Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 03-27-2009, 03:29 PM #1
rocksrock rocksrock is offline
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Default any young kids with PCS?

My 7 yr old got his stictches out today and is continuing to have a headache. The Dr wasn't too concerned about the headache and told me to watch for cognitive symptoms. Plus no sports for two weeks after the headache goes away (which is harder on him than the headaches). Reading the many, many threads I can see that this is something we may be battling for a long time. I haven't seen much here about young children and PCS and am wondering about pain meds, duration of symptoms, etc. in the young ones. It would seem that things would differ greatly with age.

Thanks in advance for your thoughts...
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Old 03-27-2009, 08:54 PM #2
Mark in Idaho Mark in Idaho is offline
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Default Youngsters and PCS

Fortunately, the younger a person is, the more likely they will have a good recovery. As for the "wait two weeks after the headache goes away before sports," I would wait six weeks. I would also make sure all of his cognitive symptoms are gone before starting the six week clock.

Does he play video games? They can sometimes be a good indicator of cognitive symptoms/recovery. I would suggest some of the learning video games so he has to do more thinking to advance in the game. Ask his teacher to watch for symptoms, too. Does he daydream or appear spacey eyed? How does he react to stress, conflict, startle, etc.? These all can be signs of recovery or ongoing symptoms.

I had my first concussion when I was 8. Then I had a bad concussion at 10 years old. I had a serious personality change after the bad one. I had problems with depression, academics, maintaining friends, etc. From then on, I have been very reactive to even minor head bumps. At 46, I had to stop driving. I haven't played contact sports since I was 15 and developed seizures from heading a soccer ball.

Yes, you have a tough road ahead keeping him from a second impact.

How bad was his concussion? Did he lose consciousness? Did he have post traumatic amnesia? Loss of awareness of surroundings? Any other changes in behavior or skill set? Was he treated by just a pediatrician or family doctor? Does he have a helmet and agree to use it and wear it correctly? Many wear their helmet too far back and expose the forehead. I would encourage a helmet that covers more than just the top of the head. Snow board and skateboard helmets usually have better coverage. Just because he has a helmet on does not mean that he can bang his head. His brain is still fragile.

Regarding the headaches, you might try teaching him to relax and see if he can cause the headache to go away. If he can, this will be a very good skill to have. His headaches may come and go for quite some time. It is all different for each person. Hard to predict.

I am on this forum almost daily so I am here for your questions. I have had 13 concussions since 8 years old, most of them very minor, only one major concussion ( 30 minutes loss of consciousness).
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Old 03-29-2009, 05:16 PM #3
rocksrock rocksrock is offline
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Default Thanks Mark

You have had a very rough road. I admire that you keep on going despite your setbacks. I have discovered that I am not as strong as I would like to be; reading so many stories here has literally changed my life. Thank you for offering your assistance. You're more experienced than any of the five Drs I've talked to.

My son didn't show any sign of concussion at the time of injury (no loss of conciousness, amnesia, dizziness, drowsiness, no "stars"; he hopped right up and said 'ow, my head') and was not diagnosed with a concussion at the ER. He merely had a deep laceration to the scalp requiring 14 stitches three layers deep. He was diagnosed with PCS at the ER when he began suffering excruciating headaches three days after the initial injury. His pediatrician indicated that it would be impossible to have a laceration such as his without a concussion.

As far as cognitive issues, so far he doesn't have anything noticeable to anyone but my husband and I. I've just noticed that he is tired earlier in the evening and is a little more sensitive or emotional about some things. His attention seems a little lacking as well, but that could be restlessness from missing so much school and not being able to do any of his favorite activities. He's learned that unlimited video gaming isn't such a great thing after all LOL.

He's good about wearing helmets when necessary. One of the Drs stated that helmets don't necessarily protect the brain from concussion since it is the movement of the brain within the skull that causes concussion. But in my opinion, anything that softens the blow is worth wearing. I have also been told that mouth guards protect against concussion but not how. Do you know how mouth guards protect in this way?

