Submit-concussion signs (Prof. Tenovuo half 1)

Submit-concussion signs (Prof. Tenovuo half 1)

Table of Contents

‘Submit-concussion signs’. Professor Tenovuo states that that is the higher approach to title the vary of lingering concussion signs that many people expertise after sustaining a concussion. He shares how the time period ‘post-concussion syndrome’ confuses sufferers and docs alike. Wanting to supply higher concussion care, he advocates for a change of terminology.

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 individuals 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 had been outdoors the common medical system, as a result of they weren’t excited about you.

[00:16 Professor Sitskoorn] Neuroplasticity really opens you as much as the world. It makes it potential to develop; it makes it potential to rehabilitate.

[00:25 Professor Wilson] Traumatic brain injury has been known as a silent epidemic for that cause, as a result of it consists of modifications and disabilities that aren’t apparent to different individuals.

[00:35 Dr. Zasler] If, as a doctor, you felt you had nothing to supply a affected person, then I feel ethically, it’s essential to say] “I don’t assume there’s something I can give you. Possibly you must see Dr. M.”

[00:48 Professor Diaz-Arrastia] Traditionally, we’ve known as these items delicate traumatic mind accidents, which means that, nicely… It might be a brain injury, but it surely’s not going to have nice penalties, proper? And that’s frankly not true.

Concerning the Concussion Tales podcast

[01:05 Melanie] Welcome to Concussion Tales, a Lifeyana podcast collection 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 as a way to discover a approach 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. Because of this I began this podcast, wrote detailed blog post and downloadable guides, supply coaching and in addition the course that I want I had again once I was recovering — educating you every thing that I wanted to know as a way to make my restoration occur.

On Concussion Tales, we dig deep whereas discussing hopeful tales of restoration in addition to the laborious stuff within the messy center. Let’s dive proper in!

Professor Tenovuo

I’m so blissful to announce the primary knowledgeable 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 massive 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 docs use for all types of harm, together with concussion. However let me let you know how I acquired to know Professor Tenovuo.

The primary time I heard him converse, was in a giant room crammed with docs and researchers. He defended all of us who expertise lingering signs after a concussion, stating how docs primarily ignore us and inform us to our faces that we’re imagining signs. He’s been carrying a superhero swimsuit in my thoughts since that second. 

Set off warning: post-concussion signs

I need to provide you with a heads up beforehand. On this episode, Professor Tenovuo says that there isn’t a such factor as post-concussion syndrome, as a result of all sufferers have totally different post-concussion signs and, due to this fact, we can’t converse of 1 syndrome that everybody has. 

Nonetheless, this can be triggering for you. As I do know, it might have been for me. To listen to that what you imagine you endure from might not exist. Your post-concussion signs do exist and nonetheless fall throughout the analysis that might now be known as post-concussion syndrome.

What Professor Tenovuo is referring to, is the truth that a bunch of researchers and docs worldwide are searching for a greater definition of post-concussion symptoms. The primary change they intention to make is concerning the wording, serving to docs higher perceive what all of us expertise, and from there, enhance affected person care.

You might be in the best place proper now. And Professor Tenovuo and I are right here that will help you transfer ahead. He’s rooting for us and actually 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 simply spoke up for post-concussion syndrome sufferers once you took the mic. I don’t know should you bear in mind?

[04:42 Professor Tenovuo] Yeah, I do bear in mind.

[04:43 Melanie] I need to ask you about that, however perhaps I can begin with a extra normal 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 wish to go along with my boat to small islands on the ocean the place it’s straightforward to seek 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 photos with colleagues, or is it one thing that you simply do outdoors of labor and no person ever will get to see your photos?

[05:57 Professor Tenovuo] Effectively, my birdwatcher colleagues see them. We share our photographs on Fb.

[06:09 Melanie] So you might have particular birdwatcher colleagues!

[06:15 Professor Tenovuo] I feel all birdwatchers world wide are colleagues in a manner.

[06:20 Melanie] Presumably associates too, proper? Since you share the identical ardour?

[06:25 Professor Tenovuo] Yeah, positive.

Submit-concussion signs

Post-concussion symptoms

[06:26 Melanie] I perceive. Circling again to the CENTER-TBI conference, I actually acquired the concept you perceive what post-concussion syndrome sufferers are going by way of. You spoke about their signs, however particularly about what they hear from docs within the medical system when these sufferers seek the advice of them. Might you share a bit about what you might have realized?

