Just Trying to Think Clearly after Head Injury Can Slow Recovery

Concussion-Mike Fender-The StarTalk about vicious circles: the stress of trying to think clearly can impair the ability to recover clear thinking.  A very strong piece of reporting by Robert Lee Hotz, titled REPERCUSSIONS IN SCHOOL FROM CONCUSSIONS ON THE FIELD, appeared recently in the Wall Street Journal.  Hotz’s investigation confirms that “almost every concussion leaves the brain unable to easily handle normal chores.  And the attempt to CONCENTRATE and FOCUS itself seems to set back the healing process.”  “When we place demands on a student’s brain, that can cause symptoms to spike,” said a program coordinator  for a return-to-school-concussion program.  “As a result, the mental exertion of normal classwork could even worsen the effects of a concussion,” writes Hotz.  The implications are significant not just for student athletes, but for CHILDREN and ADULTS who have suffered serious and/or repeated closed head injuries.

It is now common knowledge that recurrent head injuries cause progressive difficulties and that sports concussions (colorfully called having one’s “bell rung”) require significant time off-field to protect student athletes (see my blog posts July 9, 2013; May 1, 2012; August 26, 2010).  Today’s article is important because it brings awareness that the effort to think clearly is a stress in itself that may retard cognitive recovery.  “Brain-injury specialists say the mental exertion of normal classwork could even worsen the effects of a concussion,”  the article says.  One program in Pennsylvania recommends that “students not return to school until they can focus mental attention for at least 30 minutes without concussive symptoms.  Even then, the student may be required to take a 10-minute rest break after every 30 minutes of study.”

The article goes on to state that “typically 80% of high school and college student-athletes recover from a concussion in about three weeks.  The younger an athlete is, though, the more lasting the cognitive consequences, new research suggests.”

For those who have a WSJ subscription the complete article is available at this link, http://online.wsj.com/article/SB10001424127887324108204579022770562136360.html

Addendum:  The American Psychiatric Association publishes a daily compilation of articles of interest to its members.  There often are notes on concussions.  Today’s is fairly sobering:

Concussions May Impair Teens’ Academic Performance.
The Los Angeles Times (5/12, Healy) “Science Now” blog reports that “after sustaining a mild traumatic brain injury, nearly nine in 10 teens who have ongoing concussion symptoms also have academic problems related to headaches, fatigue and difficulty concentrating,” according to a study (5/6) published online May 11 in the journal Pediatrics. In addition, “more than three-quarters of those who have yet to recover fully after four weeks report a decline in such academic skills as note-taking, studying and completing homework assignments.”
CNN (5/12, LaMotte) reports that the study also revealed that “across grades of schooling, high school students reported having the most learning problems, significantly more than middle or elementary school children.” The study authors “say their findings suggest that school systems and medical professionals should be working together to support students who are still in the recovery phase.”
Focusing on the study methodology, HealthDay (5/12, Haelle) reports that investigators “surveyed 239 student-parent pairs plus another 110 parents about any concerns they had regarding school work after students experienced a concussion.” The students, who ranged in age from five to 18, “were evaluated within a month of having had a concussion with several thinking, memory and concentration tests.” Reuters (5/12, Doyle) also covers the study.


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