Local Experts: Treatment for concussions is evolving for both long and short term symptoms

ROCHESTER, N.Y. (WROC) — Most of the care related to a concussion, or other traumatic brain injury comes in the short term following the injury itself. Though in some cases, extended care may be needed for those who show long term symptoms. While not all who get a concussion end up dealing with long term impacts, for those who do, according to Dr. Anthony Petraglia, a Neurosurgeon at Rochester Regional Health, one of the main things is being educated on the risks.

“Long term health, you know, really when you think about the different approaches, it’s going to stem around, you know, prevention and education, as well as […] nutrition and all the things that factor into kind of, you know, maintaining a good cognitive functioning and brain health in general moving forward.”

In a similar way according to Dr. Petraglia, “we used to just kind of put people in a dark room and have them rest, and we’ve really gone away from that. Really engaging people early on into physical activity sooner than later has been found to be helpful with the post-concussive symptoms.”

“The analogy is like a tendonitis. If you have tendonitis you want to rest it but at the same time you want a healthy balance of actually some load bearing on that tendon as well to help reduce the injury and promote recovery. We’re finding that with the brain it’s similar. You want to strike that balance between rest and stimulation that’s going to be healthy,” said Chis Montanaro, a Physician Assistant and Lecturer in the Physician Assistant program at RIT.

Montanaro added further: “We know that getting back to activity too soon will kind of burn you out right. You’ll get worn out and then your chances of actually returning to full participation in some kind of physical activity is even worse but if you completely rest the brain for too long then you decondition and then that also hurts your chances of getting back.”

Each case is going to be unique, but there is a lot of research being done now that in the coming years could become part of future treatments according to Montanaro.

“You see in these sort of brain rehab programs there’s a lot of cool technology now that helps to using lights or sounds or even music therapy and things like that. That helped to stimulate different parts of the brain, helps to improve certain facets like reaction time, short term memory, recall.”

With many long term cases appearing in high profile former athletes, particularly surrounding the case of CTE or Chronic Traumatic Encephalopathy, it is important to note it isn’t the most common outcome in people who have sustained a traumatic brain injury.

“We certainly have a subset of patients that we’ve found that have gone on to have chronic with repetitive concussive but also sub concussive just repetitive head injuries over time that some of them could go on later in life to deal with a multitude of cognitive impairments,” said Dr. Petraglia. “The actual syndrome of CTE itself is a very specific subset just as it is dementia pugilistica, a very specific sort of clinical presentation that most athletes and most people even with repetitive injuries don’t go on to develop.”

In fact, “more often than not, you know, most patients will heal from a concussion and not go on to have long term sequela or issues,” according to Dr. Petraglia.

And while most do heal from these injuries, it is a factor that Montanaro would like to see more heavily focused on when determining return to activity in different organizations, such as the NFL.

“Return to play or return to participation protocols it’s good to have them and it’s but as equally as good to constantly readdress them because one of the pitfalls of these protocols no matter who comes up with it is it does sort of treat each event of head trauma as an isolated head trauma.”

“The NFL’s five-phase protocol for return to participation or sometimes different pediatric associations have put up kind of like a six or a seven step protocol it it doesn’t really take into account has this person suffered one concussion and that’s what we’re rehabbing or is this their third concussion in a short amount of time,” said Montanaro.

Both Montanaro, and Dr. Petraglia independently said today too that prevention at the end of the day is the first step, whether you’ve never had a concussion, or have had one or more.

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