H E A LT H & W E L L N E S S
Concussion – Advanced Treatments Making a Difference By Joseph Maroon, MD
Advances during the pandemic to identify, treat and develop a vaccine for the COVID-19 virus are unprecedented in human history. In less than one year, an unheard-of virus has undergone thousands of scientific and clinical trials with many billions of dollars spent in the U.S and trillions spent around the world to reduce its deadly toll. The resulting benefits of this massive undertaking are now being seen with some return of a normal lifestyle.
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similar, but smaller scale, push for advancement has occurred over the last 30 years to improve the prevention, identification and treatment of concussion. What we know now is based on years of concussion research and treatment outcome studies that did not exist until recently. It is important to discuss how concussion management has advanced especially as spring sports and other outdoor activities are starting up and concussion risk increases. In 1984, I had the privilege to become the first team neurosurgeon in the NFL when I was asked to advise the Pittsburgh Steelers football club on the prevention and treatment of head and spine injuries. Although concussions have been commonly recognized in medical texts for centuries, the treatment thereof mostly consisted of withdrawal from almost all activities, sedatives, mood stabilizers, antidepressants, home remedies and giving “nature” the opportunity to heal the injured brain. In 2003, my colleague, Mark Lovell, PhD, Dr. Freddie Fu, Mickey Collins, PhD and I were asked to develop a concussion treatment center at UPMC. One of our goals for the UPMC Sports Medicine Concussion Program was to develop strategies for preventing and treating long-term symptoms of post-concussion syndromes, particularly for athletes. We had previously worked with the Pittsburgh Steelers and then head coach, Chuck Noll, to develop a neurocognitive test call ImPACT. ImPACT is a computerbased test used to assess memory, cognition, the processing of information and more along with a symptom score. This test is recommended as a baseline for participants in all contact sports. It is also available for kids 5 to 12 who are most commonly injured after falls. Following a concussion at any age, the baseline and subsequent re-testing is one tool used to provide guidance on the severity of the brain injury. Over 20 million tests have thus far been administered to athletes and non-athletes alike. Clinicians at the UPMC Sports Medicine Concussion
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Program, now led by Micky Collins, PhD, see over 10,000 new patients per year. All concussions are not the same. The program has classified concussions into several different types. These include symptoms involving cognitive and fatigue complaints, anxiety and mood disturbances, dizziness or balance abnormalities, migraine type headaches, difficulty focusing and visual abnormalities. Treatments are now specialized and based on the type of concussion diagnosed. Certain medications, visual and balance training, progressive physical activity and much more are used to treat the symptoms of concussion. Additionally, the use of supplements like fish oil or omega-3, vitamin D3, magnesium, resveratrol, cannabidiol (CBD) and turmeric are being studied. If there is failure to respond to initial treatments, and, if symptoms are intractable, biofeedback and possibly hyperbaric oxygen therapy may be a consideration. We have learned women appear to be more susceptible to concussions and also more adversely affected than men. One explanation is due to the fact their necks are less muscular than men and are more prone to snap back and forth or be rotated more quickly with a fall or blow to the head. They are also more likely to suffer longer-lasting effects. Always speak to a healthcare professional if you have suffered a concussion or have concussion signs or symptoms. The good news is most concussion symptoms will resolve in the course of a few days to 1-2 weeks. Persistent symptoms and signs, however, should not be ignored following a blow to the head. We are fortunate to have a world-class concussion program right here in Pittsburgh that will continue to lead in concussion advancements. Joseph C. Maroon, MD is a Board-Certified Neurosurgeon, Nutritional and Sports Medicine Expert. Dr. Maroon has written and lectured extensively on brain health and healthy life choices. As a competitive Ironman triathlete, Dr. Maroon practices what he preaches and is committed to the promoting healthy choices to his patients and readers.
