When Allison Haggart fell and hit her head while snowboarding two years ago, she had no idea what she was in for. “I fell backwards and hit the back of my head on a patch of ice,” recalls the now 20-year-old university student. “I was dizzy, nauseated and disoriented.”
It was only hours later, when visiting her doctor, that she realized she had sustained a concussion. “He told me I had a minor concussion, to go home and sleep it off.”
But a predicted two-week recovery became an 18-month journey. "I didn't really appreciate that it would take so long,” says Haggart, who spent much of that period at home, off school. She was sensitive to light and sound, unable to read, watch TV or concentrate on much at all in the early months. “It was like having a wicked migraine for months on end,” she says.
Yet Haggart’s story has a happy ending: She ended up returning to school, graduating from high school and starting university. But the experience has taught her to be cautious. “I took up fencing in university because you’re not aiming for the head,” she laughs.
How to diagnose a concussion
Concussions can be tricky to diagnose, say experts, as they exhibit close to 100 different symptoms, and diagnostic tests such as MRIs and CT scans don’t detect them. But undiagnosed concussions can lead to neurological issues down the road, such as memory lapses, vision problems and emotional changes. And research has linked repeated concussions to certain types of dementia.
That said, a lot of progress in treating concussions has been made in the past 10 years, with family doctors becoming increasingly aware of concussion symptoms and treatment.
“We still don’t have all the answers, but we’re getting there,” says Dr. Charles Tator, a neurosurgeon at Toronto Western Hospital in Toronto, founder of ThinkFirst Canada, an injury-prevention program for schoolchildren and a board member with Parachute Canada, a national injury-prevention organization. “We have better ways to diagnose concussion.”
Tator says medical experts around the world have been working hard to develop and clarify the definition of a concussion: a type of brain injury caused by a blow to the head or other part of the body, causing the brain to shift within the skull. This has led to more awareness among doctors of the types of symptoms to look for,
Symptoms of a concussion
- Headache or sensation of pressure in the head
- Blacking out or seeing stars — momentary loss of consciousness
- Memory loss
- Ringing in the ears
- Nausea or vomiting
- Slurred speech
- Sensitivity to light or loud noises
- Vision problems
How to treat a concussion
In the past, people diagnosed with a concussion were told to lie down in a darkened room for an extended period of time to “heal the brain.” That’s no longer the case, says Tator, “Research has shown that’s useless.
“We do recommend an avoidance of precipitating factors,” he says. “And those factors differ from one person to another.”
Tator says that if you have a concussion and are sensitive to sound and light, you should stay in a quiet environment or wear sunglasses when going outside. If reading is a problem, then you should avoid it until you can gradually do it without symptoms. “No two patients are alike,” says Tator. “Management has to be very individual.”
He suggests people return to work, play or sports very gradually, to avoid the return of symptoms. To bring about a return to normalcy, he says people need to do a little more each day, rather than just take time off. He says subtle, physiotherapy-type challenges to the brain — such as reading for a short period or adding up a few numbers – can help restore its healthy functioning.
“We may say: ‘Try an hour a day. Or try every other day,’” Tator says.
How to prevent concussions
While helmets can help prevent some types of injuries, and should be worn while skiing, snowboarding, skating and sledding, they can’t prevent concussions, says Tator. Instead, the best way to avoid a brain injury is to avoid activities in which there is head-to-head contact, such as tackle football. “We have to be smarter about preventing concussion, rather than just putting a helmet on,” Tator advises.
High-risk sports such as hockey can be modified to make play safer, he says. “You really can drastically reduce the number of head impacts in hockey by stressing skill rather than violence.”
But he feels more needs to be done around preventing concussions, such as instituting new rules that limit body checking in hockey, and prohibiting it completely for kids under 16.
“We really need to wake up to the fact that there’s a problem,” says Tator.
In soccer, experts such as neurosurgeon Robert Cantu of Boston University, a leading American authority on concussion in youth sports, are now recommending that children not head the ball before age 14.
- Read more about preventing sports injuries
If you have a concussion
Three things to keep in mind:
Don’t overdo it. Pushing too hard to resume activities after a concussion can cause the return of symptoms and a delay in recovery.
Seek a second opinion. If you suspect you or someone in your family has a concussion but your physician dismisses it, seek a second opinion. It might be a good option to see a sports doctor who treats concussions frequently, says Dr. Tator.
If you’ve had one, exercise caution. Multiple concussions raise the risk of dementia and other brain diseases. At all costs, prevent a second brain injury before the brain has healed from a first concussion.