Concussion: Understanding the Symptoms and Treatment

April 10, 2023

Introduction to Concussion: Definition and Causes

A concussion is a type of traumatic brain injury (TBI) that occurs when the brain is jarred or shaken inside the skull. It can be caused by a direct blow to the head or a sudden impact that causes the head and brain to move rapidly back and forth. Concussions are a common injury, particularly in contact sports and among older adults who are more susceptible to falls.

Definition

A concussion is defined as a complex pathophysiological process that affects the brain, induced by traumatic biomechanical forces. Several common features that incorporate immediate and progressive pathophysiological events may be used to define a concussion. The essential feature of a concussion is a complex set of symptoms that may or may not involve loss of consciousness.

Causes

Concussions can be caused by a variety of events, including:

  • Blows to the head: A direct blow to the head, such as from a fall or a hit in a sport, can cause a concussion.
  • Sudden impacts: Sudden impacts, such as from a car accident or a hard hit in a sport, can cause the brain to move rapidly back and forth inside the skull, leading to a concussion.
  • Falls: Falls are a common cause of concussions, particularly among older adults.
  • Penetrating injuries: A penetrating injury, such as a bullet or knife wound, can also cause a concussion.

It’s important to note that not all concussions are caused by direct contact to the head. A blow or jolt to the body can also cause the head to move rapidly back and forth, resulting in a concussion.

Risk factors

Some factors that can increase the risk of concussion include:

  • Participation in contact sports: Athletes who participate in contact sports, such as football, soccer, and hockey, are at an increased risk of concussion.
  • Age: As we age, the brain becomes more susceptible to injury.
  • Previous concussion: Having had a concussion in the past increases the risk of having another one.
  • Other health conditions: Certain health conditions, such as migraines or attention-deficit/hyperactivity disorder (ADHD), may increase the risk of concussion.

It’s important to be aware of the signs and symptoms of concussion and to seek medical attention if you suspect you or someone you know has suffered a concussion. With proper diagnosis, treatment and management, many people make a full recovery from a concussion.

In the next section, we will explore the signs and symptoms of a concussion, and how it’s diagnosed.

Symptoms of Concussion: Recognizing the Signs

Concussion symptoms can vary widely and may not always be immediately apparent. It’s important to be aware of the signs and symptoms of a concussion and to seek medical attention if you suspect you or someone you know has suffered a concussion.

Immediate symptoms

Some common immediate symptoms of a concussion include:

  • Loss of consciousness: The individual may be briefly unconscious or “knocked out” after the injury.
  • Amnesia: The individual may have memory loss immediately before or after the injury.
  • Headache: The individual may have a headache or a pressure sensation in the head.
  • Nausea or vomiting: The individual may feel sick to the stomach or may actually vomit.
  • Dizziness or “seeing stars”: The individual may feel lightheaded or dizzy, or may see stars or flashing lights.

It’s important to note that not everyone who suffers a concussion will lose consciousness or have amnesia. And some people may not have any symptoms at all for hours or even days after the injury.

Delayed symptoms

Some common delayed symptoms of a concussion include:

  • Fatigue or drowsiness: The individual may feel very tired and may have trouble staying awake.
  • Problems with memory and concentration: The individual may have difficulty remembering things or paying attention.
  • Irritability or personality changes: The individual may become easily upset or may have changes in their personality.
  • Depression or anxiety: The individual may become depressed or anxious after the injury.
  • Sensitivity to light and noise: The individual may become more sensitive to light and noise and may have trouble tolerating bright lights or loud sounds.

If you suspect someone has a concussion, it is important to seek medical attention immediately. A healthcare professional will perform a thorough evaluation and may order imaging tests, such as a CT scan or an MRI, to check for any bleeding or other brain injuries.

In the next section, we will explore the diagnosis of concussion, including the tests and imaging used.

Diagnosis of Concussion: Tests and Imaging

If you suspect you or someone you know has suffered a concussion, it is important to seek medical attention immediately. A healthcare professional will perform a thorough evaluation to determine if a concussion has occurred and to check for any bleeding or other brain injuries.

