NEUROLOGICAL risk assessment (NRA)

Ever wonder why your GP checks your cholesterol or your blood pressure? You don’t feel that your cholesterol or blood pressure is high, so why check it? We check it because it is well known that these are risk factors for cardiovascular disease and that if you treat it early on, it can make a big difference.

Now we all know that sports-related concussion (SRC) is risk with any sport, some sports more than others. For example, the risk of concussion in hockey is about 5 times higher than it is for basketball, which may be an underestimate because how many cases never come to light? We also know that 80% of those who sustain concussion will do okay with conservative treatment, i.e. energy-conserving strategies, curricular accommodations, a step-wise approach back to activities. That is, 80% are said to recover smoothly without any hiccups. But what about the other 20%? These are the ones that will have a prolonged, more complicated recovery, i.e. may need prescription glasses, vestibular therapy, visual therapy, extensive accommodations, psychological support, medication, investigations, etc.

There are many conditions that exist in the general population that place one at a higher risk of this post-concussion syndrome. Most of these people are not even aware that they have these conditions, just as those with high cholesterol can’t feel that their cholesterol is high. Many who have these “sub-clinical” conditions are not even aware of how these conditions affect them; rather, they have just accepted that they are the way they are:

• I don’t like school

• I’m a hands-on learner

• I can’t multi-task

• My memory isn’t that good

• I get motion-sickness easily

For example, convergence insufficiency (CI) is a condition that is estimated to affect 3-5% of the population. You can still test 20/20 on a routine optometrist’s exam and have this condition. This is a condition where a person has difficulty visually performing near tasks like reading. This can cause many symptoms and adversely affect ones ability to learn. This may complicate the post-concussion picture, especially with re-integration to school and/or work.

What if you knew that you had a risk factor that put you at increased risk for a prolonged and complicated recovery from a concussion? Would you fix it if you could? What if fixing it would also likely make you a better athlete, worker/student and improve your quality of life in addition to reducing your risk of having a prolonged/complicated recovery from a potential concussion?

It is true that any detected deficit should be treated whether you had a pre-injury, undetected condition or not. The name of the game is always neurological optimization whether you have sustained a concussion or not. In fact, most of your education and extra-curricular activity is aimed to improve just that, neurological function, the effect of which will spill over to every facet of your life. So that being said, Neurological Risk Assessment is not obligatory. However, what if we could detect a specific way to further optimize your neurological function before a potential injury? That would also likely reduce the chance of the post-concussion syndrome? Having objective knowledge of how you fared on commonly used neurological functions (i.e., binocular vision functions, vestibular function, cognitive function) pre-injury would help mitigate your post-injury symptoms and unravel the specific contributing causes to your injury more efficiently.

Interested in a NRA for your team?