Mild traumatic brain injury (mTBI), commonly called a concussion, is usually caused by a blow to the head or jolt to the body and is not always clinically evident. However, the injury always should be taken seriously. Even a single concussion can lead to life-long problems and increase the risk for a second concussion. There is now evidence that concussions have cumulative effects resulting from repetitive sub-concussive brain injuries. The crisis level of such injuries is becoming evident:
- Every 15 seconds someone bumps their head hard enough to cause a concussion.
- The annual reported incidence of concussions is twice the number of reported heart attacks and strokes combined.
- After a first concussion, there is a 3-5 fold increased risk of sustaining a second one, resulting in “second-impact syndrome,” the exacerbation of symptoms and extending recovery to months or years.
- The cost to the healthcare system and lost productivity exceeds $76 billion every year.
Often times physicians must struggle to diagnose concussions based on symptoms, whose appearance can be delayed for hours, days, weeks and even months. Many testing tools have been developed but all revolve around neurological and cognitive exams. Usually, administered in combination these tools help aid in a diagnosis but are confounded by many subjective variables often making definitive diagnosis difficult. If not identified and the injured is allowed to return to normal activity, re-injury is 20-30% more likely and is in a heightened fragile state. Re-injury would precipitate a longer healing time, increase in the severity and number of symptoms and could even result in Second Impact Syndrome (SIS). SIS is when the auto regulation of the brains blood supply is lost – leads to brain swelling and increased intracranial pressure – which usually leads to catastrophic results. (Head injuries in sports, BJSM,30,289-296; Cantu, R.C. -1996)
CT imaging has the ability to locate bleeding in the brain and is frequently undertaken for head injuries. However, concussions often involve little or no apparent bleeding (micro hemorrhaging), making many of them undetectable on a CT scan. Specialty MRI programs offer advantages to document a concussion but are not widely available and so are not considered a viable diagnostic solution. Less than 5% of CT imaging will detect bleeding.
In the U.S. alone, approximately 1.7 million people are diagnosed for mTBI in the hospital ER each year. The number of concussions that go unreported or undiagnosed is not known but estimates range from 2-5 million people. Based on clinical findings the medical community and the public are fast becoming aware of the dangers and lasting effects from sustaining a concussion, especially in the younger population. Given the complexity of diagnosis and the millions of unreported concussion there is a huge compelling clinical need for an objective, low cost, rapid point-of-care diagnostic tool. Additionally, there continues to be an enormous need for more education at all levels.
The accepted treatment for most concussions has changed little since medicine first identified mild, moderate or severe traumatic brain injury—and that treatment is rest. For the more pronounced symptoms, treatment also may include pharmaceutical or over-the-counter medicines.
Resting the brain must begin when the injury is first suspected and proceed until symptoms are completely resolved. It has been demonstrated that adolescents and those younger require longer healing times (weeks to months). Adults (over age 25) can recover more quickly (days to weeks) — however, all concussions are unique.
The key to controlling the damage caused by concussions is providing timely and definitive information so the proper decision protocols can be followed and if needed, preventive measures can be undertaken. BioDirection is committed to creating a simple, fast, and accuratepoint-of-event solution helping millions of people worldwide.