Category: Concussion research

Headache medications may worsen headaches after concussions

Posted 11 November 2013 by prehab

There are many instances in which athletes present with chronic headaches post concussion. Some of them with history of migraines trigger an aggressive approach from some pediatricians. Family history of migraines, for example, increases the possibility of developing migraines and that may trigger a closer look at the benefits of headache medication. In most instants analgesics are indicated but in some times overuse of pain medication may cause the syndrome to worsen. Dr. Geoffrey Heyer, MD reports in his study presented as an abstract, here referenced, headache medications may worsen headaches after concussions and may cause chronification of a headache syndrome.

Have you had any experience in this regard? Anecdotes? How did it resolve?

Source reference: Heyer G, et al “Analgesic overuse contributes to chronic post –traumatic headaches in adolescent concussion patients: CNS 2013; Abstract 113

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Can we reduce the risk of concussions? How?

Posted 30 September 2013 by prehab

Apparently there is no new evidence that current strategies utilized to prevent concussions are as effectives as we were hoping said Dr. Carrie Esopenko, PhD researcher at Baycrest Canada. In her article, she also sites the latest efforts in the industry and strategies that work and we can all be taking in consideration in our prevention programs, who is doing what and technology available.

Just what are Effective Concussion Risk-Reduction Strategies?

Carrie Esopenko, PhD

Recently, the News has been fraught with headlines that we are facing a concussion epidemic. Every morning, it seems that we are waking up to yet another story about a high profile athlete being sidelined with a concussion. What may be worse is that these news stories are not just limited to high profile athletes. An ever increasing number of youth are also being sidelined with these injuries .So the questions we now face as clinicians, scientists, coaches, trainers, athletes, and parents are: If we know there is a concussion epidemic, what can we do? How can we prevent these invisible injuries, not only in high-profile athletes, but in our children?

There have been many strides in the right direction with respect to prevention of concussions in sport. For example, we see: equipment changes, sport-specific rule changes, and certain states implementing legislation that regulates who can determine when children can return to play following a concussion. Although these changes are definitely good moves, one must wonder, with the increasing number of concussions, are these strategies working? Recently, Benson and colleagues (2013; see citation below), carried out a review of current research examining the effectiveness of concussion risk-reduction strategies. The authors identified a number of risk-reduction strategies discussed in the literature, such as rules changes, legislation, neck strength, and head gear used in contact sports. Unfortunately, they found “little new evidence for successful interventions to reduce concussion” (pg. 5). There is no new evidence that the strategies we are using to prevent concussions are doing what we want them to. However, given the advancement in technology and techniques used in brain science, hope is not all lost that one day we will be able prevent concussion in sports. We must remember that the implementation of concussion legislation is still new, and not all sports have taken the initiative to make rule changes that would decrease head impacts, meaning that not much time has passed to see the effects of these changes.

So let this be the take home message… Although we are more aware of concussions and the prevention strategies we are developing are steps in the right direction, the strategies we have been using to prevent concussions may not be working… yet. More research needs to be done to better understand, not only the synergistic effects these changes have, but concussions themselves, before we truly prevent them.


For an review of current concussion risk-reduction strategies and future directions on how to develop better prevention strategies, check out the following  article:

Benson BW, McIntosh AS, Maddocks D, et al. What are the most effective risk-reduction strategies in sport concussion? Br J Sports Med 2013; 47: 321–326.

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Medications. Good or bad for Concussion Treatment

Posted 2 August 2013 by prehab

There is plenty of controversy about the use of medications for post concussion symptoms however there appears to be growing evidence that some of them such as Amantadine, when indicated, may not only help manage symptoms but they may actually improve verbal memory and reaction time, often affected by a concussion.

What kind of experience have you had with medications?

Read the actual study that supports these findings.

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More technology in the making to help diagnosing concussions

Posted 7 July 2013 by prehab

University of Nebraska’s Center for Brain, Biology and Behavior in Lincoln, Nebraska, (CB3), a new toy is being developed. A comprehensive mesh of sensors to help identify concussions, how severe and assisting in return to play decision. Plenty of skeptics are talking but after all it may be a good step towards the future of diagnostics. No alternative to a good clinical exam but a great attempt to improve what we have. See full article by AP published on TH Online.

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Immune system compromised after a concussion: Pills may be in the making as a cure

Posted 10 March 2013 by prehab

The processes in which a brain deals with a concussion are many and therefore a variety of treatments are being formulated by many scientists currently involved in research. The latest research points to the immune system and is something to be concerned about, according to a new study published in the Journal Plos One, last week.

As reported by Popular Science, Sub-concussive jostling to the brain could lead to a series of events that ends with cells in the immune system attacking the brain, says Jeffrey Bazarian, a physician at the University of Rochester Medical Center and a co-author on a new study about brain injury as an autoimmune response.

Here is Bazarian and his colleagues’ idea. After a head hit, even if it doesn’t result in a concussion, the blood-brain barrier that separates the brain from the rest of the circulatory system opens up, releasing a brain protein called S100B into the blood. High levels of S100B in the blood are already known as marker for head injury; in Europe, emergency rooms give head injury patients S100B tests to decide whether they need a CAT scan.

We may be onto something here if further research efforts can shed additional light on this issue that may result in a possible pill or vaccine to block the Immune response. Furthermore, testing for S100B may be an ingenious idea for the pediatric population, if safe. It can be a useful measure to prevent unnecessary CAT scans known be harmful to the developing brain.

Here is the full study in PDF for additional information on Bazarian and colleague’s findings.

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New Technology Helps Diagnosing Concussions

Posted 6 March 2013 by prehab

Great advances in technology makes diagnosing concussions possible. High definition fiber tracking is a promising technology to directly measure breaks in brain fibers that control function. This technology will allow for biological diagnosis of brain injury.

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