|Patrick Mularoni, MD|
The brain suffers an injury on the cellular level during concussion. After the injury to the brain occurs it is followed by a disturbance in the electrolytes in the brain. This disturbance requires a significant amount of cellular energy to be corrected. The brain heals through normalization of the electrolyte balance in the brain environment.
If the brain is stressed during the recovery period it can lead to worsening symptoms for the patient. A stress on the brain can be considered any process that requires energy that is being used to heal the cells that were injured. Thus, when a patient has been diagnosed with concussion the treatment usually consists of rest for the brain from both cognitive and physical stress.
When treating a patient the first and most important aspect of treatment is physical rest. A player should stop all training until they are symptom free. This not only decreases the physical stress on the brain but also decreases the risk of a second injury.
The second form of rest is called cognitive rest. This aspect is often more difficult than physical rest because most athletes are students. When a student-athlete is symptomatic, we ask teachers to limit the volume of schoolwork and ask that testing is avoided whenever possible. We ask students to limit time on computers because eye strain can worsen headaches associated with concussion. Television, texting, and video gaming should be limited as these can also cause stress to the eyes and the brain of a concussed athlete.
By allowing the brain to have an environment of physical and cognitive rest, the majority of concussion symptoms will resolve and greater than 80% of athletes will be at their baseline in just two weeks.