What is a concussion?
A concussion is a type of traumatic brain injury that is caused by a blow to the head, a fall, or any other injury that jars or shakes the brain inside the skull. Often times there are no visible signs of a brain injury.
You don’t have to pass out (lose consciousness) to have a concussion. Some people will have obvious symptoms, such as, passing out or forgetting what happened right before the injury. But other people won’t. With rest, most people fully recover from a concussion. The time that it takes to recover from a concussion depends on the severity of the injury, the speed of diagnosis, early treatment, and the individual. Symptoms of a concussion range from mild to severe and can last for hours, days, weeks or even months.
In rare cases concussions cause more serious problems. Repeated concussions or a severe concussion may lead to long-lasting problems with movement, learning or speaking. Because of the small chance of permanent brain problems, it is important to contact your doctor or a medical professional that is working with your team if you or someone you know has symptoms of a concussion.
What causes a concussion?
Your brain is a soft organ that is surrounded by spinal fluid and protected by your skull. If your head or body is hit hard enough, your brain can crash into your skull and be injured.
There are many ways to get a concussion. Some common ways include fights, falls, car crashes or participating in any sport or activity such as rugby, football, boxing, hockey, soccer, skiing or snowboarding.
Signs and symptoms of a concussion may include:
- Headache or a feeling of pressure in the head
- Temporary loss of consciousness
- Confusion or feeling as if in a fog
- Amnesia surrounding the traumatic event
- Dizziness or “seeing stars”
- Ringing in the ears
- Nausea or vomiting
- Slurred speech
Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury:
- Concentration and memory complaints
- Irritability and other personality changes
- Sensitivity to light and noise
- Sleep disturbances
- Psychological adjustment problems and depression
- Disorders of taste and smell
When to Seek Immediate Medical Attention:
In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. Contact your health care professional or emergency department right away if you have any of the following danger signs after a bump, blow, or jolt to the head or body:
- Headache that gets worse and does not go away.
- Weakness, numbness or decreased coordination.
- Repeated vomiting or nausea.
- Slurred speech.
An individual should be taken to an emergency department right away if they:
- Look very drowsy or cannot be awakened.
- Have one pupil (the black part in the middle of the eye) larger than the other.
- Have convulsions or seizures.
- Cannot recognize people or places.
- Are getting more and more confused, restless, or agitated/worsening of symptoms
- Have unusual behavior.
- Lose consciousness (a brief loss of consciousness should be taken seriously and the person should be carefully monitored).
No one should return to play or vigorous activity while signs or symptoms of a concussion are present. Experts recommend that an athlete with a suspected concussion not return to play until he or she has been medically evaluated and has followed the return to play protocol that is recommended by their sport. Experts also recommend that no one with a concussion should return to play on the same day as the injury.
Getting Better: Tips for Adults
- Get plenty of sleep at night, and rest during the day.
- Avoid activities that are physically demanding (e.g., heavy housecleaning, weightlifting/working-out) or require a lot of concentration (e.g., balancing your checkbook). They can make your symptoms worse and slow your recovery.
- Avoid activities, such as contact or recreational sports that could lead to another concussion.
- When your health care professional says you are well enough, return to your normal activities gradually, not all at once. If you are an athlete, following the return to play protocol associated with your sport.
- Because your ability to react may be slower after a concussion, ask your health care professional when you can safely drive a car, ride a bike or operate heavy equipment.
- Talk with your health care professional about when you can return to work. Ask about how you can help your employer understand what has happened to you.
- It may be necessary to talk to your employer about modifying your job duties or your schedule while you are recovering.
- Take only medications that your health care professional has approved.
- Do not drink alcohol until your health care professional says you are well enough. Alcohol and other drugs may slow your recovery and put you at risk of further injury.
- Write down the things that may be harder than usual for you to remember.
- This will help with frustration
- If you’re easily distracted, limit yourself to one activity at a time.
- Consult with family members or close friends when making important decisions.
- Some people report that flying in airplanes makes their symptoms worse shortly after a concussion.
Help Prevent Long-Term Problems
If you already had a medical condition at the time of your concussion (such as chronic headaches), it may take longer for you to recover from the concussion. Anxiety and depression may also make it harder to adjust to the symptoms of a concussion. While you are healing, you should be very careful to avoid doing anything that could cause a bump, blow, or jolt to the head or body. On rare occasions, receiving another concussion before the brain has healed can result in brain swelling, permanent brain damage, and even death, particularly among children and teens.
After you have recovered from your concussion, you should protect yourself from having another one. People who have had repeated concussions may have serious long-term problems, including chronic difficulty with concentration, memory, headache, and occasionally, physical skills, such as keeping one’s balance.
Potential complications of concussion include:
- Epilepsy. People who have had a concussion double their risk of developing epilepsy within the first five years after the injury.
- Cumulative effects of multiple brain injuries. Evidence exists indicating that people who have had multiple concussive brain injuries over the course of their lives may acquire lasting, and even progressive, cognitive impairment that limits functional ability.
- Second impact syndrome. Sometimes, experiencing a second concussion before signs and symptoms of a first concussion have resolved may result in rapid and typically fatal brain swelling. After a concussion, the levels of brain chemicals are altered. It usually takes about a week for these levels to stabilize again. However, the time it takes to recover from a concussion is variable, and it is important for athletes never to return to sports while they’re still experiencing signs and symptoms of concussion.
Involvement of the Cervical Spine
It is common for individuals that have experienced a concussion to have some lingering symptoms such as: headaches, difficulties with vision, dizziness and concentration that may be related to cervical joint or vestibular dysfunction. Having this evaluated by a physiatrist or manual physical therapist that specializes in the spine will assist in diagnosis, recovery and resolution of these symptoms.