Valerie Wood started her day last spring by participating in a fundraising bike ride to benefit world health. By the end of the day it was her own health that Wood needed to be concerned about. Near the end of the ride, she bumped tires with another rider as they headed into a curve. That bump sent Wood and her bike down hard to the ground—hard enough that the helmet she was wearing cracked.
“I knew it was a bad crash and that I probably needed medical attention,” recalls Wood, a third-year medical student at OSU, “but I was helping organize a medical school event that same day and rushed over there right after the accident.”
The next day, Wood woke with a bad headache and still not feeling like herself. She suspected she might have suffered a concussion so she called the OSU Sports Medicine Concussion Clinic and made an appointment for later that afternoon. That’s when she first met Robert Bornstein, PhD, who gave her a series of tests and diagnosed her concussion.
“His instructions to me were to ‘not think or exercise’; pretty tough for a busy med student,” says Wood. With the help and understanding of her professors, she took time off from classes and followed doctor’s orders.
“The best way to treat a concussion is complete rest—both mental and physical,” says Dr. Bornstein, who serves as the team neuropsychologist for the Columbus Blue Jackets, Columbus Crew and the OSU athletic department. “Those are tough instructions for athletes to follow since most of them have been conditioned to play through their pain. In fact, 50 percent of concussions go unreported.”
Ignoring a concussion is not a smart choice, even if that means having to miss an important game or test at school. According to Dr. Bornstein, patients need to give their minds time to “reset.” They also need to be aware that once they’ve had one concussion, they have a four to six times increased risk of suffering another concussion. It also takes longer for a person to recover from each subsequent concussion.
Wood, who also suffered a concussion several years ago when she was thrown from a horse, is grateful that although her concussion happened at a bad time during her school year, she was able to get the treatment she needed and finish her second year of medical school.
Know Your Baseline
SPOTLIGHT ON NEUROPSYCHOLOGY
Knowing when to return to work, school or other activities following a concussion can be difficult. That’s why experts recommend a baseline neuropsychological evaluation. Mandatory in many professional sports leagues, the examination is a 30-minute computerized battery of tests that focuses on reaction time, concentration and memory. “When athletes suffer a concussion, we use their baseline to help evaluate when they’ve recovered,” says Kelsey Logan, MD. “The brain doesn’t fully mature until a person is in his or her 30s, and baselines can change dramatically during the childhood and teenage years. We recommend athletes have a baseline every year until they enter high school, then every two years while they are in high school and in college.” Many local high schools have the technology to perform these baseline exams. They can also be scheduled at the OSU Sports Medicine Clinic.
The sample graph above, taken from an actual case study, demonstrates how impairments from a concussion can be compared with benchmark measurements.
Ask Your Advocate
WHAT ARE THE SYMPTOMS OF A CONCUSSION?
A person has a concussion if there is any change in mental status after sustaining a blow to the head. Some are easy to spot, such as when a person is disoriented, has balancing problems or is confused. However, most concussions are subtle with symptoms that can include a headache with slight confusion, inability to concentrate, fatigue, poor short-term memory and overall the person is “not himself.”