When it comes to concussions, Andrew Perron, MD, FACEP, knows what he doesn’t know—and he wants to teach you the same.
“There’s so much more that we don’t know than we do know,” said Dr. Perron, residency program director and emergency physician at the Maine Medical Center in Portland and the presenter at ACEP18 of “Concussion Update 2018: What We Know, What We Think We Know, and What We Don’t Know.” “A lot of what we do now is just based on expert consensus, and there’s really not a lot of science yet behind what we’re doing with concussion.”
That is the point of Dr. Perron’s annual talk—to dispel myths, update best practices, and acknowledge that there can be conflicting information in key areas. One misperception he will seek to correct is that a concussion “is a bop on the head.”
“Really, the fact is, the ‘bop on the head’ is just starting a chemical process in the brain that we really don’t understand very well,” he said. “That process, the concussion process, can continue for minutes, hours, days. And everybody is different.”
Dr. Perron noted that while the literature on concussion has grown over the past 10 years—including work on chronic traumatic encephalopathy, brain remodeling, and return-to-play guidelines for athletes—things continue to change quickly. Just five years ago, it was thought that after a concussion, patients should have strict cognitive rest. Now, it’s more conventional wisdom that after a concussion, the brain needs some degree of stimulation to push the repair process.
“You need almost an annual update in concussion these days,” Dr. Perron said. “You break your wrist, we’re going to treat it basically the same way we did 25 years ago. My talk changes annually because there is new information being found every year.”
Richard Quinn is a freelance writer in New Jersey.