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Concussions have become a hot topic in recent years but there are many misconceptions regarding them. Let’s take a moment to talk about what they are, what are the symptoms and what steps may be taken after a concussion. A concussion is a form of traumatic brain injury. More specifically, it comes under the category of “mild” traumatic brain injury. By definition, a mild traumatic brain injury may involve no loss of consciousness to a loss of consciousness of up to 30 minutes. It involves an alteration in consciousness or mental state from a quick moment to up to 24 hours. It also may also involve Post-Traumatic Amnesia, in which an individual cannot make memories and/or may act in an odd behavioral manner, for up to 24 hours. For the purpose of this blog post, we will use the term concussion instead of mild traumatic brain injury.
Generally speaking, a concussion occurs when the head is impacted by another item (e.g. fist or ground), which causes the brain to hit the inside of the skull. This impact then changes the normal functioning of the brain. An example of this is a baseball hitting a batter in the head. The batter may be dizzy or confused after the impact. In some cases, a concussion can be due to a rapid acceleration-deceleration of the head, which causes damage to the brain. An example of this would be a hard shoulder to shoulder football tackle. Although the offensive player’s head was not directly impacted, the quick snapping back of the head due to the tackle can lead to a concussion.
According to the Centers for Disease Control, the highest rate of concussions occurs in older adults and very young children. Both groups tend to have the greatest difficulties with balance and mobility, which contributes to falls. In fact, falls are the top cause of concussions. Although most people think of concussions in children as due to sports such as football, the most common activities leading to children’s concussions are when playing on playground equipment and bicycle accidents. Children spend far more time playing in a playground or riding bicycles than they do playing football so the likelihood of an accident is higher. Other accidents, such as motor vehicle accidents, also commonly lead to concussions.
The most common concussion symptoms are headaches, confusion, dizziness, nausea, difficulty with concentration, difficulty with memory and changes in vision. Individuals can have ringing in the ears, light sensitivity or difficulty sleeping. Further, they may experience irritability, low mood, fatigue or difficulty managing stress. Usually, individuals with concussions do not experience all of these symptoms but only a selection of them. Approximately 80% of individuals with a concussion will see their symptoms resolve in a few weeks to a month, oftentimes sooner. For other individuals, their symptoms will last for longer periods of time, from months to years. These individuals with longer post-concussion symptoms may be referred to rehabilitation.
Following a concussion, the most important action is to contact your doctor. Your doctor may have a variety of recommendations, depending on the severity of symptoms and previous health history. Typically, doctors will recommend a period of limiting mental and physical activities to allow the brain to rest, followed by a period of gradual return to previous activities. For instance, this may involve recommendations to significantly reduce or temporarily stop exercise workouts or screen time in front of a computer. This may also involve a temporary reduction of work or school hours. Many schools develop return to learn and return to play plans for students with concussions, allowing schools and physicians to collaborate for the best plan for the student. It is important to give time for the brain to heal from the concussion. Following the initial concussion, individuals are at a higher risk of another concussion and a more serious injury, if they should receive another concussion prior to allowing the brain to fully recover. If symptoms worsen, such as an increase in nausea or seizures, then you should immediately contact your doctor or go to the nearest emergency room, as this may be a sign of a more serious evolving brain condition such as bleeding or swelling of the brain.
There are a number of ways to reduce the likelihood of receiving a concussion; here are a few recommendations:
For those looking to learn more on concussions, the Centers for Disease Control offers a course for parents, teachers and coaches to improve in their concussion awareness.
Moody Neurorehabilitation Institute (Moody Neuro) provides personalized care to treat the unique challenges of brain injury with the singular purpose of achieving the best possible outcome for patients and their families.