Services
Services provided by the NJCC include:
Baseline Neurocognitive Testing
Baseline neurocognitive testing involves evaluating a non-injured, healthy individual’s ability to engage in various neurocognitive tasks, including decision making, memory, reaction time, processing speed and attention. At the New Jersey Concussion Center (NJCC), we utilize a widely accepted and well-validated measure, the ImPACT (Immediate Post-Concussion Assessment and Cognitive Test), to perform baseline testings. The results of this 20-minute computerized test provide valuable information regarding an individual’s pre-injury levels of neurocognitive functioning. Additionally, these results serve as a means of comparison in the event that an individual sustains a concussion.
Generally, it is recommended that baseline testing in younger individuals (those younger than 18) be completed annually(often prior to the athletic season) to ensure valid test results, given the brain growth/maturity in this population. At the NJCC, we perform individual and group baseline testings at our multiple locations. Additionally, we are able to conduct group/team testings at a facility (e.g. library, school, computer lab) convenient/proximal to you.
back to top
Post Concussion Neurocognitive Testing
Post-concussion neurocognitive testing typically involves an individual taking a repeat ImPACT test. It is advised that an individual who is suspected to have sustained a concussion take a supervised post-injury test within 24 to 72 hours after injury. In conjunction with appropriate medical evaluation, results of this test are used to assess the possibility of neurocognitive change following injury. For those who have not completed baseline testing, post-injury tests can be compared to age norms. If results indicate significant changes from baseline testing and/or significantly low performance in any assessed area (e.g. memory, reaction time, etc.), repeat tests are often given in weekly to biweekly intervals thereafter to further assess neurocognitive progress and recovery. While this computerized testing can be an important tool in evaluating concussion activity, it should never be used in isolation as a determinant for concussion diagnosis or recovery.
back to top
Concussion Diagnosis
Dependent on the results of a comprehensive medical assessment – of which post-injury neurocognitive testing is one facet -, a concussion diagnosis may be made, in addition to recommendations for appropriate treatment. At the NJCC, we have a team of expert neurologists, neurosurgeons, neuropsychologists, therapists and nurses who work together to manage your concussion as effectively as possible. Our interdisciplinary team works to provide clinically valuable information at every step of the concussion recovery process, from diagnosis to continued monitoring of symptoms to integration of necessary therapies and, ultimately, to return-to-play or other preinjury activities.
back to top
Return-To-Play Decisions/Physical Exertion Evaluations
Decisions regarding timing and appropriateness of an individual’s return-to-play should be made carefully and thoughtfully by those trained in concussion recovery to ensure safety and to avoid unnecessary additional neurocognitive insult. At the NJCC, we help guide an individual through the process of determining when he/she is able to return to sports and other activities. As a component of the evaluation process used to make this determination, we complete graduated physical exertion evaluations, as endorsed by the CDC and outlined below:
1. No activity, complete rest
2. Light aerobic exercises
3. Sport specific exercises
4. Non-contact training drills
5. Full contact training AFTER medical clearance
6. Game play
Normally, an individual would observe at least a 7-day rest period (after he/she is asymptomatic) before starting the protocol detailed above. If any symptoms occur at any level, an individual needs to rest and begin the protocol again after symptoms have resolved.
back to top
Return-To-School/Work
While much attention has been given to the physical symptoms of those suffering from a concussion, it is equally important that focus be devoted towards addressing the cognitive challenges secondary to this injury. Cognitive symptoms, including mental fatigue, inattention, distractibility, and mental sluggishness, are not uncommon and can clearly impact an individual’s ability to engage school and work-related tasks. Therefore, it is necessary that clinical attention be given to the evaluation of these symptoms. Similar to physical symptoms, restrictions related to cognitive performance may be put in place to assist in the recovery process. Additionally, depending on the severity and duration of one’s cognitive symptoms, various strategies and accommodations may be recommended to assist with concussion management in the school or the workplace setting. As with any concussion symptom area, appropriate review should occur prior to an individual’s full return to school or work, with the chart below offering a general guideline for a return to formal cognitive activity (i.e. school, work, etc.).
back to top
Neurological Evaluations
Unlike many other fields of medicine in which diseases are visible (eg, dermatology, ophthalmology) or palpable (eg, surgery), neurology is characterized by conditions that may be detected only by applying specific examination techniques and logical deduction, except when telltale cutaneous markers or other stigmata suggest the diagnosis. Considerable insight and intuition are required to interpret the symptoms and signs observed during neurologic examination. These features make the neurologic history and physical examination both challenging and rewarding.
A properly performed neurologic examination may take 90 minutes or even longer for the novice. Experienced neurologists take substantially less time and can frequently grasp the essential features of a clinical condition quickly. What might appear to be a complex problem of localization for the referring physician may turn out to have a simple explanation, and the neurologic consultation may help to avoid extensive testing.
(Oommen, 2011)
back to top
Neuropsychological Assessments
A neuropsychological assessment is a comprehensive testing method that evaluates in great detail an individual’s neurocognitive functioning. It includes gathering data about cognitive, motor, behavioral, linguistic, visual/spatial,
attention and executive functioning. Properly interpreted, these data can provide information leading to the diagnosis of a cognitive deficit or to the confirmation of a diagnosis, as well as to the localization of organic abnormalities in the central nervous system (CNS). Additionally, this information can guide effective treatment methods for the rehabilitation and recovery of individuals who present with various impairments/deficits. For individuals with Post-Concussion Syndrome, a neuropsychological assessment often proves essential in generating information necessary for managing cognitive and academic tasks during their course of concussion recovery.
back to top
Educational Training
One of the most important aspects in protecting individuals against concussions is educational training. The New Jersey Concussion Center offers schools, teams, organizations and individuals comprehensive, professional advice and education about concussion. We provide expert education about the prevention of concussion, the diagnosis and treatment of concussion, and the management of post-concussion syndrome. Our team is available for in-service lectures and training sessions that provide current and useful information about concussion activity, appropriate response, and effective Return-to-Play considerations.
back to top
Consultation
If you suspect that you or your child has sustained a concussion, we are available to assist you. All of our physicians and our clinicians are experts in the diagnosis and management of concussions. It is imperative that you be treated by a doctor who has been properly trained in this area and we are confident that our staff can serve your needs well.
back to top