The Resilient Brain

Coping with Concussion and Mild Traumatic Brain Injury

Is There Such Thing as a "Severe Concussion"?

We often hear this term in daily life, but is it real?

Not a day goes by when a news reporter in print, television or on the radio states that someone has had a “severe concussion.” We’ve all heard that Hilary Clinton and Barbara Walters had severe concussions” and we’ve heard of football players having “severe concussions.” Yet, is this term actually real?

The answer is NO, just as a mild traumatic brain injury is not mild, and you can’t be “kinda pregnant.” You are either pregnant or you are not.

Too often reporters use terminology without the slightest clue what they mean. My reaction to the use of a “severe concussion” is like hearing nails across a chalkboard. The reality of a concussion, also called a mild traumatic brain injury (mTBI), is that it is a traumatic injury to the brain. This is the actual event. The consequences of a concussion are called post concussion syndrome (PCS) in parts of the world including the US, and also called post concussion disorder (PCD) in Canada, United Kingdom and other parts of the world.

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A concussion means that the brain has been injured from an outside force, such as an automobile accident, domestic violence, sporting or recreational event or blast injury. The term concussion refers to the length of time you are not aware of your surroundings and your inability to recall information prior to or after an injury (also known as being unconscious). If that length of time is between zero and 60 minutes, it is called a concussion or mild traumatic brain injury. If that length of time is longer than 60 minutes it is called a moderate traumatic brain injury. If the loss of awareness is greater than 24 hours, it is called a coma.

With that being said, by definition it is impossible to have a “severe concussion.” What the reporters are trying to convey is that the consequences of the concussion are severe. The correct term for such consequences, as mentioned above, is post concussion syndrome (PCS), which is a group of symptoms that affect you physically; such as chronic fatigue, headaches, sleep problems; the way you think, such as the inability to focus, having memory problems; emotionally; such as being moody, having personality changes, and behavioral issues like aggression, “flying off the handle,” and being reactive.

After a concussion, some of these symptoms are noticeable and often go away after 4-6 weeks. Any of these symptoms can be severe. When these symptoms persist past 2 months, then they are labeled PCS. If you sustain another concussion while recovering from a previous concussion, this is called second impact syndrome. The consequences of multiple concussions can be very severe.

In my future postings, I will discuss more in-depth information about all the various symptoms that are included in PCS. This will include different methods and treatments for each symptom so if you have had a concussion, you will see that there is help and hope for regaining your life.

Diane Roberts Stoler, Ed.D., is a Neuropsychologist, Board Certified Health Psychologist, Board Certified Sports Psychologist, and Trauma Therapist with over 35 years experience.

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