Concussion – Steven Zonner

Concussion is technically called mTBI or “mild” traumatic brain injury implying that no anatomic finding would be seen by conventional brain imaging techniques (CT, MRI). Concussion occurs when an external force – including linear acceleration-deceleration and rotational forces – is directed through the body or brain. The shearing that occurs primarily results from a stretching of cerebellar-frontal fibers projections to the prefrontal cortex near the center of the brain below the stiff membrane of the falx cerebri – NOT an external brain bruise. The result is a neurometabolic energy crisis that leads to a complex of at least 21 different symptoms, from headache, dizziness, confusion, and loss of concentration focus due to functional cognitive, vestibular, and ocular motor impairments.

Learning Objectives:
1. mTBI implies a MILD traumatic brain injury that can not be visualized with standard MRI or CT imaging studies
2. Concussion is now broken down into 5 Subtypes or Clinical Trajectories: Oculomotor, Vestibular, Cognitive/Fatigue, Post-traumatic Migraine, Anxiety, Sleep and Cervical are considered modifiers
3. Concussion occurs when an external force is directed through the body or brain resulting in a neurometabolic energy crisis
4. Adequate, quality, sleep and early return to aerobic exercise are associated with faster recovery
5. Vestibular Therapy is a form of Physical Therapy performed by a specially trained PT