Case study ( 5558 views as of March 29, 2020 )
Bradley is a 20-year-old hockey player who collided with the boards after a hard body check. He was not knocked unconscious, but felt dizzy and nauseated. He could not remember the score in the game or the name of his coaches. A trainer at the rink assessed him for concussion and did not let him return to play.
Later, he developed a headache and couldn’t sleep that night. The next day he noted that his balance was off, he couldn’t tolerate any noise or bright lights, and he felt nauseated when looking at the TV or computer. He couldn’t organize his thoughts and he felt as though he was in a fog. He became irritable and occasionally tearful. He could not return to school.
Bradley should first be assessed by his family physician or a sports medicine specialist within 24-48 hours. He should not return to play for a minimum of four weeks, and not before his symptoms have resolved. A determination about whether a neurologist should be consulted and whether an MRI is needed can be made. Medications may be helpful to treat some of the symptoms. A psychologist may be consulted for management of mood symptoms and assessment of psychological function.
As his symptoms settle, Bradley may benefit from a graduated conditioning program under the supervision of a physiotherapist or athletic trainer. A plan for returning to play can be made with the help of his physicians. Persistent symptoms (post-concussion syndrome) may develop and he should be monitored by his physician until his symptoms resolve.Author: Dr. Dean Johnston