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Originally Posted by Mark in Idaho
rmschaver,
Do you have any links to Hovda's work. I can find lots of articles and videos or him talking about research and the needs for more research but nothing that addresses a protocol for recovery.
btw, Syndrome is used to describe a condition that is observed repeatedly. Disorder is used to describe a condition that has been scientifically established with a fixed set of diagnostic criteria. The Veterans' Admin and NIH has awarded a contract to the NeuroTrauma Foundation to establish diagnostic criteria for Post Concussion Syndrome / Disorder. The current standards are too subjective.
Hovda's work may include concussion but is primarily focused on sTBI/TBI, not mTBI. This is common in the brain injury community. He appears to still be struggling to establish a criteria for 'return to play' or 'return to action' after concussion. This is no better than the common problem most clinicians deal with.
There are other doctors who have a greater understanding of concussion. I have watched some of their lectures presented at the Howard Hughes Medical Institute.
The NIH and CDC are years behind the best concussion technology due to their need of a consensus before drafting a document. At least Hovda recognized this serious lack of consensus.
Even Mayo Clinic and Cleveland Clinic are behind the times. The Ontario NeuroTrauma Foundation is a bit ahead of the US organizations but still fighting an uphill battle with the consensus issue and the efforts of health and liability insurance companies fighting against a common diagnosis and treatment plan.
The combined knowledge on NT is much more up to date than any individual source elsewhere.
Even the multidisciplinary concussion clinics tend to have weak links in their programs/protocols. Most concussion clinics are oriented toward fee generating rather than effective treatment. Just about any group of doctors and therapists can hang out a 'Concussion Clinic' shingle. There is no standard of care or board certification for concussion specialists.
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I will look for links but as I am new member won't be able to post hyperlink. You are correct about Hovda but without his work the military and profesional sports refused to consider cuncussion as anything more than a temporary condition. Dr Hovdas work and basis is relevant as he found the smoking gun to ongoing pathologies but that is a discussion for a different forum.
The CDC and NIH are behind the times but even they acknowledge cuncussion and MTBI are interchangeable terms. Both organizations are large and large wheels turn slow and large goverment wheels are even slower.
It is an unfortunate truth but I feel we are at the seminal moment when the medical industry realizes that cuncussion or whatever you call it can be a diabling injury. Cuncussion as an injury is not well understood as anyone PCS/D can attest. The medical industry also includes insurance companies. These same companies will not acknowledge treatments that are not well established.
It is my opinion, that with so many differing organic systems in and supporting the head/brain, to assume a one treatment fits all will not work. But rather a tailored individaul treatment for the individaul would be best. The medical science portion of the industry proceeds on a scientific basis model. Analyze, hypothesize, test and then validate.
Hate to say it but I think were in the analyze/hypothize stage.
Hope we all feel better.