Concussions

What Is a Concussion?

A concussion is a type of brain injury that results in a temporary loss of brain function due to an external force applied to your head or body, causing your brain to move back and forth rapidly.

A concussion can be a mild event but can become life-threatening. Concussions can occur when you hit your head, fall, experience a physical assault, or upon impact in a car accident. Most people who experience a concussion usually recover within two weeks.

What Causes a Concussion?

A concussion occurs when the brain moves back and forth against the interior skull walls. This abrupt movement can cause injury to the brain by bouncing around or twisting within the skull. This unexpected movement can damage brain cells or result in chemical changes or other damage. A concussion can temporarily affect how the brain works. It may lead to headaches, changes in alertness, or loss of consciousness.

Do You Have to Be Knocked Out?

Most people who have concussion diagnoses do not experience a loss of consciousness. So, you do not need to be knocked out to have a concussion.

A person with a concussion can either lose consciousness suddenly or experience changes in their awareness.

Who Is Most at Risk for a Concussion?

Anyone is at risk of a concussion under the right circumstance that allows back-and-forth movement of the brain at a rapid speed. Examples of those at risk are:

• Highly active individuals such as sports players and cyclists
• Young children and older adults have a heightened fall risk that can lead to them falling or hitting their heads.
• People involved in vehicular accidents, such as passengers and pedestrians
• Military personnel involved in combat
• Victims of physical abuse

Always use caution when participating in activities that put you in a position where your head can sustain injury. Use protective gear or place protective barriers where applicable.

What Are the Symptoms of a Concussion?

Some common symptoms of a concussion are:

• Dizziness
• Feeling tired or drowsy
• An unrelenting and growing headache
• Weakness or numbness
• Seizures or convulsions
• Vomiting and nausea
• Slurred speech
• Tinnitus
• Blurry vision
• Temporary loss of consciousness

How Soon Do Symptoms Appear?

If you experience a concussion, you might not feel any symptoms immediately. It is common to develop symptoms days or weeks after the event. You should monitor your symptoms for duration and severity and seek assistance at the appropriate time. If you experience symptoms for an extended period and they get worse, seek emergency care.

When Should a Person Go to an Emergency Room?

Although concussions are common, they must be taken seriously. Concussions might vary in severity, but you need to be cognizant of what to look for.

Concussions can be hard to identify in infants and toddlers due to their inability to vocalize what they are feeling. You should immediately monitor an infant or toddler for symptoms such as:

• Visible bruises or a bump on the head
• Loss of balance in posture
• Excessive crying
• Alterations in their eating or sleeping patterns
• Dazed appearance
• Loss of interest in activities
• Vomiting

If your child experiences a head injury, contact your pediatrician and emergency care provider as soon as possible.

If you experience a head injury, you should monitor yourself. You should seek medical attention if you experience any of the following symptoms:

• Stiff neck
• Visible bruises or bumps on the head
• Change in your normal behavior
• Fluid or blood coming from the nose or ears
• Changes in vision or behavior
• Disorientation or confusion
• Weakness in extremities
• Fever
• Unrelenting tinnitus
• Dizziness

You should seek medical attention immediately if the following symptoms persist for more than two weeks:

• Vomiting multiple times
• A headache that worsens
• Loss of consciousness
• Seizures or convulsions
• Slurred speech
• Cannot wake up

Remember, concussions are common and will usually resolve on their own within two weeks. Understanding what observations to make will help you determine when to monitor or seek immediate medical attention.

Can You Get a Concussion From a Hit to the Chin or Jaw?

A concussion is caused by a sudden movement from a hit, blow, bump, or jolt to the head or body that causes the head and brain to move quickly back and forth. This means that there are many ways and places the body can get hit that may result in a concussion. Examples include:

• People who participate in sports such as boxing or karate might experience a high frequency of kicks or hits to their chin or jaw that could cause concussions.
• Someone in a vehicular accident could experience a blow to their chin or jaw, powerful enough to cause a concussion.

Remember, a concussion can be caused by rapid, back-and-forth movement of the head. The external force does not have to be limited to the skull.

What’s the Difference Between a Concussion and a Traumatic Brain Injury?

Traumatic brain injuries (TBIs) are a category of brain injury that results from an external force to the brain. A concussion is a specific type of TBI, as it results from an external force applied to your head or body that causes your brain to move back and forth at a rapid speed. A concussion results in a loss of brain function for a short period of time. Concussions are commonly referred to as mild TBIs.

Are There Worse Areas of the Brain to Have a Concussion?