You stated that you have had 13 concussions since age 8. It would seem that they have a cumulative effect. Because he's had one, is he predisposed to suffering more? Is he more likely to suffer another concussion because he's had one, even if this one is given time to heal completely?

Thank you again for your help.
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Old 03-30-2009, 08:15 PM #4
Mark in Idaho Mark in Idaho is offline
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Default PCS symptoms and second impact syndrome

rocksrock.

Yes, he will be more sensitive to a second concussion. Although this has been studied and known for decades, most Physicians do not fully understand concussions, especially the seriousness of multiple concussions.

< I've just noticed that he is tired earlier in the evening and is a little more sensitive or emotional about some things. His attention seems a little lacking as well, >

Your son's symptoms sure sound like a concussion. The emotional lability (sensitivity and emotion responses) is a common PCS symptom.

< but that could be restlessness from missing so much school and not being able to do any of his favorite activities. He's learned that unlimited video gaming isn't such a great thing after all LOL. >

What symptoms are causing you to keep him out of school? Is he doing any academic work at home?

I was knocked out on Sunday, released from the hospital on Wednesday and back to school on Friday with scabs all over my face and hands.

< He's good about wearing helmets when necessary. One of the Drs stated that helmets don't necessarily protect the brain from concussion since it is the movement of the brain within the skull that causes concussion. But in my opinion, anything that softens the blow is worth wearing. >

You are right. The Dr is dead wrong. He does not fully understand concussion or the laws of physics. A helmet that deflects (crushes from the impact) 1/8th of an inch decreases the impact by about 50 percent.

< I have also been told that mouth guards protect against concussion but not how. Do you know how mouth guards protect in this way? >

I have heard the same. Here is an article with some theories. http://www.sportsdentistry.com/concussion.html

I know that the cushioning of the lower jaw from the rest of the head is a valid point. Again, that 1/8 of an inch deflection reduces impact forces by 50 percent. I have done the physics calculations myself. I had an 8 inch drop onto a hard surface. The formula shows that I hit with a 65 G's force if my boot had an 1/8th inch deflection. If it was 0 deflection, it would have been 130 G's.

< You stated that you have had 13 concussions since age 8. It would seem that they have a cumulative effect. Because he's had one, is he predisposed to suffering more? Is he more likely to suffer another concussion because he's had one, even if this one is given time to heal completely? >

He will never heal completely. You may not notice any residual symptoms but the brain will still be weaker. It will just not show up as symptomatic until he is under stress. High altitude, low blood sugar, high fever, emotional stresses like when taking an important test, and other factors that put an additional load on the brain may cause a minor to major decompensation (relapse of symptoms).

He should be brainwashed into fear of alcohol and any drugs. Alcohol is a definite antagonist after a concussion.

He is your precious little boy. Love him to pieces but let him experience life with some reasonable cautions to protect his head. I found other sports after I was restricted from contact sports. I became a champion distance runner. Maybe he can try speed skating. With a good helmet of course.

Our minor league( ECHL) hockey team (Steelheads) has mitey-mites play between periods. I would love to see them set up a speed skating contest instead.

Fortunately, he is young and has a very plastic brain. It can do miraculous things to overcome his injury.

As he gets older, the brain gets less able to accommodate the injuries. He will need to be very careful when he is going through puberty. The brain is undergoing major maturing then and any interruption can be more problematic. Some parts of the brain may not mature properly if it is recovering from an injury. The judgment skills the brain learns between 12 and 20 are very important.

Give him a hug for me. Tell him Grampa G says Hi.
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Old 03-31-2009, 02:19 AM #5
PCS McGee PCS McGee is offline
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Quote:
Originally Posted by Mark in Idaho View Post
He should be brainwashed into fear of alcohol and any drugs. Alcohol is a definite antagonist after a concussion.
Mark, this is a bit much... there's no better way to ensure that a kid uses (and often abuses) alcohol and drugs than by constantly ordering him to never try alcohol or drugs at all.

