Concussions can cause even the simplest of sentences to suddenly turn into complex phrases. Here, UPMC Sports Medicine Concussion Fellows Paul Cohen, PsyD, and Jill Henley, PsyD, break down some of the most confusing concussion-related terminology:
Concussion Terminology
Trajectory: Also referred to as a clinical pathway, a trajectory helps us understand what system or systems in the brain have been affected due to concussion. We have identified six unique clinical trajectories that may be present, both in isolation and overlapping with other trajectories. Every trajectory requires specific treatment, which is reflected in the patient’s individual treatment plan.
Vestibular System: The sensory system that is responsible for balance and spatial orientation. It includes parts of your brain and inner ear, and provides information regarding head movements and positions to maintain visual and balance control. Common symptoms associated with a vestibular concussion include dizziness, fogginess, and nausea. Patients presenting with vestibular involvement will be referred for a more thorough evaluation and possibly vestibular therapy.
Visual Motion Sensitivity: The ability to focus on a moving target while moving (e.g., watching cars go by while you are driving). Visual motion sensitivity is common in individuals with vestibular problems following a concussion. Through vestibular therapy, we are able to help the brain reintegrate space and motion.
Ocular: Related to eyes and vision. It is not just how well we see, but also the patterns of our eye movements. If our eyes are not moving properly, it is common to develop symptoms (e.g., headache, fatigue) that make tasks associated with work and school (reading, computer use) uncomfortable.
Physical Exertion: This is another term for exercise.
Cognitive Exertion: This is another term for putting forth mental energy for cognitive tasks such as attention and memory.
Exposure-Recovery Model: This is part of our approach to concussion rehabilitation, which entails exposing yourself to provocative situations and environments (e.g., shopping malls, restaurants) until symptoms increase to about a 3 or 4 on a scale of 1-10, then removing yourself to allow for recovery (e.g., symptoms go away). Each time you do this, recovery time should be shorter, which is a good sign of progress!
Dizziness: The sensation of feeling lightheaded and/or unsteady. It may feel like the room is spinning or a slow, wavy sensation (like you are on a boat).
Fogginess: The feeling of being detached from yourself, as if you are thinking slower than normal and one step behind mentally.
Fatigue: Feeling chronically tired and becoming more exhausted than normal after routine activities.