At CNS, we take all brain injuries seriously regardless if they are caused by sports, accidents, falls, or other acquired injury mechanism. Whether the symptoms are mild or severe, we have the skill and experience to care for them all. Dr. Ostergaard has many years of experience working with student-athletes who have sustained neurotrauma, ranging from sports-related concussions to more complex injuries. We are here to help every step of the way.
If your student-athlete experiences a mild traumatic brain injury, CNS provides specialty testing and treatment designed for concussion recovery. Through concussion recovery testing, we will establish the severity of your student-athlete’s symptoms and determine a recovery treatment plan based on his or her specific needs. Dr. Ostergaard can assist with monitoring your student-athlete so you will feel confident knowing their concussion has healed before they return to activity. Our goal is to help your student-athlete make a full recovery as quickly as possible while reducing risk for long-term injury.
Excellent concussion care is the best way to help prevent complications from a concussion and to reduce the risk for further injury. Your family will work closely with Dr. Ostergaard, a highly trained specialist, who will offer expert care and guidance. Dr. Ostergaard supports student-athletes, parents, medical providers, athletic trainers, coaches, educators, and therapists by providing information regarding post-injury symptoms, recovery expectations, and guidelines for a safe and successful return-to-school and activity. Because early intervention and education improve outcomes, together we can avoid a prolonged recovery, eliminate the risk of recurrent or permanent injuries that might result in long-term consequences, and assist your student-athlete to achieve a full recovery as quickly as possible.
Concussion Injury Rates
A concussion is also known as a mild traumatic brain injury causing a temporary alteration in the way the brain functions. A concussion can occur when the head gets hit hard or when a sudden impact causes the brain to move within the skull. A student-athlete who experiences a concussion may or may not lose consciousness. Either way, the head injury can damage cells, blood vessels, and nerves in the brain. Concussions can also occur along with injuries to the neck and upper spine. Examples of these types of concussions include whiplash and “stingers” that affect the nerves in the neck or shoulder. Injury to the brain from a concussion cannot be seen on an x-ray, CT scan, or MRI. It is diagnosed based on symptoms, which may develop immediately after injury or may develop hours or days later. While most student-athletes recover from a concussion within a matter of days, for some symptoms can persist for weeks or longer.
Baseline concussion testing is a critical component of concussion care. It is used to establish a student-athlete’s functioning before there is a problem and assess a student-athlete’s recovery risk factors. In the event that a concussion occurs, concussion recovery testing is completed. By comparing pre-injury and post-injury scores, the severity of the injury can be determined, recovery monitored, and informed decisions can be made regarding return to school and activity with confidence.
Baseline concussion testing at CNS is uniquely comprehensive. Typically, computer baseline testing assesses 2 neurocognitive domains. At CNS, your student-athlete’s pre-injury functioning is established by augmenting computer assessment measures with neuropsychological testing, evaluating an additional 10 critical neurocognitive domains known to be at risk for impairment following a head injury. Further, measures of effort are administered to ensure reliability and validity of test findings. This best practice model ensures that comparison testing following an injury will result in informed, confident, reliable, and valid conclusions regarding recovery and treatment, effectively eliminating the guess work that often accompanies recovery from a head injury.
Research has shown that younger student-athletes are more susceptible to severe injury following minor insults, as well as a protracted recovery period. Computer based baseline testing is only appropriate for student-athletes 12-years-old and older. Based on empirical evidence and experience, although some computer based measures will generate test findings for student-athletes as young as 10-years-old, these findings have been unreliable. At CNS, our best practice model of baseline testing allows student-athletes 11-years-old and younger to establish reliable baseline neurocognitive functioning prior to injury.
Several elite sporting organizations now mandate that their athletes participate in baseline concussion testing to ensure the most successful recovery of their concussion injuries. Most notable was the decision by the NFL in 2006 to require all players to complete baseline concussion testing before each pre-season. Other organizations utilizing baseline concussion testing include the NHL, MLS, MLB, NBA, NASCAR, US National Soccer Team, most elite college sports programs, and over 3500 high school sport teams across the country.
Neuropsychological testing is recognized as playing a vital role in the management of sport concussion injuries by the Center for Disease Control, National Athletic Trainers Association, and the 4th International Conference on Concussion In Sports. Whereas CT and MRI scans are useful in assessing physical changes in brain structure, concussion recovery testing provides information regarding how the brain functions. This is particularly useful in conditions where brain structure may be normal, as in mild head injuries or concussions. When changes in functioning are mild, which is often the case following a concussion, concussion recovery testing may be the only way to detect them. Using standardized neuropsychological testing, a neuropsychologist can judge whether or not your student-athlete’s scores fall within expected ranges for their age. The pattern of the student-athlete’s test scores will also be reviewed to evaluate individual strengths and weaknesses. Injury severity and recovery is most easily determined when a comparison can be made to baseline concussion testing or a student-athlete’s scores before an injury occurs. By comparing pre-injury to post-injury scores, individual changes in functioning can be quantified to inform return-to-school and activity decisions with confidence. Before clearing a student-athlete to return-to-school and activity, concussion recovery testing is recommended to ensure recovery and return to baseline or pre-injury functioning.
