#263 ‒ Concussions and head trauma: symptoms, treatment, and recovery | Micky Collins, Ph.D.

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Jul 24, 2023

Micky Collins, a leading expert in sports-related concussions and director at the University of Pittsburgh Medical Center's Concussion Program, delves into the complexities of concussions. He discusses the six types of concussions, associated symptoms, and risk factors that affect recovery, emphasizing the need for prompt treatment. Micky explores innovative treatments like hyperbaric oxygen therapy and synthetic ketones, and shares vital advice for parents of young athletes. The conversation highlights the importance of understanding concussion management for better recovery outcomes.

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ANECDOTE

Mickey Collins's Journey into Concussion Research

Mickey Collins's interest in concussion sparked during a neuroscience class in college, fueled by his love for sports.
He later pioneered the first concussion clinic at UPMC, witnessing its growth from a niche area to a major field in sports medicine.

INSIGHT

The Pathophysiology of Concussion

Concussion is a metabolic mismatch caused by the brain shifting inside the skull, leading to an energy crisis at the cellular level.
This stretching disrupts potassium and calcium levels, affecting energy demand and supply but not causing cell death.

INSIGHT

Concussion Risk Factors and Phenotypes

Pre-existing conditions like car sickness, migraine, or lazy eye increase concussion risk and influence symptom presentation.
This suggests the concept of a "concussive reserve," similar to cognitive or movement reserve.

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Michael “Micky” Collins is an internationally renowned expert in sports-related concussions and a consultant for multiple professional sports organizations. In this episode, Mickey first explains the definition and diagnosis of a concussion, as well as the diverse signs and symptoms associated with different types of concussions. He discusses the risk factors that contribute to increased susceptibility and/or severity of concussions in certain individuals, emphasizes the significance of prompt treatment, and uses case studies to illustrate the latest in treatment protocols and recovery process. Additionally, Mickey provides insight into the evolving field of concussion treatments, including the exploration of hyperbaric oxygen and synthetic ketones. He gives advice to parents of kids who play sports and discusses the promising prospects in the realm of concussion management.

We discuss:

Micky’s interest in concussion and how he started the first concussion clinic [3:15];
Concussion: definition, pathophysiology, and risk factors making someone more susceptible [9:45];
Symptoms of concussion, predictors of severity, and the importance of early and effective treatment [20:00];
The six types of concussion, the effectiveness of treatment, and factors that impact recovery [25:45];
The importance of seeing a specialist and the prognosis for recovery [30:00];
Case study of a racecar driver who suffered a vestibular concussion [32:15];
Why vestibular concussions are particularly problematic [42:45];
A treatment plan for the racecar driver, possible use of medications, and how to address the root cause [45:45];
Exploring alternative treatments: hyperbaric oxygen, synthetic ketones, and more [52:00];
The natural history of a concussion if untreated and the effect, if any, of concussion on subsequent risk of brain disease [57:15];
Chronic traumatic encephalopathy (CTE) [1:01:45];
Advice for parents of kids who play sports: when and where to seek treatment for a possible concussion [1:04:45];
Is there any evidence that the APOE4 genotype increases susceptibility to concussion or TBI? [1:10:15];
The increased risk of concussions in older adults and a case study of a 90-year-old patient who suffered a head injury in a fall [1:11:15];
Funding for concussion research and fellowship programs to train concussion specialists [1:15:30]; and
More.

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