilitat- ing. We need to treat them aggressively and thoroughly just like any other disease and hopefully fi nd better ways to prevent them altogether. Dr. Ryan Lynch is a board-certified neurologist with special interest in neuro- rehabilitation, stroke and brain injury. He is co-medical director of the Brain Injury Program at Neurology and Neuroscience Associates, Inc. (NNA) and practices medicine at NNA's West Akron and Green offi ces. n