Just as a student-athlete needs to rest his or her body after an injury, he or she also must rest the brain after a concussion. This may include modifying school activities or staying home from school completely. A neuropsychologist with expertise in understanding neurocognitive functioning is uniquely equipped to prescribe academic accommodations. Every student-athlete is unique and no two concussion injuries are alike. Each student-athlete should have a personal treatment plan rather than a fixed schedule of academic modifications. Upon completion of concussion recovery testing, a custom treatment plan can be tailored to each student-athlete’s individual needs and goals.
The student-athlete will complete concussion recovery testing and scores will be compared to a normative sample. While not ideal, neurocognitive injury severity can be determined and recovery monitored.
- Team sports
- Motor vehicle accidents
- Physical violence
- Inadequate supervision
Younger athletes are at higher risk for sustaining a concussion and are likely to take longer to recover.
Annually, as many as 3.5 million athletes will experience a concussion each season.
- Loss of consciousness
- Nausea or vomiting
- Balance or dizziness problems
- Poor coordination
- Double or blurred vision
- Noise and light sensitivity
- Numbness or tingling
- Slurred or slow speech
- Sleeping more or less than usual
- Trouble falling or staying asleep
- Lack of interest in favorite activities
- More emotional than usual
- Poor attention or memory
- Confused or forgetful
- Asking the same question repeatedly
- Answering questions or following directions slowly
- Slower reaction time
- Decline in school performance
- After a suspected concussion, a physician should always evaluate your student-athlete.
- It is very important to rest from cognitive and physical activity while recovering from a concussion. However, your student-athlete should return to school as soon as possible with the support of academic accommodations and modifications, which can be tailored to meet their individual needs by completing concussion recovery testing.
- Most student-athletes experience a full recovery within a matter of days to weeks following an injury. However, if your student-athlete’s concussion symptoms persist beyond 4 weeks and/or they are struggling academically, emotionally, behaviorally, or socially, they should be seen for concussion recovery testing.
- Concussion recovery testing is also recommended prior to returning to school and activities for student-athletes who have a history of multiple concussions.
Whereas CT and MRI scans are useful in assessing physical changes in brain structure, neuropsychological testing provides information regarding how the brain functions. This is particularly useful in conditions where brain structure may be normal, as in mild head injuries or concussions. When changes in functioning are mild, which is often the case following a concussion, concussion recovery testing may be the only way to detect them. By comparing pre-injury to post-injury scores, changes in functioning can be quantified, symptom severity can be determined, and recovery can be monitored to inform return-to-school and activity decisions with confidence.
Because every injury is different, recovery time varies. Some student-athletes recover in days, while others require weeks or months. Permanent or long-term neurocognitive, behavioral, emotional, and social deficits resulting from mild head injury are extremely rare.
There are a number of factors that contribute to concussion recovery:
- History of previous concussion(s)
- Pre-injury conditions (e.g., sleep disturbance, headaches, depression, anxiety, ADHD, learning problems, etc.)
- Injury management
Typically, symptoms remit within a few days to a few weeks (4 weeks) following injury. However, despite being symptom free, the brain can still be in recovery and continue to show deficits on neuropsychological testing.
A student-athlete must be symptom free at rest and exertion. However, even student-athletes who are not experiencing any symptoms can still be involved in a recovery process. The use of concussion recovery testing can assist in determining if an athlete is still actively recovering from a head injury and inform return-to-school and activity decisions.
Concussions take time and proper care to heal. If your student-athlete experiences a second concussion before the first has healed, serious and long-lasting symptoms may occur.
Student-athletes that return to activity while their brain is still injured are at significantly higher risk of sustaining another brain injury, even from a more mild blow to the head. This cumulative injury can be very serious, complicating the recovery process and placing the student-athlete at greater risk for a prolonged recovery with severe consequences, such as chronic and more severe symptoms, an inability to participate in the remainder of the season, ending play in a desired sport, or permanent brain damage. In extremely rare cases, death from Second Impact Syndrome may occur due to rapid swelling of the brain after a student-athlete experiences a second concussion before previous concussion symptoms have healed.
You Have Questions & CNS Has Answers
You may have a lot of questions about your student-athlete’s concussion. We will answer all your questions about concussion and treatment. You will also receive written instructions about your student-athlete’s treatment plan, including any specific accommodations for school or activity.
We Know You May Want More Information
The Center for Disease Control provides a range of information about concussion, including sports-related concussion prevention and treatment.