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Desk of contents:
02:05 Professor Tenovuo
06:26 Post-concussion symptoms
11:31 MRI and CT often can’t diagnose concussion
Concussion Tales podcast introduction
[00:00 Melanie] If I say there may be hope for full restoration for folks with a concussion, you say…?
[00:07 Professor McCrea] 100%!
[00:08 Professor Maas] And in reality, you didn’t solely really feel it] you have been exterior the common medical system, as a result of they weren’t fascinated with you.
[00:16 Professor Sitskoorn] Neuroplasticity truly opens you as much as the world. It makes it attainable to develop; it makes it attainable to rehabilitate.
[00:25 Professor Wilson] Traumatic brain injury has been referred to as a silent epidemic for that motive, as a result of it consists of modifications and disabilities that aren’t apparent to different folks.
[00:35 Dr. Zasler] If, as a doctor, you felt you had nothing to supply a affected person, then I believe ethically, it’s essential to say] “I don’t assume there’s something I can give you. Possibly it’s best to see Dr. M.”
[00:48 Professor Diaz-Arrastia] Traditionally, we have now referred to as this stuff gentle traumatic mind accidents, which suggests that, effectively… It might be a brain injury, but it surely’s not going to have nice penalties, proper? And that’s frankly not true.
In regards to the Concussion Tales podcast
[01:05 Melanie] Welcome to Concussion Tales, a Lifeyana podcast sequence crammed with hope. I’m right here to let you recognize that you’re not alone in your post-concussion restoration journey. My title is Melanie and I spent six and a half years studying, experimenting, and coaching with the intention to discover a technique to heal myself from post-concussion syndrome.
After making a full restoration by the tip of 2018, I launched into this mission to make the restoration journey simpler for you. For this reason I began this podcast, wrote detailed blog post and downloadable guides, provide coaching and in addition the course that I want I had again after I was recovering — educating you all the pieces that I wanted to know with the intention to make my restoration occur.
On Concussion Tales, we dig deep whereas discussing hopeful tales of restoration in addition to the exhausting stuff within the messy center. Let’s dive proper in!
Professor Tenovuo
I’m so glad to announce the primary professional of this season. His title is Olli Tenovuo and he’s a professor of neuro-traumatology on the College of Turku in Finland. He’s a part of CENTER-TBI, the big analysis group in Europe, researching traumatic brain injury (TBI) and advocating for higher concussion care. Keep in mind, traumatic brain injury is the medical phrase that medical doctors use for all kinds of harm, together with concussion. However let me let you know how I bought to know Professor Tenovuo.
The primary time I heard him converse, was in an enormous room crammed with medical doctors and researchers. He defended all of us who expertise lingering signs after a concussion, stating how medical doctors basically ignore us and inform us to our faces that we’re imagining signs. He’s been carrying a superhero go well with in my thoughts since that second.
Set off warning: post-concussion signs
I wish to offer you a heads up beforehand. On this episode, Professor Tenovuo says that there is no such thing as a such factor as post-concussion syndrome, as a result of all sufferers have completely different post-concussion signs and, subsequently, we can’t converse of 1 syndrome that everybody has.
Nevertheless, this can be triggering for you. As I do know, it might have been for me. To listen to that what you consider you endure from might not exist. Your post-concussion signs do exist and nonetheless fall inside the prognosis that may now be referred to as post-concussion syndrome.
What Professor Tenovuo is referring to, is the truth that a bunch of researchers and medical doctors worldwide are in search of a greater definition of post-concussion symptoms. The primary change they goal to make is in regards to the wording, serving to medical doctors higher perceive what all of us expertise, and from there, enhance affected person care.
You’re in the proper place proper now. And Professor Tenovuo and I are right here that can assist you transfer ahead. He’s rooting for us and really understands the frustrations and struggles most of us undergo with regard to the medical system. Having stated that, let’s begin with the primary out of a minimum of 4 episodes with Professor Tenovuo.
Professor Tenovuo’s ardour
Thanks once more for doing this recording, this podcast episode with me, as a result of after our assembly on the CENTER-TBI, I actually felt that you just spoke up for post-concussion syndrome sufferers whenever you took the mic. I don’t know if you happen to keep in mind?
[04:42 Professor Tenovuo] Yeah, I do keep in mind.
[04:43 Melanie] I wish to ask you about that, however possibly I can begin with a extra basic query first, in order that listeners can get to know you a bit. Outdoors of labor, what are issues that convey you pleasure?
[05:05 Professor Tenovuo] Oh, that’s a straightforward query. I’ve been an keen birdwatcher since I used to be 15 within the 70s. When I’ve free time, I all the time go birdwatching at my summer season home by the Baltic Sea. I prefer to go together with my boat to small islands on the ocean the place it’s straightforward to search out birds and to see them close by. I additionally do pictures, that’s my ardour.
[05:49 Melanie] And do you then generally share your footage with colleagues, or is it one thing that you just do exterior of labor and no one ever will get to see your footage?
[05:57 Professor Tenovuo] Properly, my birdwatcher colleagues see them. We share our pictures on Fb.
[06:09 Melanie] So you could have particular birdwatcher colleagues!
[06:15 Professor Tenovuo] I believe all birdwatchers world wide are colleagues in a approach.
[06:20 Melanie] Probably mates too, proper? Since you share the identical ardour?
[06:25 Professor Tenovuo] Yeah, positive.
Publish-concussion signs

[06:26 Melanie] I perceive. Circling again to the CENTER-TBI conference, I actually bought the concept that you perceive what post-concussion syndrome sufferers are going by way of. You spoke about their signs, however particularly about what they hear from medical doctors within the medical system when these sufferers seek the advice of them. May you share a bit about what you could have realized?
