In the last four years, research into the complex effects of mild traumatic brain injury and concussion have skyrocketed, due in part to the increased awareness of sports concussion and military-related blast injury. As a result, recovery expectations, clinical management, and return to sport or combat guidelines are evolving rapidly.
In a recent review of mild traumatic brain injury, researchers have pointed out the most common hurdles and challenges to date.
- Symptom complications-some people experience post-concussion syndrome, a set of common symptoms (insomnia, depression, anxiety, headaches, irritability) that can occur 1-3 months after a mild brain injury. However, similar symptoms may also be directly related to chronic or post traumatic stress disorder, sleep deprivation, altered sleep schedules, previous concussion, or chronic pain. Without knowing the root cause of the symptom, treatment may be ineffective.
- Maladaptive behaviors-an inability to cope or adapt to change and social settings can result from prolonged exposure to the depression and anxiety that is common after a mild brain injury. Cognitive behavioral therapy that has been modified for a person with a brain injury (more frequent breaks, repetition of the most important concepts) is effective for maladaptive behaviors, but many do not receive this type of therapy.
- Insomnia-sleep disorders are common after a mild brain injury and often need to be treated before recovery from any other symptom can be addressed.
- Multiple concussions-are common in both sports and military-related brain injury. The effect of multiple concussions can quickly compound, and may sometimes lead to a separate degenerative disorder called chronic traumatic encephalopathy. A premature return to sport or combat can increase the risk of multiple concussions.
Kelly J, Amerson EH, & Barth JT. Mild traumatic brain injury: Lessons learned from clinical, sports and combat concussions. Rehabilitation Research and Practice. May 2012.