Concussion and Minor Head Injury

Minor head injury is described as having a loss of consciousness of less than 30 minutes or a period of confusion or memory impairment of less than 24 hours without loss of consciousness. Most commonly minor head injury is caused by falls, sports, road accidents or assaults. Many cases resolve in a few days or weeks however, in some instances symptoms can persist for months.

Between 70% and 90% of all traumatic brain injuries are categorised as concussion or mild brain injury.

"[Mild traumatic brain injury] makes the largest contribution to the global burdon of disability. Timely intervention and structured follow up in this group could deliver substantial gains on public health and societal costs"

Maas et al (2017)
Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research
The Lancet Neurology

Medical Diagnosis

The use of neuro-imaging techniques such as CT and MRI scans are not necessarily capable of establishing the absence of injury. The diagnosis of mild injury and concussive effects have been proven to be acheived effectively through symptom-based analysis, rather than medical imaging. This means that investigating what has changed for the individual since the event and how it affects them. Where symptoms persist, this analysis can be intrumental in starting the rehabilitation process towards recovery.

Self Help

Immediately after a concussive event, the NHS advise the following:

Get plenty of rest and avoid stressful situations
Ask someone to stay with you for the first 48 hours so they can look out for problems such as changes in your behaviour or difficulty concentrating or understanding
Take paracetamol or ibuprofen if you have a headache; do not take aspirin because it could cause your injury to bleed
Avoid alcohol
When you feel better, gradually increase how much activity you do each day; do as much as you can without your symptoms coming back
Avoid a return to things like work, college, school, driving or riding a bike until you feel you've recovered
Avoid sports or strenuous exercise for at least a week, and avoiding contact sports for at least 3 weeks
Speak to a GP if your symptoms persist for more than 2 weeks

When Do Concussive Symptoms Become Post-Concussive Syndrome?

Most people make a full recovery in the period to 3 months post injury. However, in some cases the symptoms of concussion can last much longer, and this is known as post-concussion syndrome.

How Do You Know If Someone Has Post-Concussion Syndrome

Where symptoms persist, they can have a significant impact upon the individual, compromising their occupational performance, social and personal relationships. Our team of specialist neuro-rehabilitation occupational therapists have described cases where ongoing symptoms that have previously been left untreated due to late intervention have had a detrimental effect on all aspects of a persons life.

Timely therapeutic intervention, as offered by Reach, can help to identify problems and treat them early, thereby minimising or curtailing the longer-term effects of post-concussion syndrome.

Further Investigation

Studies have suggested that pituitary function can be disrupted following a concussive event and may cause issues like fatigue and sleep disturbance. Where appropriate, it is advisable to obtain an endocrinology test to exclude this condition. We suggest speaking to your General Practiioner about this.

In addition to minor head injury and concussion, there may be psychological trauma caused by the event, such as Post-Traumatic Stress Disorder, or PTSD, which can negatively impact upon an individual's long term occupational performance. In such cases, a referral to counselling or psychological services would be advised.

What Can Reach Offer?

Assessment

We offer a screening assessment for post concussion and minor head injury that is symptom based. Our assessment is an assistive tool in establishing whether or not an individual would benefit from therapeutic intervention, informs the intensity of the intervention, whilst identifying the need for referral to external services, such as physiotherapists and counsellors.

Intervention

Based on assessment findings, Reach offer bespoke treatment packages to address many of the symptoms found in the assessment. This is comprised of an educational element, and provision of strategies to help manage symptoms. We facilitate individuals to grade their progress, keep focussed on a return to normal function through achievable goal setting. We listen to the anxieties and concerns that might chellenge progress, and involve family members in the programme, especially if they will be instrumental in reinforcing advice and strategies.

Communication

We remain connected with both our patients and our referrers, and are happy to be approached at any point in our process. At both the midway and end point of our programme, we provide a comprehensive written report on the therapuetic journey and outcome of each indivdual in treatment. Should issues arise that trhreaten the success a programme, we submit to the referrer for instruction.

Please use our contact page to make further enquiries about or services, or to seek advice relating to individual cases.

 

Symptoms of Concussion

Light and/or noise sensitivity

Dizziness

Nausea

Visual distortion

Confusion

Headache

Anxiety

Low mood or irritability

Difficulty processing information

Fatigue

Memory impairment