Physical examination

The healthcare professional will perform a physical examination which includes:

  • Checking the individual’s level of consciousness: The healthcare professional will assess the individual’s level of alertness and check for any signs of confusion or disorientation.
  • Checking for signs of injury: The healthcare professional will check for any signs of injury, such as cuts, bruises, or swelling, around the head and face.
  • Checking the eyes: The healthcare professional will check the individual’s eyes for any signs of injury or bleeding in the retina.
  • Checking the ears: The healthcare professional will check the individual’s ears for any signs of bleeding or other injuries.

Neurocognitive testing

The healthcare professional may also perform neurocognitive testing, which includes:

  • Memory tests: The individual may be asked to repeat a list of words or numbers, or to recall details of a story or event.
  • Concentration tests: The individual may be asked to count backwards from a certain number or to do simple math problems.
  • Balance tests: The individual may be asked to stand or walk in a straight line or to stand on one foot.

Imaging tests

Imaging tests such as CT scan or MRI may be ordered if there are any concerns of a skull fracture or other brain injuries. However, it’s important to note that most concussions do not show up on imaging tests.

Concussion management protocols

It is important to follow a concussion management protocol when assessing and managing concussion. This may include a graded symptom-limited return to activity protocol, and a stepwise return to normal activities, with close monitoring of symptoms.

In the next section, we will explore the treatment options for a concussion and the rehabilitation process.

Treatment of Concussion: Medical Management and Rehabilitation

The treatment of a concussion is typically focused on managing symptoms and allowing the brain time to heal. There is no specific medication to treat a concussion, and treatment is often focused on rest and symptom management.

Medical management

The healthcare professional may recommend the following for symptom management:

  • Pain relief: Over-the-counter pain medication, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), may be recommended to help with headache or other pain.
  • Rest: The individual should get plenty of rest and avoid activities that may make symptoms worse.
  • Cognitive rest: The individual should avoid activities that require concentration or mental effort, such as reading, using a computer, or playing video games.

Rehabilitation

Once the individual is stable and symptoms have improved, a rehabilitation program may be recommended to help the individual return to normal activities. This may include:

  • Physical therapy: Physical therapy may be recommended to help with balance and coordination.
  • Cognitive therapy: Cognitive therapy may be recommended to help with memory and concentration.
  • Counseling: The individual may benefit from counseling to help cope with the emotional and psychological effects of a concussion.

Return to normal activities

The individual should not return to normal activities, including work or school, until they are symptom-free and have been cleared by a healthcare professional. A graded return to normal activities is recommended, starting with light activities and gradually increasing to more strenuous activities.

Return to sports

The individual should not return to contact sports or other high-risk activities until they have been cleared by a healthcare professional. A stepwise return to sport protocol is recommended, starting with light exercise and gradually increasing to more strenuous activities.

In the next section, we will explore ways to prevent and manage concussions, specifically tips for athletes and caregivers.

Prevention and Management of Concussion: Tips for Athletes and Caregivers

Preventing concussions and managing them properly is crucial for the individual’s recovery and overall health. There are several ways to prevent and manage concussions for both athletes and caregivers.

Tips for athletes

  • Wear proper safety gear: Athletes should wear proper safety gear, such as helmets and mouth guards, during sports and other high-risk activities.
  • Learn proper technique: Athletes should learn proper technique for the sport or activity they are participating in to reduce the risk of injury.
  • Follow return-to-play guidelines: Athletes should not return to play or other high-risk activities until they have been cleared by a healthcare professional and have followed a stepwise return-to-play protocol.
  • Recognize the signs and symptoms of a concussion: Athletes should be aware of the signs and symptoms of a concussion and should report any symptoms to a healthcare professional immediately.

Tips for caregivers

  • Be aware of the signs and symptoms of a concussion: Caregivers should be aware of the signs and symptoms of a concussion and should seek medical attention if they suspect a concussion has occurred.
  • Monitor the individual: Caregivers should monitor the individual for any changes in symptoms and should report any changes to a healthcare professional immediately.
  • Encourage rest: Caregivers should encourage the individual to get plenty of rest and to avoid activities that may make symptoms worse.
  • Follow the healthcare professional’s instructions: Caregivers should follow the healthcare professional’s instructions for managing symptoms and for a safe return to normal activities.

It’s important to note that each person’s recovery from a concussion will be unique and may take a varying amount of time. It’s important to work closely with a healthcare professional throughout the recovery process to ensure a safe and successful outcome.

Sources & references used in this article: