concussion management guidelines
Concussions FAQs
Most of the common questions we receive are answered in these FAQ, organized by general topic. We are happy to answer additional questions by phone or in writing – reach out by telephone, email info@brainhealthpllc.com, or complete our Contact Form here.
Nope! Most people diagnosed with a concussion do not “pass out” or “black out” (lose consciousness). One of the biggest problems in treating concussions is the absence of recognition and identification of the injury. Look here [link to my Concussions page] for a brief definition of what a concussion is, and common signs and symptoms.
Sometimes, the only symptom after a hard direct or indirect hit is that the person “just doesn’t feel right” – if unsure, allow evaluation by a trained professional before allowing return to sports with risk of contact to the head. Returning to sport prior to complete recovery can trigger more serious, and sometimes (albeit rarely) life-threatening brain injury.
Sports Neuropsychologists are doctoral level health care professionals – doctors – who have more specialized training in how the brain functions than any other kind of doctor. Not only can concussions affect physical functioning – the symptoms that your medical doctor or physical therapist will assess and may treat – concussions also affect all the aspects of functioning that sports neuropsychologists are trained to evaluate and manage – thinking (attention/memory), behaviors, emotions, and sleep.
Thus, sports neuropsychologists have unique skills to provide individualized care to help individuals recover from concussion quickly and safely and return to optimal performance.
Since concussions are a different kind of brain injury than a structural injury caused by a tumor, stroke, or penetrating object, not all neuropsychologists have the additional, specialized training needed for appropriate concussion evaluation and management, and especially within the context of sports-related injuries.
Yes you can – but it doesn’t mean that you should, and you certainly shouldn’t take them at home alone on your own time and in your own way! Without appropriate conditions, those test results may not be very reliable or valid. And, you want to be sure the person interpreting the testing has appropriate training.
Just as you wouldn’t ask a podiatrist to read a mammogram, you wouldn’t want someone without the appropriate degree and training giving and interpreting tests measuring brain functioning. A weekend workshop isn’t a substitute for 6-8 years of training, and there are no good shortcuts.
Neuropsychologists are often regarded as testing experts, and we have many tools to choose from. Common computerized concussion tests are just one tool for determining if you’re 100% back to your pre- injury functioning, but those tests also have drawbacks and there’s no such thing as a “passing score.” When needed, Dr. Shapiro can administer some tests via telehealth or in-person, assist your local Athletic
Trainer or physician with interpretation, or refer you to someone else. Working as a team is essential.
Neuropsychological testing for concussions is not nearly as extensive as “traditional” neuropsychological testing, since functioning is expected to change rapidly over time. Even in cases of chronic or persistent post-concussion symptoms, more than 1-2 hours of formal testing is rarely needed, with evaluations typically including extensive clinical interviewing and symptom assessment, with some oculomotor and/or
vestibular screening.
Yes…and no! Everyone recovers at their own rate, but recovery should take days or weeks, not months. Recovery should continue to progress quickly and when it doesn’t, Dr. Shapiro screens for barriers to recovery and known risk factors for prolonged recovery. A standard 20- or 40-minute medical exam is not going to allow enough time, or yield the information that is needed, to expedite recovery.
Dr. Shapiro provides individualized recommendations for supports in home, classroom, and workplace to help manage symptoms in a way that allows clients to return to life while facilitating recovery. When needed,
she refers to related providers in your area with the right training and specialized skills to help you, too.
Everyone recovers at their own rate because of all the factors that can affect symptoms and recovery. Most healthy individuals recover fully in a few weeks. If recovery seems slow, is taking longer, or you have a history of anxiety, depression, learning or attention problems, poor sleep, prior concussions, dizziness,
migraine or other chronic pain, you want a sports neuropsychologist involved to help manage those risk factors associated with longer recoveries. Sooner vs. later never hurts, as we can usually help speed recovery at any age or stage but work with sports neuropsychology is not always needed for everyone.
Many doctors recommend that, but just as a medical doctor decides what kinds of tests – like blood tests or imaging, for example – is needed to evaluate an injury or illness, Dr. Shapiro decides what kind of testing or evaluation is needed for her clients. She uses many sources of information to evaluate functioning, but she does not always need hours and hours of the traditional neuropsychological testing that your doctor may be thinking of, either. It all starts with intake questionnaires and an initial 1-2 hour
initial evaluation – usually via telehealth. From there Dr. Shapiro will work with clients to determine the
best next steps.
No, it’s not. Continued headaches suggest that recovery is not complete.
