Baseline Concussion Testing

by Kaitlin Mahoney, D.O., CAQSM

Baseline Concussion Testing

A concussion is a type of brain injury caused by your head moving quickly and jostling your brain. Concussions are very common, and can be a result of falls, sports games, car accidents, or any other time your head is quickly moved.

The ImPACT test

The ImPACT test is a neurocognitive test that measures how well your brain is currently functioning. The test asks for symptoms and tests your verbal memory, your visual memory, your reaction time, and your impulse control. After you take it, you get a score that is compared with other people of your age and gender.

If you take the test now, before a concussion, you will have a baseline score to compare against if you do get a concussion. The baseline test can be taken at home on a computer (unfortunately not on a smartphone or tablet) and takes about 30 minutes in a quiet room.

The ImPACT baseline test is very helpful to your medical team because it shows which symptoms are common for you and which may be a result of a concussion. For example, headaches or car sickness may be everyday conditions for one person and concussion symptoms in another. Taking the baseline test will let you reflect those symptoms in your baseline and give you a score for how you would do on your ideal day. If you get a concussion, we’ll be able to compare your scores from the baseline test and the test after a concussion.

If you’re an athlete, especially in a sport like soccer where concussions are common, I recommend taking the baseline test. Having taken the baseline test prepares you for doing the test after a possible concussion, since you know what to expect and already have a score to compare against.

If you don’t have a baseline score, we will use the initial test post-concussion as a starting point and see how much you improve. You can take the ImPACT test again as you’re recovering from your concussion as one method of measuring improvement.

If you are worried that you have a concussion, you can't take this test on your own and use the results to decide that you do or do not have a concussion. If you might have a concussion, please talk with a health care provider. To diagnose or rule out a concussion we have to be able to look at your scores, talk to you, and do a physical exam.

Symptoms

The most-known symptom of a concussion is the post-traumatic migraine, with symptoms such as a headache and light and noise sensitivity. However, the migraine is only one of the types of concussion symptoms.

Another symptom is neck pain from a very stiff neck. Or debilitating anxiety and mood issues, such as being very sad for no reason.

Vestibular issues may also happen. The vestibular system is difficult to describe but deals with motion and where your body is in space. You may be dizzy or be lightheaded when you stand up or when you turn your head. Relatedly, you may have ocular symptoms like difficulty looking at a test during school or trouble looking at your phone. You may have cognitive fatigue, such as headaches at the end of the workday or school day that cannot be explained.

Not all concussions have the same symptoms, so you and a friend may both have concussions but they seem nothing alike.

Statistics

· Approximately 3 million concussions happen each year via sports.

· About 50% of people with concussions continue to play even when they show concussion symptoms; if the game is important, the number can be even higher.

· Girls are more likely to suffer from a concussion than boys are.

· Soccer is the 3rd most common cause of concussions in girls’ high school sports.

Treatment

Rest is the most well-known treatment for a concussion. How much rest you need can vary person-by-person, and it is not the only treatment.

If you’re having symptoms such as dizziness when you turn your head, you may need vestibular therapy to desensitize you and correct the dizziness. Vestibular therapy and ocular therapy, which have some overlap, are specialized types of therapy that help your balance and your eyes. If you’re having issues such as one eye skipping around unable to focus, the therapist is able to do exercises with you so you can improve and symptoms can go away.

FAQs

Many athletes don’t want to admit that they have hit their head because they know they won’t be allowed to keep playing. How do coaches and parents convince them that they need to report?

The athlete needs to understand if you are concussed, you’re slowed down. You’re not going to react the same way. You’re not going to be as quick. You’re not going to be able to take a hit and respond the same way, which could put you at risk of a second concussion or even another injury that you're not aware of because you're not at the top of your game. If you do go play through these things and don’t give yourself the appropriate rest, that could prolong your symptoms. Ultimately, that's not good for the team and it's not good for you as an athlete either.

If I hit my head but I don't think I have any symptoms, should I still be evaluated for a concussion?

Yes, you should be evaluated. It’s very hard for you or a loved one to assess if you have a concussion. If you hit your head, it’s a good idea to talk to your primary care doctor or another health care provider to check.

What symptoms should parents be on the lookout for?

Parents of student-athletes should be on the lookout for their children not acting like themselves. They may not sleep enough, may sleep too much, or may have trouble sleeping. They may have adequate sleep but be tired. Grades could decline, and they could be behind on schoolwork. Their mood could change unexpectedly. If you’re watching them play and they don’t seem to be playing as usual, such as being slower with a longer reaction time. If you see these symptoms after a head injury or potential head injury, it’s a good idea to have them evaluated.

Can I go to school or work when I'm recovering from a concussion?

Everyone is different. Sometimes people just need a day or two of rest, while others need additional accommodations like extra time to complete tasks or breaks throughout the day. After we assess you we’ll work with you to figure out the accommodations that are needed at school or work.

How can I reduce the risk of getting a concussion?

If your neck muscles are stronger you're able to control your body better and reduce the risk of a concussion. In this case, strength training could potentially be helpful. If you need glasses, wearing your glasses. Additionally, paying attention, eating healthy and sleeping enough.

Are concussions only from head hits?

No, you can have a concussion without having hit your head. If you have a strong impact, such as a car accident, you may have a concussion without having hit your head.

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