Concussions: Is What we Know Enough?

Concussions: Is what we Know Enough?
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A concussion is a traumatic brain injury (TBI) triggered by biomedical forces and is conceived as the mildest kind of traumatic brain injury. Concussions constitute a subcategory of neurological injuries termed traumatic brain injuries. In this context, traumatic brain injuries are categorized into different severity magnitudes ranging from mild, transient manifestations to prolonged timescales of shifted consciousness. Although its definition includes "mild," it does not imply the injury's severity but instead the lack of structural brain damage. Concussions are classified into five subtypes: migraine or headache, ocular-motor, vestibular, mood/anxiety, and cognitive. They are typically associated with cervical strain and sleep disturbance. Neurological impairment is the primary symptom of concussions, and it typically happens rapidly and disappears unexpectedly after a short timescale. The individual might also lose consciousness. This report evaluates the knowledge of concussions to establish whether what is known is enough.
Etiology
A concussion happens due to either an indirect or direct injury to the head. This implies that concussions are caused by a direct impact on an individual's head or a transmitted force triggered by an impact in other body areas. Healthcare providers typically consider the direct impact or traumatic blow to the patient's head as the leading cause of concussions. Nevertheless, indirect traumatic forces in other parts of the body can also result in an acute deceleration or acceleration injury to the patient's head, potentially culminating in a concussion (Ferry & DeCastro, 2019). According to Macdonald and Baumann (2023), sport-related concussions are triggered by a direct impact to the face, neck or head, or even other body parts and typically lead to rapid initiation of short-lived neurological symptoms and impairments.
Epidemiology
According to the Centers for Disease Control and Prevention (2022), the United States (U.S.) recorded roughly 64,321 TBI-associated hospitalizations in 2020 and 223,135 TBI-associated hospitalizations in 2019. This depicts over 611 TBI-associated hospitalizations and 176 TBI-associated deaths every day. These estimates do not incorporate TBIs mainly treated within emergency units, urgent care, primary care, or unmanaged (Centers for Disease Control and Prevention, 2022). Concussions are usually triggered by motor vehicle accidents, being hit by an assault or object, or participating in recreational athletics. Much of the current research emphasizes sport-related concussions, although these constitute an insignificant share of the recorded concussions. This implies that most of the study emanates from sports-associated head injuries.
Pathophysiology
The pathophysiology dynamics of a concussion remain complex. Concussions have acute clinical manifestations due mainly to "functional disturbances instead of structural injury" (Ferry & DeCastro, 2019). Neurometabolic and neurochemical incidents induced by injuries to the head lead to shifts in neurologic functioning. Rotation, deceleration, or acceleration of the head leads to acute axonal injury through disruptions within the neurofilament organization framework. The electrolytes release via ion channel depolarization triggers the neurotransmitters' production, ensuring neurologic dysfunction. In addition, shifts in glucose metabolism reduce blood supply to cerebral and mitochondrial dysfunction (Ferry & DeCastro, 2019).
History and Physical Evaluation
The history component of evaluation involves a discussion of the circumstances surrounding the injury, including the mechanism of injury, the location and force of impact, and any loss of consciousness or amnesia. Learning about the person's medical background, especially previous head traumas or concussions, medical illnesses, and prescription drugs. Learning about the person's symptoms, such as headaches, dizziness, balance issues, and memory loss, is also critical. Physical evaluation, on the other hand, involves a neurological examination, cognitive testing and sensory and motor abilities, and their capacity to carry out specific tasks like standing on one leg or walking straight forward, which may also be assessed by the healthcare professional. The assessment of the person's neck, spine, and other potential injury-prone body parts may also be a part of the evaluation.
Management/Treatment
Rest is critical to managing a concussion (University of California San Francisco, 2023). Injuries that lead to concussions may tear and injure the nerve fibres in the brain. Hence for the nerves to heal, physical and cognitive rests are necessary. Physical rest involves activities that could worsen symptoms, such as sporting or work activities. Cognitive rest, on the other hand, involves activities that involve the brain, or rather that lead to mental extortion, such as reading. When ...