A concussion is a mild brain injury in which trauma to the head results in a temporary disruption of normal brain function and is often interchangeable with the term traumatic brain injury (TBI). The injury may involve subtle pulling, tugging, or shearing of brain cells without causing any obvious structural damage. After a concussion, the brain does not work right for a while. Loss of consciousness may or may not occur, but confusion or problems with awareness or memory are usually present.
Causes
Anything that makes the brain bounce around and against the side of the skull can cause a concussion. For example:
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A blow or jolt to the head
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Severe jarring or shaking
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Abruptly coming to a stop
Concussion often results from accidents that involve:
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
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A previous concussion or head injury
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Sex: Male
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Certain age groups:
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Contact sports, such as football or boxing
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Work that involves farming, logging, or construction
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Travelling by vehicle at a high rate of speed
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Use of alcohol
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Lack of sleep
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Medications that cause drowsiness
Symptoms
The signs and symptoms of a traumatic brain injury (TBI) can be subtle. Symptoms of a TBI may not appear until days or weeks following the injury or may even be missed as people may look fine even though they may act or feel differently. The following are some common signs and symptoms of a TBI:
- Headaches or neck pain that do not go away;
- Difficulty remembering, concentrating, or making decisions;
- Slowness in thinking, speaking, acting, or reading;
- Getting lost or easily confused;
- Feeling tired all of the time, having no energy or motivation;
- Mood changes (feeling sad or angry for no reason);
- Changes in sleep patterns (sleeping a lot more or having a hard time sleeping);
- Light-headedness, dizziness, or loss of balance;
- Urge to vomit (nausea);
- Increased sensitivity to lights, sounds, or distractions;
- Blurred vision or eyes that tire easily;
- Loss of sense of smell or taste; and
- Ringing in the ears.
Children with a brain injury can have the same symptoms as adults, but it is often harder for them to let others know how they feel. Call your child’s doctor if they have had a blow to the head and you notice any of these symptoms:
- Tiredness or listlessness;
- Irritability or crankiness (will not stop crying or cannot be consoled);
- Changes in eating (will not eat or nurse);
- Changes in sleep patterns;
- Changes in the way the child plays;
- Changes in performance at school;
- Lack of interest in favorite toys or activities;
- Loss of new skills, such as toilet training;
- Loss of balance or unsteady walking; or
- Vomiting.1
If you think you or someone you know has a TBI, contact your health care provider. Your health care provider can refer you to a neurologist, neuropsychologist, neurosurgeon, or specialist in rehabilitation (such as a speech pathologist). Getting help soon after the injury by trained specialists may speed recovery.
Diagnosis
The doctor will ask you and others who were present at the time of injury about your symptoms and how the injury occurred. The physical exam usually includes checking for strength, sensation, balance, reflexes, and memory.
Tests may include:
CT Scan – a type of x-ray that uses a computer to make pictures of structures inside the head
Magnetic Resonance Imaging (MRI) Scan – a test that uses magnetic waves to make pictures of structures inside the head
Treatment
The goal of treatment is to allow the brain injury to heal.
Treatment may include:
Rest – providing adequate time for recovery. This means not rushing back into daily activities such work or school.
Observation by a responsible adult – someone to awaken you every few hours as advised by your doctor. The doctor will explain how to watch for complications such as bleeding in the brain.
Limiting exposure to drugs – not taking medicines without your doctor's permission. This is especially true for aspirin, blood thinners, and drugs that cause drowsiness. Avoid use of alcohol and illicit drugs.
Preventing re-injury – avoiding activities that might jolt or jar your head. Never return to a sports activity until your doctor has given you clearance. Ask when it's safe to drive a car, ride a bike, work or play at heights, or use heavy equipment.
Preventing "Second Impact Syndrome" – avoiding a second head injury in children and adolescents who have had a concussion. Even a mild second injury in children and adolescents can rapidly increase swelling, causing unconsciousness and even death. Opinions vary regarding when it is safe to return to contact sports or other activities that may lead to another concussion. Parents should seek medical attention for any child with a concussion and address the issue of returning to activities.
Prevention
The following safety measures may help you avoid getting a concussion:
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Don't drink and drive.
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Avoid use of sedating drugs, especially when driving or using heavy equipment.
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Obey speed limits and other driving laws.
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Always use child safety seats, seatbelts, and shoulder harnesses in vehicles. Also learn how to safely use air bags.
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Wear a helmet when:
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Make sure your child's playing surface is soft and free of rocks, holes, and debris.
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Reduce falling hazards at home for children and adults.
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Keep firearms and bullets locked safely away.
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Wear mouth guards, face guards, pads, and other safety gear during sports.
RESOURCES:
American Association of Neurological Surgeons
http://www.aans.org
Brain Injury Association of America
http://www.biausa.org
Brain Injury Society
http://www.bisociety.org
National Resource Center for Traumatic Brain Injury
http://www.neuro.pmr.vcu.edu
References:
American Association of Neurological Surgeons website. Available at: http://www.aans.org.
Harmon KG. Assessment and management of concussion in sports. Am Fam Physician. Sep 1, 1999.
Centers for Disease Control and Prevention (CDC), Facts about concussion and brain injury, 1999.
National Center for Injury Prevention and Control website. Available at: http://www.cdc.gov/ncipc/.
