the Carolina Headache Institute .
“ Repeat concussions appear to make it more likely that these headaches will become intractable ,” Dr . Finkel says .
THE RISK FOR PERMANENT DAMAGE
In addition to extending a headache condition , repeat concussion can also turn other concussion side effects ( e . g ., memory and concentration deficits , sleep disorders and balance difficulties ) into more serious and longer-lasting concerns .
Perhaps even more alarming , repeat concussion can lead to permanent brain damage , including the potential for a progressive degenerative disease called chronic traumatic encephalopathy ( CTE ). Although CTE was once known as a boxer ’ s condition and is receiving media attention for its effects on football players , it can affect anyone with multiple head traumas . The condition , which leads to brain atrophy and nerve cell damage , can cause progressive memory and cognition deficits , long-term personality changes , suicidal behavior and dementia . 4 ( Turn to page 24 to learn more about CTE .)
Repeat concussion can also trigger second-impact syndrome ( SIS ), a rare complication in which the brain swells rapidly , leading to death or severe disability . SIS can develop if a second concussion occurs before symptoms of an earlier one have subsided .
Unfortunately , researchers don ’ t yet know how many concussions are too many and which concussion might lead to permanent damage . The threshold may vary from person to person , depending on differences in genetics , the environment and the dynamics of the injury , according to Dr . Cady . Uncertainty aside , physicians do agree that prevention and early treatment can help reduce concussion risks .
THE IMPORTANCE OF DOWNTIME
Helmets and protective gear can help reduce the risk of head trauma to an extent . Dr . Finkel suggests it would also be helpful for the military to train soldiers “ to avoid situations where head injuries are more prevalent .” But ultimately , Dr . Finkel and Dr . Cady agree that , given the way wars are fought today , there is really no effective way to prevent a concussion .
“ The military provides sophisticated protective gear and training to help soldiers in combat prevent injury ,” Dr . Cady says . “ However , the magnitude of an assault like that of an improvised explosive device is beyond the limits of this protection .”
To optimize recovery following a head injury , early diagnosis and treatment of post-traumatic headache is essential . Further , military servicemen and women must be offered an environment in which the brain has time to recover from the assault , Dr . Cady says .
“ When adequate time and proper environment for recovery are not provided , this can lead to more disabling headaches and other symptoms associated with concussion ,” Dr . Cady says . “ Also , when the brain is concussed , reaction time and cognition may be affected , which increases the risk of re-injury .”
To fully recuperate , military personnel may need to take time off from active duty . While this may seem initially disruptive , it can lead to a healthier life in the long-term and the maintenance of a functional deployed status . With proper conservative care and a gradual return to regular activities , most brains recover from injury , even after repeat concussion , Dr . Cady says .
Unfortunately , with the risk of a disrupted tour of duty , soldiers may be reluctant to seek treatment . But military leaders are increasingly urging servicemen and women to seek treatment instead of downplaying their symptoms . In an effort to reduce the side effects of traumatic brain injury , the U . S . Army developed new guidelines that require troops caught within 165 feet of a blast to be removed from the battlefield for at least 24 hours and examined for evidence of a concussion . 5 Soldiers sustaining three concussions in one deployment are required to undergo a more detailed evaluation before being cleared to return to combat .
If implemented successfully , the latter effort combined with adequate downtime could save many soldiers from carrying home the insidious effects of concussion . HW www
Learn more about concussions at www . besmartbewell . com / tbi .
4 . Stern et al . “ Long-term Consequences of Repetitive Brain Trauma : Chronic Traumatic Encephalopathy .” PM & R . 2011 ; 3 : S460-S467 .
5 . Zoroya . “ More Troops ’ Concussions Diagnosed Under New Rules .” USA Today . October 28 , 2010 .
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