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Home , Concussion

May 2013

National Institutes of Health • Department of Health and Human Services • newsinhealth.nih.gov

Inside News: 3 Healthy Feet... 4 Smoking and Weight... Allergies and Complementary Medicine... NIH Initiative A Bang to the Brain What We Know About Concussions Your brain is your body’s command pediatric center. Its soft, sensitive tissues float and prevention in a cushioning fluid within the hard at the University and sturdy . But a swift blow to of Washington the head or violent shaking can over- in Seattle. “A ride these protections and lead to a concussion can mild type of brain known as a arise from the concussion. brain moving More than 1 million mild traumatic either rapidly brain injuries occur nationwide each back and forth or year. These injuries can be caused banging against the by falls, car crashes or recreational side of the skull.” This activities like bike riding, skate- sudden movement can boarding, skiing or even playing at stretch and damage brain the playground. More than half of tissue and trigger a chain concussions occur in children—often of harmful changes within the when playing organized such brain that interfere with normal as football and soccer. brain activities. “Although concussions are More serious brain injuries that considered to be a mild brain injury, involve , bleeding in the next day or two,” Rivara adds. they need to be taken seriously. the brain or swelling of the brain For about 9 in 10 people with They should not be treated as can be detected with X-rays or other concussions, symptoms disappear minor injuries that quickly resolve,” imaging methods. But concussions within 7 to 10 days. Scientists have says Dr. Beth Ansel, an expert on can be more difficult to identify. been working to learn more about rehabilitation research at NIH. With “A concussion isn’t visible from those who take longer to recover. proper care, most people recover the outside, and you can’t see it with In one NIH-funded study, Dr. Keith fully from a concussion. “But in standard imaging tools like MRI and Yeates of Ohio State University some cases, a concussion can have a CAT scans,” says Dr. Christopher Giza, looked at 8- to 15-year-olds treated lasting effect on thinking, , a pediatric brain specialist at the in an emergency room for mild learning and ,” Ansel adds. University of California, Los Angeles. . A single concussion is also “Instead we look for the signs “We found that the majority of known to raise your risk for having and symptoms of abnormal brain these kids recovered quite quickly another concussion—and a second function to make a diagnosis.” or showed no increase in symptoms concussion may be more severe. It’s Common symptoms include at all,” Yeates says. “But a subgroup important to learn to recognize the nausea, , , dizzi- of kids, about 10% or 20%, showed causes and symptoms of concussion ness and memory problems. Loss of a dramatic onset of symptoms after so you can take steps to prevent or consciousness occurs in about 1 in 10 continued on page 2 treat these head injuries. concussions. A person with a concus- “The skull is designed to prevent sion might have trouble answering most traumas to the brain, but it basic questions and move in an @ doesn’t really prevent the brain from awkward, clumsy way. Subscribe moving around inside the skull,” says “Symptoms can arise quickly, or Dr. Frederick Rivara, a specialist in they can be delayed and appear over newsinhealth.nih.gov