Rocks - Mark is an excellent source for information on the brain, its functions, and what can happen to it following injuries, and I find myself consistently impressed with his knowledge base on these subjects, HOWEVER in my opinion he often errs in making a catastrophe out of every concussion that anyone ever experiences. The fact of the matter is that most of the people who use this forum are medical anomalies - people who developed extremely severe symptoms from seemingly minor injuries. 1 in 10,000, if not 1 in 100,000, or 1 in a million kind of cases. Make no mistake, brain injuries regardless of their perceived severity are THE MOST serious injuries a person can incur, but if what has happened to the people on this forum was the norm there would be A LOT more than 10 or so people using this site on a daily basis, you can rest assured of that.

This is true: Almost everyone experiences at least one concussion at some point during their life. Almost all of these people will report no lingering symptoms from this injury beyond a couple weeks after the initial impact (they may unknowingly be experiencing lingering deficiencies, but if they don't notice them I think it's safe to assume that they deficiencies they have as a result of injury are extremely minute in scale). The brain has a remarkable ability to bring itself back from all sorts of traumatic occurrences, ESPECIALLY when those traumatic occurrences (provided they aren't catastrophic in nature) happen during a person's youth when the brain is in its most elastic state.

Here's all I'm trying to say in a nutshell: Taking all the precautions that your doctor has advised (particularly in relation to sports) is a great idea, but don't plan on keeping a cage around him when he's 13 just because he hit his head when he was 7. Keep a keen eye on him over the next few weeks - longer if it seems appropriate to you - but this injury he's incurred is almost certainly not the end of the world. In all likelihood he will appear to be back to 100%, and will feel back to 100%, within a couple of weeks (if not sooner), at which point you can feel safe letting him go right back to living a full, healthy life again, with all the opportunities open to him that every other kid his age has.

Be mindful, be careful, be loving, and be attentive, but don't be suffocating.

Best of luck to you!

Last edited by PCS McGee; 03-31-2009 at 02:39 AM.
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Old 03-31-2009, 03:12 AM #6
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If your 7 year old has only just got stitches out it is only early days yet. I think that your 7 year old will be fine and will probably not do anything that he doesn't feel like doing. If I recall correctly it was very difficult getting a 7 year old boy to do anything that he didn't want to do which means that it would be unlikely for him to have the problem of forcing himself to do anything when his brain is so tired and in recovery mode.

I know that I had some terrible bumps on my head when I was young and as a teenager. My current problems didn't happen until I was 45 when I had 2 concussions within 6 weeks.

Lynlee
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Old 03-31-2009, 09:12 PM #7
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Default PCS statistics and PCSMcGee

PCS McGee is in serious denial. The statistics show that 5 percent of head injuries result in life long disabilities. My disabilities started in elementary school. It was not until my "mild" concussion at 46 years old that those disabilities magnified to be job and major life function disabling.

As I said, love your little boy to pieces and let him experience life. It is reasonable to teach him the dangers of alcohol and drugs with his history of head injury. It may be something that will need to be done as he gets older, say 10 to 12 years old. Using a helmet should also not be a hard concept to teach him. My first concussion was the year (9 yo) before my bad concussion at 10 yo. I fell down the stairs and got a good bump on my forehead. It most likely set me up for more serious damage from the second concussion.

I would be interested to see what PCSMcGee has to say in ten or fifteen years if he has another concussion and becomes disabled.

The issue of drugs and alcohol are two fold. The chemical damage done to the brain and the risk of a concussion from a trauma as a result of being drunk or even mildly impaired. There is also research that show that getting drunk during the teen years or younger has lifelong implications. The brain becomes much less tolerant of alcohol as an adult. Those who minimized alcohol to the point of no bad drunk episodes, are much more able to tolerate alcohol after the age of 25. This is due to the interruption of the brain's maturing during the teen years.

