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Shepherd Center Launches Complex Concussion Clinic to Tackle Complications of Mild Brain Injuries

A comprehensive approach leads to better outcomes when concussions are slow to heal.

Recently, the dangers of concussions have captured national attention, particularly related to the increased risk of hits, blows and falls of football, hockey, boxing and other sports. Whether on the field, in the workplace or at home, every year, millions of people sustain a sudden jolt or blow to the head that causes a concussion. While most heal quickly with no further problems, in approximately one in five cases, symptoms persist beyond the typical timeframe for healing.

Now, Shepherd Center’s new Complex Concussion Clinic is bringing together an interdisciplinary team of specialists to address complications and provide a streamlined path to full recovery.

This isn’t the first time Shepherd Center has forayed into care for people with complex concussions. For nearly 10 years, Shepherd Center has treated complicated concussions among service men and women through its SHARE Military Initiative.

Like SHARE, the Complex Concussion Clinic offers a comprehensive approach to evaluation and treatment, so patients no longer have to seek out multiple clinicians for their range of symptoms. The clinic, the only one of its kind in the Atlanta region, provides a one-stop resource with specialists in neurology, vestibular and balance disorders, athletic training, rehabilitation medicine, neuropsychology and neurosurgery. Assessments include cognitive, ocular-motor, vestibular and balance testing, and, when needed, advanced imaging using three-dimensional and high-resolution technology.

“Every injury is different, and the injury can affect different parts of the brain,” said Russell Gore, M.D., a vestibular neurologist who is medical director of Shepherd Center’s SHARE Military Initiative and director of the new Complex Concussion Clinic. “Impairments in specific areas tend to respond best to certain types of treatment.”

For example, a concussion may affect the vestibular system, causing dizziness and balance problems. Patients may have difficulty concentrating, sensitivity to light or noise, trouble going to sleep or staying asleep, headaches and mood changes. The ocular-motor system encompasses a large portion of the brain, and impairment there also can cause balance problems.

Concussions pose unique issues for athletes in youth, collegiate and professional sports, and the Complex Concussion Clinic provides expertise, including telemedicine symptom checks and advice about how to engage in light activity before making a full return to a sport or activity.

“The return-to-play protocol is very complicated for parents and coaches,” said Cheryl Appleberry, lead athletic trainer for the Complex Concussion Clinic. “We’ll guide them through their recovery program.”

To be evaluated by the Complex Concussion Clinic, potential patients should seek a referral through their frontline provider, which could be a sports medicine, emergency room or primary care physician or athletic trainer. Referral is appropriate for patients who have dizziness, balance problems and nausea lasting more than a few days after the injury, or symptoms such as headaches, dizziness, difficulty sleeping or concentrating that persist two to three weeks after injury.

People with a history of migraines, learning challenges, or a previous concussion that required an extended recovery should obtain a comprehensive assessment soon after their injury, Dr. Gore said.

Based on their needs, patients receive recreational therapy, cognitive therapy, occupational therapy, counseling, vestibular therapy and athletic training. The treatment duration varies but typically involves outpatient visits for eight to 12 weeks, and it is usually covered by insurance.

The Complex Concussion Clinic treats patients in the first-floor multispecialty clinic at Shepherd Center’s main campus at 2020 Peachtree Road Northwest in Atlanta. In the first half of 2017, it will move into a new center nearby at 80 Peachtree Park Drive, which will include a 4,000-square-foot therapy space with state-of-the-art equipment and technology. Patients who need rehabilitation for moderate to severe traumatic brain injury will continue to be seen at Shepherd Pathways in Decatur.

The Complex Concussion Clinic’s focused treatment plans minimize the use of medication while speeding recovery.

“As a rehabilitation center, we’re very goal-directed,” Dr. Gore said. “We want to maximize the performance and recovery of every patient.”

Bu Michele Cohen Marill

About Shepherd Center

Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. An elite center recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems, Shepherd Center is ranked by U.S. News as one of the nation’s top hospitals for rehabilitation. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again.