Dr Debbie Snell
“It was just a silly knock”: myths about recovering from concussion.
Up to 24000 New Zealanders experience concussion or mild traumatic brain injury (MTBI) each year. A MTBI involves a short (no more than 20-30 minutes) period of disturbed consciousness and memory loss for a few hours followed by headaches, tiredness, dizziness, memory and attention problems, irritability and being more emotional. Most people recover from a MTBI but not enough is known about why some people take longer than others. Also, most people don’t know very much about MTBI and this can affect recovery because people can have expectations about recovery that are not realistic. This article briefly reviews some common ‘myths’ about recovering from a MTBI.
MTBI is not serious
MTBI causes chemical changes in the way that certain brain cells function. While these changes are thought to be temporary, during this ‘acute’ period (usually the first week or so) people often report very severe symptoms. However in some cases MTBIs can be so mild there is complete recovery in less than one day. Here the person may have been dazed for a brief period and have headaches, dizziness and slowed thinking for just a few hours. The good news is that most people recover relatively quickly but the bottom line is, any injury that causes even temporary disrupted brain function is not a minor injury.
You’ll be fine to return to work in a few days
Many people are told they can return to normal activities in a few days. This can be unrealistic and unhelpful advice. There is much research that indicates complete recovery occurs usually somewhere between three and 12 months after injury although in fact most people recover within the first three months. Even so, this is still much longer than most people expect. When recovery is slow (that is more than three to six months) several factors have been suggested that help us understand this, such as having other injuries in the same accident, other health problems, getting depressed or coping poorly with stress. There is much interest in why some people get better faster than others and there is much ongoing research into this issue.
If you still have symptoms from a MTBI they must be psychological
Some assume that if recovery doesn’t occur within a few weeks there must be a psychological reason, the person is exaggerating or worse even outright malingering (faking). These views show a lack of understanding about MTBI. There is enormous individual variation in rates of recovery after MTBI and recovering from an injury can be stressful. It is never helpful to “blame the patient” for not getting better in the expected way.
There is no treatment for MTBI
While it is true that there is no specific medicine that can be taken to mend a MTBI, it is not true that nothing that helps. The best approach is to return to usual activities gradually. Over-exertion especially during the first few days or weeks is unhelpful and can sometimes hinder recovery. Getting information about recovering from a MTBI is important because this helps you understand the symptoms, what to expect and how to access the right support.
If you are worried that you have symptoms of a MTBI that are not improving, get some advice from a health professional such as your GP. Alternatively contact the Brain Injury Association for advice (www.brain-injury.org.nz or phone (03) 365 3262).