2 May 2013 http://newsinhealth.nih.gov/issue/May2013 continued from page 1 “These kids were also more likely to their injury and persistent symptoms have what looked like significant re- Web Links that in some cases remained even ductions in overall quality of life. And there was some evidence they were 12 months after the injury.” For more information about concussion, Body-related symptoms, such as more likely to have academic prob- click the “Links” tab at: headache and dizziness, tended to lems than the kids without persistent fade fairly quickly, the researchers symptoms,” Yeates says. http://newsinhealth.nih.gov/issue/May2013/Feature1 found. But thinking-related symp- Yeates and others continue to toms, including problems with mem- explore ways to predict a person’s ory and paying attention, tended to response to concussion. Much happens in the after linger in some kids throughout the remains unknown about the first and second injuries,” Giza adds. year-long study. Children who had underlying biology and outcomes Studies have found that the risk lost consciousness or had some ad- of mild head injuries. Some NIH- for a second injury is greatest in the ditional abnormality that showed up funded researchers are looking at 10 days following an initial concus- on MRI scans after the injury had an how injury and recovery processes sion. If you suspect that someone has increased risk for lasting problems. differ in immature and adult . a concussion, make sure they stop Other scientists are examining whatever activity they’re doing, es- the problems that can arise from pecially if they’re involved in a . Wise Choices repeated injuries to the brain. Their brain dysfunction might not Symptoms of Researchers know that immedi- only cloud their thinking. It can also slow reaction times and their Concussion ately after a concussion, the brain is especially vulnerable to having a so they become more likely Stop activity if you have these second, more serious injury. But it’s to have another injury. symptoms. Athletes should not not clear why—or how long that “If someone has symptoms of con- return to play until evaluated by a vulnerable period lasts. Giza and his cussion, they shouldn’t try to finish health care provider. colleagues have found that a single the quarter or finish the game. They n Headache or “pressure” in head mild injury reduces the brain’s use of need to be taken out of play right away and be seen by a health care n Nausea or the sugar as a fuel, at least in rats. A second mild injury 24 hours provider,” Rivara says. “The current n Balance problems or dizziness later leads to an even steeper drop in recommendations are to avoid physi- n Double or blurry vision glucose use and memory problems cal activity for a period of time until all the symptoms have resolved, and n Sensitivity to light or noise that last longer. But when the brain has several days to recover, and the then have a gradual return to play.” n Feeling sluggish or groggy use of glucose returns to normal, a Take steps to avoid concussions. n Concentration or memory second mild brain injury seems to be “Wear helmets when appropriate, problems no worse than the first. such as if you’re bicycling, skate- boarding or riding a horse,” says n Confusion “The finding suggests that when you superimpose 2 injuries on top of Rivara. Athletes can decrease their n Feeling “down” or “not right” each other, the consequences can be risk of concussion by wearing proper n Changes to sleep patterns greater,” Giza says. The brain’s use of headgear and following the rules of glucose might be a way to assess risk good sportsmanship. Make living Adapted from the U.S. Centers for areas safer for seniors by removing Disease Control and Prevention and recovery time. “But we don’t yet have a clear understanding of what tripping hazards such as throw rugs and clutter in walkways, and install handrails on both sides of stairways. NIH News in Health (ISSN 1556-3898) “The bottom line is that we still National Institutes of Health Managing Editor Harrison Wein, Ph.D. need to determine the best ways to Office of Communications Editor Vicki Contie prevent, accurately diagnose, treat & Public Liaison Contributors Vicki Contie, Alan Defibaugh and assess outcomes after mild Building 31, Room 5B64 (illustrations), and Harrison Wein traumatic brain injury,” says Ansel. Bethesda, MD 20892-2094 [email protected] While this research continues, do Tel: 301-435-7489 Fax: 301-496-0019 newsinhealth.nih.gov what you can to prevent concus- sions. Learn to recognize the Attention Editors Reprint our articles and symptoms. And make sure that illustrations in your own publication. Our material For more health information from NIH, visit is not copyrighted. Please acknowledge NIH News people with signs of concussion in Health as the source and send us a copy. http://health.nih.gov stop their activities and seek medical attention. n http://newsinhealth.nih.gov/issue/May2013 May 2013 3

On Sound Footing The Health of Your Feet Your feet are pretty small, consider- and back as well. ing they have to support the entire These problems can height and weight of your body. But multiply, limiting they can cause big problems. So pay your activity and some attention to your feet. affecting your “Feet don’t get any respect,” says quality of life. Dr. Marian T. Hannan, who studies Several things can foot disorders at the Institute for contribute to foot Aging Research at Hebrew Senior- pain or numbness. Life. “They’re sort of the Rodney Sports and physical Dangerfield of the human body.” activity can cause Each step you take involves a re- your feet to hurt markably intricate network of bones, or become numb. muscles, tendons and ligaments. Going too far, too That complexity—combined with all fast or not warming the weight they carry—accounts for up properly before why feet can be so prone to prob- exercise can set you lems, including bone fractures, up for painful or arthritis and plantar fasciitis, a swell- numbing injuries. ing of the thick band of tissue that Excess weight puts extra stress on You can help keep your feet runs along the bottom of the foot. your feet. Poorly fitting shoes and healthy by wearing comfortable, well- If left untreated, foot problems other footwear are common causes fitting shoes. Wash your feet regularly may worsen. Eventually, the pain of foot problems as well. (especially between your toes), wear could interfere with your ability to Health problems can also affect clean socks and try to rotate your do even the most basic things like the feet. Lack of feeling in your feet shoes to give them time to air out. walking up stairs or down the street. could be a sign of a serious illness, “The more you exercise your feet, If pain alters the way you walk, it such as diabetes or a nerve disorder. the better the flow is to the can lead to pain in your knees, hips See your health care provider if you feet, and that’s important for general have unusual numbness in your feet foot health,” Hannan says. or foot pain that is severe, comes on Walking is a great way to exercise Wise Choices suddenly, or doesn’t improve with your feet. You can also try specific Foot Health Tips simple measures such as rest or over- foot exercises. Sit down and rotate the-counter pain . your ankles in one direction, then the n Use appropriate, well-fitting “The good news is that most other. In bare feet, sit in a chair and footwear. foot disorders are either treatable curl your toes, then spread them out. or modifiable,” Hannan says. “The This helps stretch and strengthen n Wear clean socks. first thing that you can do is notice your feet to help you balance. n Keep your feet clean. and keep track of it to see if there’s Seeing what someone’s foot looks n Exercise your feet. a pattern to it.” Once you figure out like is incredibly informative, Hannan when you feel pain or numbness, says. “I think we’re going to be seeing n If you’re overweight, try to lose she explains, talk to an expert who a lot more health care providers weight. can help. paying attention to the feet,” she n Avoid standing long hours. How you walk and move affects predicts. n n When exercising or playing in your feet. Part of that is inherited. sports, build up gradually. “Not only do our feet look like our parents’ but we also walk like our Web Links n If you have diabetes, examine parents,” Hannan says. But you For more about healthy feet, your feet regularly for problems can modify your gait—either with like cuts, , blisters, sores training or by changing shoes or click the “Links” tab at: or swelling. using shoe inserts or pads. http://newsinhealth.nih.gov/issue/May2013/Feature2 4 May 2013 http://newsinhealth.nih.gov/issue/May2013

