[kellym.14]

Hello everyone,

I came across this forum about six months ago, but haven't posted in a long time. I suffered a concussion last November playing hockey and had symptoms for quite some time since the injury. I have improved immensely since April, both mentally and physically. My ImPACT tests are all back to normal, and I am symptom-free, even when exerting myself physically.

I got an MRI done in July, just as a precaution because my symptoms persisted so long. While there was no evidence of a bleed, they did find lesions located in different parts of my brain. The amount that I have is slightly high for someone my age, and thus considered abnormal. I have to wait to talk to my neurologist (who hopefully knows more), but just talking to my team doctor, she does not know what the cause of the lesions are. I have heard everything from trauma-induced, to MS, to absolutely harmless. I have to wait a year and have another MRI to see if any changes have occurred.

I was just wondering if anyone else has that has had MRI's done have came across this problem? Does anyone know if they would be caused by my concussion, or was it just a coincidence that I have these? My thought is that they aren't caused from head trauma, because they are not in the same area, but rather distributed in random areas. Apparently there is nothing I can do that would make the lesions better or worse.

Any insights on this would really be appreciated, thanks!

[Mark in Idaho]

The research shows that the small bleeds from a concussion/contusion will be absorbed by the body within a few days. Any space left will be quickly filled by brain mass. My neuro said that MS shows up like a lighted Christmas tree.

Any dead brain cells will also be absorbed. If too many brain cells die and get absorbed, they will notice a lack of brain volume. For PCS, this is called CTE (Chronic Traumatic Encephalopathy). In essence, the brain has atrophied. This is not 'likely' unless you have suffered many concussions and / or sub-concussive impacts. In some cases, one concussion is enough, though.

If you are concerned, I would suggest asking for a full neuro-psych assessment. The ImPACT test is not adequate at diagnosing long term issues. It focuses more on reaction times, coordination issues, visual perception, etc. The little bit of memory function it tests is weak at best. It is more an indicator of risk of Second Impact Syndrome, a situation that is fatal in 50% of cases.

Please, please be careful if you are going to continue playing hockey. You will likely be sensitive to very minor bumps to you head now. Hockey helmets are very poor at protecting you from concussion, especially a second concussion.

If you can, try to get your images reviewed by someone with serious expertise in concussion. Dr Julian Bailes at Univ of West Virginia Medical Center, Dr Cantu of U Mass/ Mass General Hospital. I can list a few others but I think these are the best.

The Sports Legacy Institute also has good connections to concussion specialists. Their FaceBook page is at http://www.facebook.com/pages/Waltha...te/50243649481 I can remember their main web site.

Here is a good article for you to read. http://abcnews.go.com/Nightline/rese...8838451&page=2 Keep in mind that this imaging was done post-mortem.

My best to you.

[kellym.14]

Hi Mark,

Thanks for your quick response.

At this point I am unsure if I am able to play hockey again. I have been symptom free exerting myself off the ice, and was planning on skating once I was back at school to see how I was able to handle that. My thoughts were that if I was symptom free when playing hockey, I would be able to play this season. I was willing to accept the fact that I wouldn't be able to play if I was still experiencing symptoms, but I have not yet been given the opportunity to skate.

Right now, my team physician won't clear me to play because of these lesions. She is obviously not a specialist, and does not know much about them. That is why I am trying to do some more research to see if they are related to my concussion, or caused by some other factor. I need to double check this, but I'm pretty sure the neurosurgeon I was referred to in the summer said these lesions were not caused by the concussion. I'm just trying to confirm this so that I can hopefully be cleared to play. Do you think playing hockey (or doing anything else for that matter) would have any effects on these lesions?

I am trying to schedule another appointment with the neurosurgeon to clarify these issues, and I have also been referred to a concussion clinic for a second opinion on everything. Just hoping to do a bit of research in the meantime, because I am not the type of person that can just sit around and wait for things to happen!

Thanks for your help Mark, and I hope you're doing well.

[shezbut]

Hi kellym.14,

Have you seen your neurologist yet? Any professional explanation of the MRI results and prognosis?

Personally, I'd advise you to avoid hockey. After a person's first concussion, others become more easy to suffer. Many of us with head injuries will attest to that fact.

I hope that the MRI is explained well to you. Hopefully, there will be no lasting injuries for you. If you're under 26 years old, your brain is still growing. Prognosis for younger sufferers is therefore more positive, as chances are good that one's brain will grow new area to work with.

Best wishes to you!
Shez