Headache is the most common symptom of concussion. Brain Injury Awareness Month is coming in March, an effort to increase awareness of brain injuries and their significance. The Brain Injury Association of America recently updated their definition of traumatic brain injury: TBI is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force. Even seemingly mild jolts to the brain can actually cause a concussion. Ever get that feeling of being dazed? That’s a concussion, too. Headaches can occur immediately at the time of impact or in the ensuing days afterwards, and can be brief, or can result in prolonged and chronic problems.
It was a notable weekend where numerous severe neurological injuries were incurred during football games. Representatives from the NFL have stated that there will be new penalties enforced for devastating and illegal hits, to help protect players from concussion and other injuries.
Protecting athletes from concussion is a good thing. The most important issue here in my mind, is the NFL making a statement and setting a standard for younger players and their leagues. When the NFL comes out with a strong statement like this, people listen. How this will affect the game and the way players play is entirely another thing, and not something that I can truly comment on.
Concussion is under recognized, and under reported, and can have devastating neurological consequences, including even death. Of course, most concussions are mild, and people recover from them. It is more likely, though, that permanent brain damage will result if a first concussion is not fully healed before a second concussion happens. You must allow the brain to heal FULLY before engaging in risky activity. You should see a doctor to help determine when that healing is complete.
There is also an increased risk of sustaining permanent brain damage after recurrent concussions, and the more concussions you have, the more you’re likely to get.
Knowledge and awareness helps to guide us through making important decisions. The decision on whether to play should only be made with full awareness of the potential risks. But in the end, it is the choice of the individual and/or parent, so providing the appropriate information on which to base decisions is an important step.
Vertigo and dizziness are common problems in migraine sufferers. In general, as a neurologist, I see a lot of patients with dizziness. The problem tends to be more prominent in migraineurs. There are several different potential causes of vertigo, and even more in migraineurs.
Vertigo can be present as a part of migraine, is very common after concussion, and can be caused by a host of middle and inner ear disorders, as well as brain disorders. In some cases, dizziness can be related to dehydration, blood pressure drops, or heart problems.
Vertigo can be an associated symptom of migraine (like nausea and sensitivity to light), it can be an aura-type symptom (preceding the migraine in a very distinct episode), it can be the only manifestation of migraine (migrainous vertigo, a variant of migraine) or it can be a symptom in the general life, intermittently and not associated with actual migraine attacks, of a migraineur, but related to the migraine by the genetic underlying sensitivities.
Of course, migraineurs can also get vertigo from the more typical and non-migraine related causes, such as inner ear infections, labyrinthitis, benign positional vertigo, menierie’s disease, other ear problems, and even strokes.
It is an interesting and common problem. It, unfortunately, is very difficult to treat. Keep yourself well hydrated and ask your doctor if any of your medications can be adding to the problem. Often times it will go away on it’s own, if it is from a benign cause. In severe chronic cases of vertigo, a special type of rehabilitation can be useful.
With kids, young and old, all out of school there is plenty of time and good weather for sports, recreation, and travel. We need to be cautious with our fun, just a little, to avoid potentially long term problems. That is truly the issue, who wants to think about head injuries as your heading to the pool or out for a game of softball? Since the 1970’s when I grew up, though, times have changed. Kids now wear helmets when they ride bikes, and sit in carseats til they’re 10 or so? I remember, but won’t go in to detail, riding on what was essentially the hood of my dad’s car while he drove 30 mph down our street. Boy, it was fun. We blasted Fleetwood Mac, the wind racing through our hair… those times are over, though. Car seats, seat belts, all this safety. But we, as a society, decided to make these changes because we knew the tragedy of losing a young healthy vital person for no reason. Now, all kids wear helmets when riding bikes, and they are getting more and more common on the ski slopes too. Why? Because even though we all want to feel the wind in our hair, we know better. We don’t want the tragedy to be our own loved ones, or our own selves. When this all started, everyone was upset. But we got used to it as a society, and now we all do it. I, for one, rebelled against seatbelts for a few years. Now, I feel naked without one.
So, back to summertime fun and concussions. We need to think about it, talk about it, know about it. Fatal brain injuries are tragic, and thankfully uncommon. Concussions are surprisingly common, and surprisingly dismissed. Yet, concussion can be downright dangerous, and can lead to long term consequences for our brains. We neurologists have some idea about the consequences in adults, and still don’t understand many of the consequences in children. In adults, concussions can lead to headaches, memory loss, mood changes, depression, dizziness, balance problems, impaired concentration, and more.
Think about safety and your brain. Protect it. You might need it one day. (or tomorrow.) If you get a concussion, stop doing what you’re doing, rest, and contact your doctor.
Damage to blood vessels in the neck and head, can cause headaches. The type of damage I’m talking about is arterial dissection. This can happen after trauma, but sometimes the trauma is very innocuous, or there is no trauma at all. Also, sometimes this type of problem is associated with stroke like symptoms, but sometimes it’s just a headache.
Trauma that can lead to dissection includes whiplash type injuries, anything with prolonged hyperextension of the neck, and even cracking your own neck. So be careful out there… protect your head and neck.