For links to more information, see these stories online: Health Capsules http://newsinhealth.nih.gov/issue/May2013/Capsule1 Ex-Smokers Gain Health Benefits Despite Added Pounds Quitting smoking can improve your including heart attack, stroke and found that, despite gaining weight, heart health even if you gain a little heart failure. So health professionals participants who stopped smoking weight, a new study suggests. The wondered whether the weight gain maintained their lower risk of findings underscore the importance might counteract the health benefits cardiovascular disease. of putting a stop to smoking. of quitting. “Our findings suggest that a Cigarette smoking causes about To learn more, NIH scientists and modest weight gain, around 5 to 10 1 in 5 deaths nationwide each year. their colleagues analyzed data from pounds, has a negligible effect on Smoking can harm nearly every more than 3,000 adults. People the net benefit of quitting smoking,” organ in your body, including the without diabetes who quit smoking says study co-author Dr. Caroline heart, lungs, eyes and digestive had about half the risk of cardiovas- S. Fox of NIH. The researchers plan organs. Cardiovascular and other cular problems as those who smoked. to conduct follow-up studies to health risks drop dramatically when A similar benefit was seen among determine whether this finding holds smokers quit. But quitting can also people with diabetes. But the study among people with diabetes. n lead to weight gain, and obesity is a didn’t have enough participants with risk factor for cardiovascular disease, diabetes to determine if this finding was due to chance. Featured Website Recent quitters gained about Definitions 6 pounds over a 4-year period. A NIH BRAIN Initiative smaller weight gain, about 2 pounds, Cardiovascular was seen in smokers, nonsmokers http://www.nih.gov/science/brain/ The system of heart and vessels that and smokers who’d quit more than circulates blood through the body. 4 years before. The researchers The NIH BRAIN Initiative aims to revolutionize our understanding of the human brain. Learn more about wide- Allergies and Complementary Medicine ranging research efforts to uncover the When trees, flowers and grasses start nasal irrigation, butterbur, honey, complexities of this mysterious organ. to bloom each year, you might find acupuncture and other practices. Find videos, fact sheets and more. yourself feeling awful if you suffer If you’re considering any of these from seasonal allergies, or “hay fever.” complementary methods for the It’s caused by a reaction to the pol- relief of seasonal allergy symptoms, lens released by many plants in the be sure to learn what the science spring, summer or fall. Symptoms says. Get details at http://nccam.nih.gov/ can include runny nose, scratchy health/allergies. throat, nasal congestion, sneezing, This new NIH web page can help and itchy, red or watery eyes. you learn about specific complemen- Many people manage their tary practices. Get an overview of the seasonal allergy symptoms by current evidence on effectiveness taking medications, such as anti- and safety. And always remember histamines or decongestants. But to talk to your health care provider some people try complementary about the best ways to manage your health approaches, such as saline seasonal allergy symptoms. n How to get NIH News in Health Read it online. Get it by email. Get it in print. Visit newsinhealth.nih.gov Click the “Subscribe” button on Contact us (see page 2) to get free our home page to sign up for print copies for display in offices, email updates when new issues libraries or clinics within the U.S. are posted online. Subscribe NIH . . . Turning Discovery Into Health