Photo: Krissy McCabe
Our understanding of concussions is rapidly evolving.
Neurology nurse practitioner Mandi Swanson had just switched to a neurosurgery specialization when her life took a dramatic turn. “I got to see a brain surgery that day, and then several hours later, I was in an ambulance on my way to the hospital,” Swanson says. The Plymouth resident and her husband at the time were in a violent car accident. Swanson, who was sitting in the passenger seat, says, “I took the brunt of the force of the accident and initially didn’t really think much of it.” She had incurred a handful of minor concussions playing sports as a child. Nothing lasted more than a day. Except, this time, her headache didn’t go away. It got worse.
Swanson reached out to a neurology colleague to get assessed for a concussion. “When I went in to see him that week, not only did I have my headache, which was even worse at that point, but my eyes weren’t tracking together, and when I closed my eyes, I couldn’t stand straight,” she says. Her symptoms continued to unfold. “I had speech issues,” Swanson says. “I couldn’t finish a sentence. I couldn’t remember words. I couldn’t remember my medical terminology. Couldn’t walk a straight line very well. Activity tolerance was awful. I was training for a marathon when the accident happened, and I got to the point where I could barely walk around my house without getting winded.”
It took two years and a mix of both traditional and nontraditional therapies for Swanson to improve to the point where she could return to work, and even then, her sensory sensitivities meant she couldn’t resume her former role. Instead, her neurologist colleague pitched a position she was particularly apt for: developing a concussion clinic at Minneapolis Clinic of Neurology in Coon Rapids. “I am the only provider that solely sees concussions, and I kind of bridge traditional medicine with those outside-the-box thinking things,” she says.
Many of Swanson’s patients have presented symptoms for months, if not years. “Many of them didn’t get a diagnosis until long after the injury happened because maybe they had some whiplash, and they didn’t actually hit their head,” she says. For a long time, medical convention dictated that a concussion required either hitting your head or a loss of consciousness, neither of which are true. “You don’t have to hit your head,” Swanson says. “Only about half really do. The other half are from a whiplash type of injury, and only 10 percent of people lose consciousness.”
Untreated concussions can present with dizziness, headache, irritability, memory loss, personality change, visual impairment and more. “People historically have thought that there’s nothing to be done,” Swanson says. Luckily, treatment can still alleviate such symptoms, even if they’ve been persistent for years. If symptoms continue, Swanson recommends getting evaluated by a general care physician. “The faster they get treatment involved, the faster people will get better,” she says.
Red Flag Symptoms
Nurse practitioner Mandi Swanson recommends visiting urgent care or the emergency room to be evaluated before going to sleep if any of the following concussion symptoms are present:
- A headache that gets worse
- Behavioral changes
- Difficulty waking up
- Losing consciousness for more than 30 minutes
- Numbness or weakness in the limbs
- Slurred speech
- Vomiting, especially multiple times
Other Symptoms
The list of other potential concussion symptoms is very long, but Swanson shares some common ones to be aware of:
- Activity intolerance
- Anxiety or depression
- Blurred or double vision
- Brain fog
- Difficulties with sleep (either sleeping too much or too little)
- Difficulty concentrating or focusing
- Difficulty controlling motor functions
- Dizziness, feeling off balance
- Persistent fatigue
- Sensory sensitivity
Swanson hosts Brain Wellness – the Podcast to share her insights and the stories of caregivers, patients and physicians who have insights pertaining to brain health and concussion recovery. Swanson and her guests cover topics from prevention to recovery timelines, serving as a resource for those who want to learn more about concussions and traumatic brain injuries.
Consult your primary care physician or other qualified healthcare provider with any questions regarding a medical condition or treatment.
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