McGee, I think you understand the point here. If you had slowed down with your drinking, you might not have suffered the later concussions. And, you are wrong, researchers believe that 60 to 80 percent of the population never suffers a concussion. Once a concussion is suffered, the likelihood of a second concussion increases three to four fold. Concussion numbers in the USA are at one half of one percent of the population. That does not adjust out the multiple concussions. The repeat concussion statistics show that most are not the first concussion. This leaves the likelihood of first concussion at possibly below one tenth of one percent or one out of 1,000. Lifetime statistics would follow that one out of fifteen people suffers a concussion during their lifetime (7 percent). Remember that second concussions can manifest from a much lower impact force. This accounts for most of the repeat concussions.

The vast majority of repeat concussions occur during sports activities. This is also when concussions are more likely to be spaced close together. This close spacing of even minor concussions is far more damaging than the infrequent more serious concussion.

On of the premier concussion researchers in the US is working to develop a concussion monitoring device that can be worn during sports, football, rugby, soccer, etc, so that the player can be pulled from the field. There are two systems that are used to track recovery in school sports concussions. One is called ImPACT, the other is called CNS Vital Signs. The insurance companies are beginning to take serious notice of the damage from repeat concussions.

I knew to be careful about concussions ever since my third at 16 years old. Still, I have suffered 10 more since then, most being very minor impact forces.

The prison system in British Columbia did a study and found that 60 percent of the inmates have symptoms of a head injury. Similar studies have been done on the homeless and found similar head injury symptoms. The US prison population reports an 87 percent concussion prevalence.

Having watched too many people suffer from dementia and be unable to remember or recognize family, ending life with Mild Cognitive Impairment is something that should cause people to take all reasonable precautions. A simple observation of the retired NFL football players who suffer from serious dementia in their 40's will cause you to think twice about concussion risk. They are suing the NFL Players Association and league for better care of these poor men.
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Old 03-31-2009, 10:59 PM #8
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nevermind.

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Old 04-01-2009, 12:01 AM #9
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Default McGee, You can't have it both ways

PCSMcGee,

You claim to understand concussion but you still continue to state that one can recover 100 percent from a concussion. There is not a lack of understanding concussion in the medical industry. It is any trauma to the head that cause symptoms such as: any level of amnesia, confusion, nausea, headache, dizziness, awareness of surroundings (this includes date, names, location, etc) visual disturbance, loss of consciousness, ringing in the ears (tinnitus), and some other similar symptoms. The problem the industry has is getting over the long disproven idea that unless there is a loss of consciousness and serious post traumatic amnesia, 100 percent recovery should be expected within a short time period.

You appear to have been listening to the same old tired ideas of the psychological oriented cause of ongoing symptoms. Most neurologists and psychologists still do not properly understand the long term effects of concussion.

< THAT SAID, advising a 7 year old who's experienced 1 non-catastrophic concussion to not drink 12 years from now, particularly when nothing is known about his upcoming recovery period, is ridiculous. >

You are making assumptions about his recovery period having something to do with residual problems. It is ridiculous to claim that recovery period has any bearing on his long term condition. The research says it does not. In fact, the research says just the opposite. You cannot predict long term outcome based on intensity of impact nor recover speed or levels. The one thing that can be predicted is the susceptibility to a second impact. That does not mean that he will sustain an impact of similar force or that he will be more likely to bump his head. What it means is that he will be far more likely to experience the symptoms of a concussion, often because a much weaker force will produce concussion symptoms.

Regarding drinking, you do not have to get passed out drunk to suffer effects of alcohol after a concussion.

