Even a Mild Concussion Could Cause Long-Term Problems

March 16, 2022 — At age 32, Carole Starr, a Maine-based instructor {and professional} musician, was in a automotive accident and had a concussion.

“Everything in my life modified,” she says. She grew to become extraordinarily delicate to sounds and had to surrender enjoying in an orchestra and singing. She additionally developed issues along with her pondering expertise. “When I tried to teach, I looked at the lesson plan I had written, but it didn’t make sense anymore.”

Starr consulted several health care professionals who dismissed her symptoms, as she had a “mild” concussion. “The first neurologist said to me — pardon the language — ‘Get off your ass and get a job.’ He didn’t understand that I was desperately trying to go back to work and failing miserably.”

She is not alone. A new study published in Neurology dispels the notion that “mild” concussions have no lasting impact on mental skills like thinking, remembering, and learning.

The results suggest that problems with thinking and memory a year after a concussion “may be more common than previously thought, although it’s reassuring this happens only in a minority of these patients,” says lead researcher Raquel Gardner, MD, of the University of California, San Francisco.

Long-Term, Chronic Effects

The study followed people with a mild concussion, also called a traumatic brain injury (TBI), for a year after their injury, measuring their thinking and memory with multiple tests. The study compared 656 people who’d had concussions, ages 17 or older (average age 40 years old), to 156 people who hadn’t gotten brain injuries.

Those in the study were given up to three neurological evaluations after their injury, 2 weeks, 6 months, and 1 year later. Each evaluation provided five scores from tests of memory, language skills, processing speed, and other brain functions, also called cognition.

The researchers wanted to define recovery after a mild concussion in a way that was relevant for each person, Gardner says, taking into account expectations for test scores based on a person’s age and education and trends in the test scores as time passed.

“What if someone started off cognitively way above average, but their cognition got progressively worse [after the TBI], even if they had not reached the threshold of being ‘below average’?” she says. “If somebody skilled a big decline, we known as it a poor cognitive end result.”

The researchers discovered that near 14% of people that’d had delicate concussions had poor cognitive outcomes a yr later, in comparison with about 5% of individuals and not using a mind damage.

Of the folks with a concussion who had poor cognitive outcomes, 10% had cognitive impairment solely, about 2% had cognitive decline solely, and about 2% had each. About 3% of the non-injured folks had cognitive impairment solely, none had cognitive decline solely, and only one% had each.

“There is a big minority of people that have a measurable cognitive drawback 1 yr later,” says Gardner. The researchers don’t know but if the issues will proceed past a yr, however they may preserve monitoring the individuals who have been studied to gather knowledge on cognition and temper and be taught extra in regards to the long-term results of delicate concussions.

The researchers discovered a number of issues have been related to a higher danger of getting poor cognitive outcomes, together with decrease training, not having medical insurance, being depressed earlier than the damage, and excessive blood sugar.

People with good cognitive outcomes have been extra more likely to have a better satisfaction with life a yr after their concussion, whereas folks with worse 1-year cognitive outcomes had extra misery and extra temper issues.

There are many causes for cognitive impairment after a gentle concussion, Gardner says. The damage may have straight broken components of the mind, or issues with sleep or temper from the concussion may then trigger issues with cognition.

Starr grew to become depressed as a result of the concussion had upended her life. “I felt my life was over, like there was no chance of a significant life once more if I couldn’t work or be who I used to be.”

Dispelling a Myth

People have the concept those that’ve had a gentle concussion at all times get higher, says Gregory O’Shanick, MD, director emeritus of the Brain Injury Association of America. But the brand new examine exhibits “this isn’t at all times the case.”

O’Shanick, who can also be medical director of the Center for Neurorehabilitation Services in Richmond, VA, believes the problem is far larger than what the examine coated, because it didn’t consider all kinds of cognitive efficiency. Also, it didn’t embrace youngsters.

He factors to a comparatively new subspecialty, known as mind damage drugs, through which medical doctors are aware of the components of psychiatry, neurology, and bodily rehabilitation related to mind accidents. This allows extra focused analysis and therapy of people that have had a concussion.

“If you will have any concern about your cognitive operate, see your physician and, if essential, advocate to have extra of an analysis with a neurologist or a neuropsychologist,” Gardner advises.

You can discover extra info and assets about mind damage rehabilitation on the web sites of the Brain Injury Association of America and the Brain Trauma Foundation.

Starr says when she lastly discovered well being care professionals who have been capable of assist her, she “actually broke down and sobbed with reduction of their workplace.”

It took her a few years to grieve the lack of her outdated life and sense of self and settle for her mind damage and the brand new particular person she had develop into.

Starr now teaches folks about mind damage at scientific conferences. She based and helps the survivor volunteer group Brain Injury Voices, and she or he is the writer of To Root and to Rise: Accepting Brain Injury.

“I’ve reinvented myself by specializing in what I can do, one small step at a time.”