Preventing and Managing Concussion – Why it is Still Important

Summer 2021

In the most recent Pittsburgh 55+ Magazine issue, Dr. Joseph Maroon discusses the importance concussion in an article entitled,  Preventing and Managing Concussion – Why it is Still Important (page 8). A concussion refers to a post-traumatic brain injury that results in temporary interference with neurological function. Prior to the pandemic studies have reported that only 50 percent of concussions are reported to healthcare providers. With an estimated 2 million to 4 million per concussions in the US per year, this means million go uncared for.

Depending on a person’s age, sex, history of past head injury and concussion severity many are not getting the proper evaluation and treatment after a concussion. Because only about 10 percent of concussions are associated with a loss of consciousness or being “knocked out”, many people ignore the signs and symptoms of post-concussion syndrome. These can include symptoms of “fogginess” or feeling poorly, difficulty with concentration, headaches, memory impairment, dizziness, or balance problems, and occasionally nausea or vomiting. Concussed patients may appear dazed or stunned and be forgetful about events prior to the injury (retrograde amnesia) or after the fall or blow to the head (anterograde amnesia). Additional complaints can include mental and fatigue complaints, anxiety and mood disturbances, dizziness or balance abnormalities, migraine-type headaches, difficulty focusing, and ocular or visual abnormalities.

As a neurosurgeon, I have witnessed first hand the devastating results of concussions due to falls in seniors. A concussion can have lifelong and life threatening consequences. Adults aged 75 and older have the highest rates of traumatic brain injury-related hospitalization and death. Falls are the leading cause of brain injury for older adults (51%), and motor vehicle traffic crashes are second (9%). Generally, after the age of 65, brain changes can occur the can increase the severity of a brain injury.  One change is reduced brain volume or “shrinkage” that can occur.   In addition, preexisting chronic medical conditions, such as diabetes, heart and kidney diseases, diminish the chances of surviving a head injury. Also, preinjury use of anticoagulant and antiplatelet drugs, commonly use for those with heart conditions or those with a history of blood clots, increases the risk of brain bleeding due to trauma.  The bottom-line is do not ignore symptoms or any of the changes (described above) you might have after suffering a blow to the head. Always seek out medical help and practice head injury prevention when it comes to fall risk.


Traumatic Brain Injury in Older Adults: Epidemiology, Outcomes, and Future Implications, J Am Geriatr Soc. 2006 Oct; 54(10): 1590–1595. doi: 10.1111/j.1532-5415.2006.00894.x