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New Toronto Rehab concussion clinic starts treatment and research on patients within a week of brain injury

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​​​​​​Image of Lynsey Hayton
Lynsey Hayton, 25, started treatment at Hull-Ellis a few days following a concussion caused by a slip and fall on ice. She now considers herself symptom-free thanks to the various closely-monitored assessments and physician visits at Hull-Ellis. (Photo: UHN)

Lynsey Hayton, 25, was walking home from a quiet night with friends when she slipped on ice and fell face-first on the ground. Aside from injuries sustained to her nose, she felt fine.

While at work the next day, little more than 12 hours later, she suddenly felt very nauseous and began to vomit.

"When I wouldn't stop throwing up within a few hours, one of my colleagues pointed out to me that because I had fallen the night before, I probably had a concussion," explains Lynsey.

Her colleague was right. With symptoms including nausea, vomiting, a severe headache, confusion and mild short-term memory loss, Lynsey's suspicions were confirmed at Toronto Western Hospital's Emergency Room.

Upon discharge, she was referred to Toronto Rehab's Hull-Ellis Concussion and Research Clinic, ­­a new and unique concussion clinic that sees patients within one week of they sustain a brain injury, provides care and management of their symptoms, and gathers research on their progress.

"This is a formalized program that broadens the scope of concussion treatment from sports-related injuries to an emphasis on caring for the general population," explains Dr. Paul Comper, a neuropsychologist and consultant to the NHL Players' Association.

"Most of these injuries are falls, car accidents, and day-to-day injuries to the head. We're trying to characterize this population within days of injury to see what normal recovery looks like and to quantify that so we can properly plan intervention."

'Important to monitor at this acute stage'

The Hull-Ellis Clinic provides patients with a weekly program that runs for eight weeks or until they are no longer symptomatic, whichever comes first, with follow-ups at weeks eight, 12 and 16 post-injury.

"It's important to monitor and study the early symptoms of concussion in this acute stage," explains Tharshini Chandra, Hull-Ellis Clinical Coordinator and former Psychometrist in Neurology Services at Toronto Rehab.

"Even though the current standard of care for concussions is rest and follow-up visits as needed by a family doctor, many patients do not follow up with their family doctor. Our patients benefit from ongoing monitoring, education and support from a central location as they recover from their concussion symptoms."

The weekly visits include various assessments set at specific intervals by a doctor, a clinical coordinator, and any other required healthcare professionals specific to the patient's needs such as psychologists, neuropsychologists and physiotherapists.

Lynsey, prior to having her concussion, lived with insomnia and vertigo.

"I didn't normally go to the doctor very often. The doctor I've seen in Hull-Ellis has helped me recognize and deal with symptoms that I have directly from my concussion and symptoms that I lived with before it," explains Lynsey.

"You can definitely see the improvement when you're seeing your doctor on a regular basis."

Providing clinical care and gathering research

Dr. Comper emphasizes that the cornerstones of the Hull-Ellis Clinic are clinical care and research.

"Patients are referred to us right from the ER, and they start formal concussion management with our experts as soon as possible. It's unique to have such a direct hand-off to a specialized clinic in a teaching hospital, in the time frame we have set. Early intervention is often the key to successful outcome in this type of injury," explains Dr. Comper.

"Our patients are not only receiving clinical treatment, but through them we are able to gather data on cognitive measures, behavioural measures and the medical process involved."

In addition to physician assessments, other assessments throughout the program vary to include cognitive, balance and mobility, and mood and personality.

Currently, Hull-Ellis concussion patients are referred from the Emergency Rooms at Toronto General Hospital and Toronto Western Hospital. Dr. Comper hopes to expand the clinic's services to include other hospital emergency rooms.

Hull-Ellis patients can eventually be referred to TWH's Canadian Concussion Centre for further treatment and research.​​

"Hull-Ellis has benefited me so much in understanding and helping my symptoms, so if the research gathered on my progress also benefits others too, then that's even better, and it makes no difference to my treatment," explains Lynsey.

Lynsey's symptoms including the nausea and short term memory loss were gone within the first week of her concussion. She now considers herself symptom-free for the most part.

"I'm way more health-conscious now. I don't see why anybody wouldn't enroll in a program like this."

 

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