Brain injuries like concussions can occur in any region of the brain. Different brain regions are responsible for different brain functions. The injured brain region will exhibit alterations in its associated functions and observed symptoms. Since concussions are mild TBI and usually resolve on their own, the area affected is not relevant.

According to a study in Frontiers in Neurology, concussion-related brain injury, which results in structural changes that alter a brain region, can have differing symptoms. Most experienced symptoms fall within four categories: somatic symptoms, cognitive symptoms, emotional symptoms, and sleep-altering symptoms.

• Somatic symptoms include headaches, nausea, motor control problems, pain, vomiting, fatigue, numbness, dizziness, and noise sensitivity
• Cognitive symptoms include mental slowness or fogginess, challenges in concentration or memory, and speech or language issues
• Emotional symptoms include irritability, feelings of anxiety, nervousness, or hopelessness
• Sleep symptoms include drowsiness, trouble falling asleep, or sleeping for longer periods

Relatively speaking, there can be worse areas to have a concussion-related brain injury. Your current state of mental, medical, and physical health should be factors in addition to the experienced symptoms.

How Is a Concussion Diagnosed?

A healthcare provider usually gives a concussion diagnosis after they perform a physical and neurological exam. The physical exam allows them to obtain information on the injury. The neurological exam allows the assessment of your vision, coordination, balance, and reflexes. They might perform neurocognitive testing to evaluate your memory, problem-solving, concentration, or ability to recall information.

Depending on the outcome of the neurological exam, a computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan might be recommended to determine bleeding, inflammation, or even the presence of a skull fracture.

For adolescents, observation is usually recommended for a child who receives a diagnosis of a concussion to ensure the symptoms do not worsen.

How Is a Concussion Treated?

Rest, pain relievers, and reestablishing routines are common treatments for concussions.

Physical and mental rest is necessary to allow the brain to recover from the incident. You should also limit activities that require intense brain function, which may worsen the symptoms. Avoiding intense physical activity and sports to prevent further brain injury is best.

Select painkillers, such as acetaminophen or Tylenol, or agents that do not increase the risk of bleeding, can relieve headaches and other injury-related pain. However, aspirin, ibuprofen (Motrin or Advil), naproxen, or other non-steroidal anti-inflammatory drugs are not recommended.

A gradual return to normal activities can assist in recovery from a brain injury upon the guidance of your healthcare provider.

What Is Concussion Protocol?

A concussion protocol refers to a set of policies and procedures outlining how to care for someone who experiences a head injury for a return to normalcy. It varies by organization and is based on the party of interest (such as children, adults, athletes, elderly, etc.). It can include definitions, signs and symptoms, injury management, and adjustments to work or school obligations to aid recovery for an ongoing return to normal activity.

Here is an example from the Centers for Disease Control and Prevention for a 6-Step Return to Play Progression for athletes.

6-Step Return to Play Progression

• Step 1: Back to regular activities
• Step 2: Light aerobic activity
• Step 3: Moderate activity
• Step 4: Heavy, non-contact activity
• Step 5: Practice & full contact
• Step 6: Competition

Remember, each step should last at least 24 hours. It is important to monitor the athlete to watch for concussion symptoms after each day’s return to sports advancement activity.

How Can I Prevent Concussion?

To prevent or minimize the risk of concussions, consider wearing protective gear while playing sports or high-impact activities, safeguarding your house with appropriate lighting, securing loose objects, and wearing safety restraints when in a moving vehicle.

What Are the Long-Term Complications?

Some people have long-term complications after a concussion or concussion-related brain injury. They may experience:

• Unrelenting headaches
• Vertigo (a sense of spinning or dizziness)
• Persistent post-concussive symptoms
• Multiple brain injuries
• Second-impact syndrome

These can last for a varied amount of time after the initial brain injury event.

What Type of Healthcare Provider Treats Concussion?

Healthcare providers who treat concussions come from a variety of departments, including emergency medicine, family medicine, neurology, pediatric rehabilitation, sports medicine, physical medicine and rehabilitation, and even general medicine.

When you make an appointment with a clinician, remember to list your symptoms and medical information, follow pre-appointment instructions, write down questions to ask (e.g., diagnosis, tests, treatment options, or time to recovery), and consider taking someone for support.

Concussion Essentials

Concussions, while often mild, can have significant short- and long-term effects on brain function. Early diagnosis, proper treatment, and preventive measures are crucial in managing this common type of brain injury. Understanding the symptoms and risks associated with concussions can help you seek appropriate care and avoid further complications. Regular monitoring and following healthcare provider recommendations are essential for recovery and prevention of additional injuries.