This article investigates the causes, treatments, and diagnosis of concussion. Concussion is also known as mild brain injury, mild traumatic brain injury, mild head injury, and minor head trauma.
In 2009, there were 446,788 sports-related head injuries treated in hospital emergency rooms in the United States.
Some experts define concussion as a head injury with temporary loss of brain function, which can cause cognitive, physical, and emotional symptoms.
Concussion may also be defined as an injury to the brain, often caused by a jolt, or blow to the head. In the majority of cases, the individual does not lose consciousness.
This MNT Knowledge Center article will look at how to spot a concussion, how they are treated, and ways to avoid becoming concussed.
Fast facts on concussions
- Usually, concussions are caused by a jolt or blow to the head.
- Some research shows that the effects of a concussion on cognitive ability can still be measured 30 years later.
- Initial symptoms might include dizziness, slurred speech, and amnesia.
Signs
Signs of concussion may not be noticeable straight away.
Immediate signs
Signs of a concussion that can be noticed immediately include:
- loss of consciousness
- confusion
- a headache
- slurred speech
- dizziness
- ringing in the ears
- nausea
- vomiting
- amnesia
- tiredness
Non-immediate symptoms
The following symptoms may not be noticeable for several hours or even days:
- amnesia
- depression
- disturbed sleep
- sensitivity to sounds
- irritability
- lack of concentration or focus
- moodiness
- sensitivity to light
Serious symptoms that need immediate attention
The following signs and symptoms of concussion may be linked to a more serious injury, and immediate medical help should be sought:
- prolonged headache
- prolonged dizziness
- dilated of different-sized pupils
- prolonged nausea and vomiting
- consistent memory loss
- ringing in the ears
- loss of sense of smell or taste
In children
Concussion signs and symptoms are most difficult to detect in very young children because they cannot explain how they feel. Signs may include:
- lethargy and listlessness
- irritability
- changing sleeping patterns
- altered appetite
- walking or standing unsteadily, or any signs of balance and dizziness problems
Serious signs in children
The following signs usually mean the child needs immediate medical attention:
- loss of consciousness
- after attempting to stem the bleeding, a cut continues to bleed
- any change in the way the child walks
- bleeding from the ears or nose
- blurred vision
- confusion
- continuous crying
- seizure
- discharge from the ears or nose
- dizziness
- loss of appetite
- prolonged headache
- prolonged irritability
- prolonged listlessness, fatigue, and lethargy
- repeated or forceful vomiting
- slurred speech
- worsening headache
Diagnosis
If an individual has experienced a severe jolt or blow to the head that has left them dazed, confused, or wobbly, they have concussion.
Determining the severity of the concussion is more difficult because the signs may not be evident. A report published in The American Journal of Sports Medicine explains that athletes may have a severe concussion without becoming unconscious. According to the authors, amnesia and confusion on the field after injury may be as important, if not more important, in making a return-to-play decision.
A doctor will ask the patient details about the trauma. It may be necessary to question the people who accompanied the patient. A neurological examination will also be done, which will include evaluating the following factors:
- balance
- concentration
- coordination
- hearing
- memory
- reflexes
- vision
A CT scan may also be ordered if internal bleeding or swelling of the brain is a concern.
Treatment
Most concussion or mild traumatic brain injury (MTBI) symptoms will go away without treatment. Guidelines for managing a concussion include:
- Rest: This is vital. It takes time for the brain to recover, and recovery is quicker if the body is resting and getting good sleep each night.
- Headaches: Acetaminophen, such as Tylenol, is the best painkiller for a headache due to a head injury. Drugs such as aspirin, ibuprofen, and other NSAIDs should be avoided because they thin the blood and increase the risk of internal bleeding.
- Sports: It is important not to return to any sporting activity too soon. Ask a doctor.
- Alcohol: People should avoid consuming alcohol until all symptoms have completely disappeared because it slows healing.
- Migraine: The occurrence of a migraine after a concussion may indicate an increased risk of neurocognitive impairment.
- Worsening symptoms: If symptoms get worse, visit a doctor.
Only a small percentage of patients with MTBI require surgery.
Recovery time
Ignoring symptoms can be dangerous. Recovering from a concussion can take a long time, especially in severe cases, so rest is crucial.
If physical signs return during this time, it is a strong indicator that you are overexerting yourself. Do not immediately return to driving a car, riding a bike, or operating heavy machinery after a concussion.
It is important to concentrate on one task at a time, avoiding using computers too often and writing down anything that it may be a struggle to remember.
Return to work and normal activity gradually. Be sure to avoid activities that run the risk of another concussion, such as contact sports, until all signs have stopped occurring.
Causes
The brain floats in cerebral fluid, which protects it from jolts and bumps. A violent jolt or a severe blow to the head can cause the brain to bump hard against the skull. This can result in the tearing of nerve fibers and the rupturing of blood vessels under the skull, leading to a build-up of blood.
Concussions are most commonly caused by:
- automobile accidents
- sports injuries
- falls
- horseback riding accident
- playground accidents
- cycling accidents
- assaults
- explosions
Prevention
Preventing concussion means finding ways to avoid physical injury, especially to the head.
- Helmets and other protective headgear: It is important to buy new protective headgear, not second-hand ones. Headgear will need to be replaced periodically.
- Seat belt: wearing a seat belt has been proven to significantly reduce the risk of head injury during vehicle accidents.
- Driving under the influence: Never drive under the influence of alcohol, illegal drugs, or some medications.
- Mouthguard: A good mouthguard can help prevent concussion in contact sports.
- At home: Consider adding lighting to areas that may be hazardous. Be alert for clutter that could cause people to fall over. If there are toddlers in the house, place pads on sharp edges of furniture, use a stair gate, install window guards.
- Playgrounds: There should be an underlay of soft material, either sand or special matting.
- Jogging in busy streets: Wear bright colored clothing and use eyes and ears when crossing the road. Keep to the sidewalk.
- Cycling at night: Make sure the bicycle has good lighting in front and behind. Wear bright clothing with reflectors.
- Nutrition and exercise: A well-balanced diet and plenty of exercise can help maintain good bone mass and bone density. This is especially important for older individuals and post-menopausal women. Stronger bones may reduce the severity of brain injury following a blow to the head.
A concussion can be easily prevented, but accidents happen. If you do experience concussion, be sure to give it a prolonged amount of recovery time.