[07:04 Professor Tenovuo] Yeah, in fact. The entire idea of post-concussion syndrome is an issue as a result of really, there may be not such a syndrome. With a syndrome, you imply a selected constellation of signs. Though many sufferers share related post-concussion signs, they’re all the time particular person, so there’s a nice number of totally different signs. Nonetheless, you typically hear the time period post-concussion syndrome. Really, you must talk about post-concussion signs.

There isn’t any concussion definition

Utilizing the phrase ‘concussion’ is an issue, too. That’s as a result of there isn’t a correct definition for concussion. This additionally signifies that if a affected person is recognized with concussion, docs assume that there needs to be no main penalties to this type of harm. And if there are penalties, they need to come from one thing else, like despair, post-traumatic stress, psychosomatic causes, litigation, or the rest.

Mind harm classification is deceptive

The opposite facet of the issue is that it is extremely tough to precisely outline the true severity of the harm. That is one cause we attempt to do away with the definitions of mild, moderate, and severe traumatic brain injury. This categorization relies on obscure grounds, and it typically has a variety of confounders assessing the severity. These labels are sometimes very deceptive, they usually really trigger sufferers extra typically hurt than profit.

[09:26 Melanie] Sure, well-spoken. That is concerning 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 in addition docs, have ideas of their minds about what one thing is or isn’t, and what the outcomes of that may be.

Delicate TBI must be taken severely

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 severely, and that it doesn’t have long-term results. Nonetheless, 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 really not being useful phrases to make use of, as a result of we’ve the mistaken concepts about it. However, in fact, we’ve to work with them so long as we haven’t developed new phrases.

[11:05 Professor Tenovuo] Yeah, we, in a manner, base our classifications, our therapies and the pathway of care on these sorts of unsure and sometimes deceptive labels. I hate that.

[11:26 Melanie] I agree with you!

MRI and CT typically can’t diagnose concussion

MRI and CT often 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 perhaps it should want a brand new phrase, certainly. However concussion was one thing that we couldn’t see earlier than. 

Identifiers similar to having amnesia, or having a mind bleed, had been formed by docs who had been working with issues they may see. Solely now are we uncovering that concussion is far more refined, however the results might be main.

Diffuse axonal harm is microscopic

[13:10 Professor Tenovuo] Yeah. There may be 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 isn’t a main drawback with you. Every thing needs to be okay.” 

Nonetheless, 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 stage. So, in precept, standard MRI is unable to indicate it. It’s absolutely unable to indicate it.

Restoration potential after extreme brain injury

Alternatively, we additionally see sufferers who’ve pretty giant contusions, so giant injured areas within the mind, they usually might have a full restoration. That’s one other facet of the coin: you’ll have pretty giant focal lesions in your mind and get well nicely in case your mind community is spared.

Higher concussion analysis instruments

[14:41 Melanie] So, new instruments are wanted as a way to assess post-concussion signs and diagnose people with concussion or delicate traumatic brain injury. I now really feel like I shouldn’t say concussion, due to your thesis, however we nonetheless want the phrases for individuals to grasp.

[15:04 Professor Tenovuo] I forgive you.

[15:11 Melanie] We want higher instruments. 

Practitioner consciousness & concussion protocols

However largely I really feel that no matter software there can be in three, 4 or 5 years from now (I don’t know the way sluggish or sooner we’ll go), the very first thing we want is consciousness on the caretaker’s facet. 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 severely. 

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 start out speaking with sufferers: “It is a critical factor. You needn’t solely relaxation, however you want different issues as nicely as a way to get well.”

Penny to your ideas?

Now, I might love to listen to from you. What do you are taking away from this episode? Is there one thing that you may apply to your life immediately? Head on over to and depart your remark now.

And if you wish to hear and skim extra Concussion Tales, actionable steps and inspiration, you should definitely subscribe to the Lifeyana e-mail listing when you’re there, so that you simply by no means miss out on new supplies we continuously make for you.

If you wish to assist this podcast, head on over to Thanks for listening to this concussion tales episode by Lifeyana. Might you be nicely, and will you be blissful.

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