[07:04 Professor Tenovuo] Yeah, in fact. The entire idea of post-concussion syndrome is an issue as a result of truly, there may be not such a syndrome. With a syndrome, you imply a selected constellation of signs. Though many sufferers share comparable post-concussion signs, they’re all the time particular person, so there’s a nice number of completely different signs. Nevertheless, you usually hear the time period post-concussion syndrome. Truly, it’s best to talk about post-concussion signs.
There isn’t a concussion definition
Utilizing the phrase ‘concussion’ is an issue, too. That’s as a result of there is no such thing as a correct definition for concussion. This additionally signifies that if a affected person is recognized with concussion, medical doctors assume that there must be no main penalties to this type of harm. And if there are penalties, they need to come from one thing else, like melancholy, post-traumatic stress, psychosomatic causes, litigation, or anything.
Mind harm classification is deceptive
The opposite aspect of the issue is that it is rather tough to precisely outline the true severity of the harm. That is one motive we attempt to do away with the definitions of mild, moderate, and severe traumatic brain injury. This categorization is predicated on obscure grounds, and it usually has loads of confounders assessing the severity. These labels are sometimes very deceptive, and so they truly trigger sufferers extra usually hurt than profit.
[09:26 Melanie] Sure, well-spoken. That is in regards to the abstract of my expertise with the medical system.
[09:34 Professor Tenovuo] You aren’t the one one.
[09:36 Melanie] No, I do know. And I’m laughing now, however in fact it isn’t humorous in any respect. It’s clarifying the way you clarify the difficulty with these ideas. All of us in society, but additionally medical doctors, have ideas of their minds about what one thing is or isn’t, and what the outcomes of that may be.
Gentle TBI must be taken significantly
You co-wrote a paper stating that we should always revise mild, moderate and severe traumatic brain injuries as classes. The most important drawback, in fact, is that this categorization suggests {that a} ‘mild’ brain injury isn’t to be taken significantly, and that it doesn’t have long-term results. Nevertheless, CENTER-TBI has uncovered that over 50% of people that go to the ER have post-concussion signs over six months after sustaining a concussion.
Now, I perceive what you’re saying about concussion and post-concussion syndrome truly not being useful phrases to make use of, as a result of we have now the improper concepts about it. However, in fact, we have now to work with them so long as we haven’t developed new phrases.
[11:05 Professor Tenovuo] Yeah, we, in a approach, base our classifications, our remedies and the pathway of care on these sorts of unsure and infrequently deceptive labels. I hate that.
[11:26 Melanie] I agree with you!
MRI and CT usually can’t diagnose concussion

I really feel that with mind accidents, particularly micro accidents that we can’t see on CTs and we generally begin to have the ability to see in blood or on superb MRI scans, solely now we’re beginning to uncover what’s a concussion, actually. And possibly it is going to want a brand new phrase, certainly. However concussion was one thing that we couldn’t see earlier than.
Identifiers akin to having amnesia, or having a mind bleed, have been formed by medical doctors who have been working with issues they may see. Solely now are we uncovering that concussion is far more delicate, however the results might be main.
Diffuse axonal harm is microscopic
[13:10 Professor Tenovuo] Yeah. There’s an previous saying: what you’ll be able to’t see, doesn’t exist. You possibly can acknowledge that in lots of points in our lives. However sure, you’ll be able to fairly often nonetheless see the angle: “Head MRI is regular, so there is no such thing as a main drawback with you. All the things must be okay.”
Nevertheless, we all know {that a} diffuse axonal injury is by far the commonest mechanism of brain injury. And this all the time occurs on the microscopic degree. So, in precept, typical MRI is unable to point out it. It’s absolutely unable to point out it.
Restoration potential after extreme brain injury
Alternatively, we additionally see sufferers who’ve pretty massive contusions, so massive injured areas within the mind, and so they might have a full restoration. That’s one other aspect of the coin: you could have pretty massive focal lesions in your mind and recuperate effectively in case your mind community is spared.
Higher concussion prognosis instruments
[14:41 Melanie] So, new instruments are wanted with the intention to assess post-concussion signs and diagnose people with concussion or gentle traumatic brain injury. I now really feel like I shouldn’t say concussion, due to your thesis, however we nonetheless want the phrases for folks to grasp.
[15:04 Professor Tenovuo] I forgive you.
[15:11 Melanie] We’d like higher instruments.
Practitioner consciousness & concussion protocols
However largely I really feel that no matter software there might be in three, 4 or 5 years from now (I don’t understand how gradual or quicker we are going to go), the very first thing we want is consciousness on the caretaker’s aspect. So, GPs or practitioners within the ER – individuals who first encounter sufferers with a concussion – must know that if sufferers complain about fogginess, or ringing of their ears, or headache, or blurry imaginative and prescient or something, they should take it significantly.
This may be a brain injury, and simply describing the signs is sufficient to begin a brand new protocol that we so desperately want. They particularly want to begin speaking with sufferers: “It is a severe factor. You needn’t solely relaxation, however you want different issues as effectively with the intention to recuperate.”
Penny on your ideas?
Now, I’d love to listen to from you. What do you are taking away from this episode? Is there one thing which you could apply to your life instantly? Head on over to lifeyana.com and depart your remark now.
And if you wish to hear and skim extra Concussion Tales, actionable steps and inspiration, remember to subscribe to the Lifeyana e mail checklist whilst you’re there, so that you just by no means miss out on new supplies we continually make for you.
If you wish to help this podcast, head on over to patreon.com/concussionstories. Thanks for listening to this concussion tales episode by Lifeyana. Could you be effectively, and should you be glad.
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