As I said, rocksrock has plenty of time to convince her son to avoid alcohol. For the time being, he just needs to know to take less risks that can cause another bump to his head. Most likely, he will bump his head. Not necessarily from taking risks, but from just being an active young boy. When this next bump comes, he will be more symptomatic and begin to understand the need to be more protective of his head. He does not need to be made to feel like a victim of a head injury for him to decide to be more careful. He does not need to feel guilty about his recent head injury either. He will just be ahead of the pack by acknowledging a need to protect his head.

The sports industry is quickly making changes due to public awareness of head injury. Look at the increased use of helmets in skiing and snowboarding. The insurance industry will be getting more involved too.

Oh yeh, you said, < The fact of the matter is that most of the people who use this forum are medical anomalies - people who developed extremely severe symptoms from seemingly minor injuries. >

Those medical anomalies are not anomalies at all. They are statistically significant numbers. Just because they do not find this forum means nothing. I have been studying concussion on the internet for more than 12 years and I just found this forum. The fact that they have extremely severe symptoms from seemingly minor injuries is just the point. Nobody can say what the long term residual problems will be. There are some rules of thumb based on research done as far back as 1974. Those rules of thumb say that impact force and immediate symptoms are not a predictor of long term outcome.

As I said, let him live his life. Just be aware of his head injury history and take reasonable precautions. As my mom said yesterday when I was talking to her, Nobody told us what to do after my head injury at 10 yo. In fact, the only comment was before I was discharged, the doctor tried to tell me to tell my mother to have me seen by the family doctor when I got back home. ( I was in a hospital 45 minutes from my home). I remembered this comment about six weeks later. She wishes she had a better understanding of my need to protect my head. My minor concussion in high school and and again in college changed the direction of my life permanently.

I would rather have not played soccer for four seasons than have to live with the disabilities I have now. It is all about risk versus reward.

Informed consent is a valuable commodity.
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Old 04-01-2009, 10:06 AM #10
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Hello Everyone,

This is my first time posting on this site. I also suffer from a fragile brain from 6 concussions I incurred while in high school and college. Anytime I come across a thread discussion like this one, I always make a point to inform the readers about nueroplasticity and neurofeedback. Of course, neuorplasticity is the new buzz word in the neuroscience community. There are many famous examples of people who have either incurred a stroke or incurred a serious concussion and regained full functionality afterwords. It has been proven scientifically that given the proper stimulation, the brain is able to reorganize itself and develop new neurons, through the process of neurogenesis, in order to heal itself. Sometimes that can be overnight, other times it may take 5 years. This segways me into neurofeedback. Neurofeedback is the catalyst to help anyone's brain get better, regardless of the situation. There were studies done on brain injured patients in the 60's and 70's that showed that neurofeedack improved symptoms by 70-80% in 78% of the study group. Fortunately, the technology has dramatically improved since then, so I would venture that the same study done today would yield improvements in 100% of the study group. Dr. Diane Roberts, whom I would encourage everyone to visit her website, is a great example of someone who has benefited from neurofeedback. She was involved in a serious car accident and was told she would never be able to walk or speak again by the medical community (some of the best neurologists in the country). Well, thanks to neurofeedback, today she runs a very successful therapy practice, has written two books on the subject, and she is considered an expert on the field of neurorehabilitation.

A few caveats to neurofeedback:

One is that is has not been accepted by the medical community, which is a bunch of b.s. The main reasons for this are because it directly competes with the pharmecuitical companies who make medication for add/adhd, and also because it isn't taught in medical school. It is also,

Two, there are many different forms of neurofeedback available. It took me a year or so to finally find the right person and therapy that helped me get better.

Three, it is not -unfortunately- covered by insurance. However, can you put a price tag on your health?

So, I would confidently say that anyone can improve their condition if they want to. If anyone wants further information, simply google neurofeedback. Also, I can connect you with the people I know as well. The great thing about it is that if you live in an area that doesn't have a therapist, you can buy home training equipment and have someone monitor your progress remotely.

Cheers,

Mike
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