THE HUMAN BRAIN IS COMPOSED OF APPROXIMATELY 86 BILLION NEURONS
leading to various physical, cognitive, and emotional symptoms.
Causes and risk factors Concussion can happen to anyone, but it is especially common in sports, such as cycling, football, rugby, hockey, and boxing. Other common causes of concussions include falls, and car accidents. According to Headway (The Brain Injury Association), there were 356,699 UK admissions to hospital with acquired brain injury in 2019-20. This is a 12% increase since 2005-6. Factors such as age, previous concussions, and participation in contact sports can increase the risk of experiencing a concussion.
Diagnosis
Pharmacists should be aware of the challenges in diagnosing concussions due to their often- invisible nature. The diagnosis of concussion is based on the history of the injury and the symptoms reported by the person or observed by others. There is no single test that can confirm or rule out a concussion, but some tests may be performed to rule out more severe brain injuries,
such as bleeding or swelling in the brain. These tests may include a physical examination, neurological assessment, cognitive testing, and imaging studies, such as CT or MRI scans. It is therefore important that concussion should only be diagnosed by a health professional trained in assessing patients with head injury. They will be able to rule out serious brain injury that needs a brain scan or surgery. Patients should visit their nearest accident and emergency (A&E) department if they or someone in their care has a head injury and develops signs and symptoms1 of injury.
Symptoms Concussion symptoms can vary widely and may not be immediately apparent. Symptoms of concussion include brief: • loss of consciousness after the head injury • periods of memory loss • disturbances in vision, such as “seeing stars” or blurry vision
• periods of confusion, a blank expression, or a delay in answering questions immediately after the head injury
Other symptoms may include headaches, dizziness, nausea, vomiting, memory problems, and mood changes.
Treatment The treatment of concussion depends on the severity and duration of the symptoms. The main principle of treatment is ‘Cognitive Rest’ - to allow the brain to rest and heal. This means avoiding any physical or mental activities that may worsen the symptoms or increase the risk of another concussion. Some examples of activities to avoid are sports, exercise, driving, reading, watching TV, playing video games, and using a computer or phone. The patient should also avoid alcohol and drugs that may affect the brain function. Patients should be advised to ensure they get adequate sleep. As pharmacists, we can provide guidance on maintaining a restful environment and improving sleep quality.
Medication recommendations Pharmacists can offer valuable recommendations for OTC medications to manage concussion symptoms. For example, paracetamol can be recommended for headache relief, while antiemetics can help with nausea and vomiting. However, it's essential to caution patients about the appropriate use of these medications to prevent potential overuse or misuse.
Return to activities Concussion recovery often involves a gradual return to activities. Whether it's returning to work, school, or sports, patients must follow specific protocols to ensure their safety. Pharmacists can educate patients about these protocols and the importance of not rushing the recovery process. “If in doubt, sit it out.”
1 Source:
https://www.nhsinform.scot/illnesses-and- conditions/injuries/head-and-neck-injuries/concussion/
THE MAIN PRINCIPLE OF TREATMENT IS ‘COGNITIVE REST’
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