This article will look at the causes, treatments and diagnosis of concussion. We will also look at its implications for long-term cognitive changes and ways to avoid becoming concussed in the first instance.
According to the Brain Injury Association of America, males are twice as likely as females to sustain a brain injury. Those at highest risk of a brain injury are males aged 15 to 24 years.
People who have had a brain injury are more likely to experience a subsequent brain injury. In 2008, there were 351,992 sports-related head injuries that were treated in hospital emergency rooms in the USA, according to the U.S. Consumer Product Safety Commission.
Contents of this article:
Fast facts on concussion
Here are some key points about concussion. More detail and supporting information is in the main article.
- Concussion is also known as mild traumatic brain injury (MTBI)
- Males are twice as likely to sustain a brain injury than females
- Generally, concussions are caused by a jolt or blow to the head
- Some research shows that the effects of a concussion on cognitive ability can still be measured 30 years later
- Automobile accidents and contact sports are two of the most common causes of concussions
- Initial symptoms might include dizziness, slurred speech and amnesia
- A Canadian study showed that most minor league hockey players are unable to identify a concussion
- The Glasgow Coma Scale helps doctors decide whether to conduct a computerized tomography (CT) scan
- Rest and sleep are essential when recovering from a concussion
- Preventing a concussion can be as simple as wearing a helmet.
What is concussion?
Concussion can cause cognitive, physical and emotional changes.
Concussion may also be defined as an injury to the brain generally caused by a jolt or blow to the head - in the majority of cases the individual does not lose consciousness.
According to Medilexicon's medical dictionary, concussion is "An injury of a soft structure, as the brain, resulting from a blow or violent shaking."
In sports medicine, the term concussion is commonly used, while in general medicine MTBI (mild traumatic brain injury) may be used as well. Lay people are more familiar with the term concussion.
Researchers from Toronto University reported that children take longer to recover from second or third concussions, compared to those with a first concussion. They reported their findings in the journal Pedatrics (June 2013 issue).
Researchers from the Centre de recherche en neuropsychologie et cognition, Université de Montréal, Canada found evidence that athletes who were concussed during their earlier sporting life show a decline in their mental and physical processes more than 30 years later.
On Monday, March 18th, 2013, the American Academy of Neurology launched:
- The "Updated Sports Concussion Guideline" which states that athletes should be removed immediately from play if concussion is suspected.
- An app called "Concussion Quick Check" which is available for iPad, Android, IOS (Apple) and some other mobile communication devices. It is aimed at helping trainers, coaches, parents and other athletes quickly determine whether somebody has suspected concussion and needs to see a doctor.
Causes of concussionThe brain floats in cerebral fluid which protects it from jolts and bumps. A violent jolt or a severe blow to the head can cause the brain to bump hard against the skull. This can result in the tearing of fiber nerves as well as blood vessel rupture under the skull, leading to an accumulation of blood. Concussions can be caused by:
- Automobile accidents - concussions commonly occur from severe jolts to the head; this can happen when a vehicle suddenly loses speed or stops dead, causing the brain to jar (bash, bump hard) against the skull
- Sports injuries - especially contact sports, such as martial arts, boxing, rugby, American football, and hockey. Non-contact sports such as snowboarding and skiing as well
- Falls - any fall that results in a blow to the head or a severe jolt. The majority of concussion cases in very young children and elderly individuals in the USA and UK occur as a result of a fall in the home
- Horseback riding accidents - there were 11,749 cases of head injuries resulting from horseback riding accidents in 2008 in the USA, according to the U.S. Consumer Product Safety Commission
- Playground accidents - especially in playgrounds that do not have proper soft underlays
- Cycling accidents - according to the U.S. Consumer Product Safety Commission there were 70,802 cases of head injuries that resulted from cycling accidents
- Assaults - 11% of traumatic brain injuries in the USA are caused by assaults (people being attacked), according to the CDC (Centers for Disease Control and Prevention)
- Explosions - concussions caused by explosions (bombs, grenades and mortar shells, for example) are common among veterans who have served in Afghanistan and Iraq.
Recent developments on veterans and concussion from MNT news
Brain injury experts find that combat veterans exposed to repeated mild explosions show chronic changes in neuron activity in certain brain regions - and the more blasts they are exposed to, the more of the lasting changes they show.
Grades of concussion
Concussions are regularly split into three grades.
- Cantu guidelines
(Devised by Dr. Robert Cantu, medical director of the National Center for Catastrophic Sports Injury Research)
Grade 1 - Some amnesia lasting no longer than 30 minutes, no loss of consciousness
Grade 2 - Loss of consciousness lasting no longer than 5 minutes. Amnesia lasting from 30 minutes to 24 hours
Grade 3 - Loss of consciousness lasting more than 5 minutes. Amnesia lasting more than 24 hours.
- Colorado Medical Society guidelines:
Grade 1 - Confusion. No loss of consciousness
Grade 2 - Confusion. Amnesia. No loss of consciousness
Grade 3 - Any loss of consciousness.
- American Academy of Neurology guidelines:
Grade 1 - Confusion that lasts less than 15 minutes. No loss of consciousness.
Grade 2 - Confusion last lasts for more than 15 minutes. No loss of consciousness.
Grade 3 - Loss of consciousness (IIIa coma lasts seconds, IIIb coma lasts for minutes).
On the next page, we look at the symptoms and diagnosis of concussion.