Ask Dr. Vieder
I saw that there are new guidelines for diagnosing sports related concussions in young athletes. What has changed?
After reviewing 25 years of scientifi c research from 1990 to 2015, there are now new guidelines for the diagnosis and management of a mild
traumatic brain injury (mTBI), commonly known as a concussion. One of the more important aspects is the recommendation to not perform a
complete diagnostic brain imaging by CT scan unless there is a specifi c set of signs and symptoms present indicating high risk factor that would
justify the use of neuroimaging. There are a number of excellent updated validated concussion assessment tools now available to physicians to
help guide in the diagnosis and treatment of TBI. The Centers for Disease Control has excellent resources for patients and families who wish to
learn more about head injuries and more, at www.CDC.gov.
If my son has a concussion, is total bed rest still the best treatment option?
New research indicates that a small amount of bed rest is appropriate over the fi rst 48 to 72 hours after a mild traumatic brain injury or
concussion. The newest recommendations are to limit bedrest to no more than three days and encourage a gradual return to normal activities,
as long as there are no obvious continued symptoms such as headaches, dizziness, nausea, poor balance or visual disturbances. Close monitoring
for symptoms during the recovery period is critical.
How soon after a concussion can my son resume playing sports?
Current recommendations for return to athletic activity follows a six-step program beginning three days after the initial
injury with a return to normal school routines and light to moderate activity such as fast walking or riding a stationary
bike. If there are no symptoms associated with this initial step, then there is a progression to moderate aerobic activity to
increase heart rate and head movement, such as jogging, or sports skill related drills. If your student remains symptom-
free, there is a stepwise progression to heavy aerobic activity, full unrestricted practice and fi nally a return to competition.
In general, this process takes approximately 2-3 weeks, but should be guided by the managing physician in concert
with either the athletic trainer or team coach. It is important to note that if symptoms do reoccur, the process would be
restarted and require reevaluation by a physician who is familiar with concussion recovery programs. Most importantly, it
is critical to understand that injuries to the brain can take a long time to heal and the treatment and recovery plan should
be guided by a health professional knowledgeable of these types of injuries.
For more health information, visit the Ask Dr. Vieder page at LakesUrgentCare.com
Dr. Sanford Vieder, DO, FACEP, FACOEP, Medical Director at Lakes Urgent Care, West Bloomfi eld/Livonia
If you want the best in
home health care…raise
your hand for Supportive
Home Health Care!
“
Excellent therapy ...kind,
caring, understanding nurse and
therapist. They understood my
mother’s situation physically and
emotionally, and worked with it.”
Elaine Beresh , daughter of
Miriam Shenkman
Have you recently returned from a hospital or post-
acute stay, are concerned about falling or are recovering
from a chronic illness? Supportive HHC can help.
We’re a partnership between Jewish Senior Life of
Metropolitan Detroit and experienced leaders in home
KHDOWKFDUH:HSURYLGH0HGLFDUHFHUWLˉHGKRPHKHDOWK
care services in skilled nursing, physical, speech and
occupational therapy, and medical social work.
Contact us today!
Not only did we score 95% in client
satisfaction, we’re recommended by
9 out of 10 of our clients.
Talk to your doctor or contact
Supportive HHC to learn more
about our services. If you are
a JSL resident, your JSL social
worker can assist.
SupportiveHHC.com
Call 248-291-5806
jn
September 27 • 2018
47