Concussions are growing in the public eye; there is new research, new worries and discoveries about how much about concussions has been ignored in the past, or simply not been known. Even as society learns more about concussions, there still lacks objective ways of telling when a concussion is healed (or even if there is one there in the first place). Concussions have few signs that include headache, temporary loss of consciousness, confusions, nausea, fatigue, and a ringing in the ears (http://www.mayoclinic.org/diseases-conditions/concussion/basics/symptoms/con-20019272). Yet, these signs alone are often not enough to diagnose a concussion. Imaging can be done on the brain (CTs and MRIs are most common), but even then these images are not telling the whole story of what is going on in the brain. Often, diagnosing a concussion is reliant on how the patient describes how they are feeling, which has a level of subjectivity to it. Even if the concussion is properly identified, there is still the question of when the brain will recover, and as every concussion is unique, and there is not really an objective source to learn when the brain has recovered. Thus often there is the question of when is the proper period of time to “return to play” and continue on with activity? These tests are also not objective, often relying on the patient to tell the truth of whether or not they are fully recovered. There is something called ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) which evaluates someone’s mental state and how well their neurocognitive skills relate pre and post-concussion (https://www.impacttest.com/about/). This assessment an athlete will typically take at the beginning of the season in order to establish a baseline, and then must achieve a similar score after having had a concussion in order to show that their brain is working in the same way which it was before. But, if one was a dedicated sports player, couldn’t they just score lower on the test on purpose for the baseline in order to be able to pass it once they were concussed? Yes. It is for this reason that whether or not a coach or doctor will consider a concussion healed is largely based off of how much information the patient is not sharing. There are other ways to determine if a player is well enough to return to play, often involving various activities like running, or even walking without experiencing any symptoms. Yet, if someone is determined to return to play, then it could be easy to say they were fine. The only problem with that is that the patient is risking further injury or brain damage. With concussions, one is harmful, but a second one within a short period of time is severely disabling or fatal. This event is referred to as second impact syndrome, and is largest risk of returning to play before the brain is totally healed. Second impact syndrome can be dangerous for those who have been cleared to return to play if even though the patient no longer experiences symptoms, as the brain may not be fully healed yet, but there is no way to tell. However, those that return to play too early run the risk of second impact syndrome, which is in my opinion too large a risk. Fortunately, second impact syndrome does not often occur, and there have been only a small number of recorded cases (https://en.wikipedia.org/wiki/Second-impact_syndrome). As knowledge of concussions has grown in science, the public eye has seem to have taken a larger interest, which is leading to larger awareness of the risks that people with concussions take by resuming with activities that may lead to further injury. Yet, the prevention of further injury is largely dependent on the patient, for the best way to currently identify when a concussion is healed is when someone feels their brain is properly functioning again.
When Can it be Safe to Say a Concussion is Healed?
