This article investigates the causes, treatments, and diagnosis of concussion, also known as mild brain injury, mild traumatic brain injury (MTBI), mild head injury, and minor head trauma.
We will look at how to spot a concussion, how they are treated, and ways to avoid becoming concussed.
In 2009, there were 446,788 sports-related head injuries treated in hospital emergency rooms in the United States.
Fast facts on concussions
Here are some key points about concussion. More detail and supporting information is in the main article.
- 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
- Initial symptoms might include dizziness, slurred speech, and amnesia
What is a concussion?
Some experts define concussion as a head injury with temporary loss of brain function, which can cause cognitive, physical, and emotional symptoms.
Concussion may also be defined as an injury to the brain, often caused by a jolt or blow to the head - in the majority of cases, the individual does not lose consciousness.
Causes of concussion
Concussion can cause cognitive, physical and emotional changes.
The 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 nerve fibers and the rupturing of blood vessels under the skull, leading to a build-up of blood.
Concussions are most commonly caused by:
- Automobile accidents
- Sports injuries
- Horseback riding accident
- Playground accidents
- Cycling accidents
Symptoms of concussion
Dilated pupils might signify a more serious head injury.
Signs and symptoms of concussion may not be noticeable straight away; however, immediate signs and symptoms can include:
- Loss of consciousness
- Slurred speech
- Ringing in the ears
- Tiredness (fatigue)
The following symptoms may not be noticeable for several hours, or even days:
- Disturbed sleep
- Hyperacusis - sensitivity to sounds
- Lack of concentration, focus
- Photophobia - sensitivity to light
The following signs and symptoms of concussion may be linked to a more serious injury and medical help should be sought:
- Prolonged headache
- Prolonged dizziness
- Dilated pupils
- The two pupils are not the same size
- Prolonged nausea and vomiting
- Memory loss does not improve
- Ringing in the ears
- Loss of sense of smell or taste
Concussion signs and symptoms are most difficult to detect in very young children because they do not have the ability to explain how they feel. Signs may include:
- Lethargy, listlessness
- Irritability - the child gets cross easily
- Changing sleeping patterns
- Altered appetite
- Walking and/or standing unsteadily (any signs of balance, dizziness problems)
The following signs usually mean the child needs immediate medical attention:
- Loses consciousness
- After attempting to stem the bleeding, a cut continues to bleed
- Any change in the way the child walks
- Bleeding from the ears or nose
- Blurred vision
- Confusion - the child does not know where they are, may not recognize familiar people
- Continuous crying
- Convulsion (seizure)
- Discharge from the ears or nose
- Loss of appetite
- Prolonged headache
- Prolonged irritability
- Prolonged listlessness, fatigue, lethargy
- Repeated or forceful vomiting
- Slurred speech
- Worsening headache
Diagnosis of concussion
Some medical professionals believe that concussions are misunderstood by many members of the public.
Most people can diagnose concussion if the symptoms are present immediately; if an individual has experienced a severe jolt or blow to the head which has left them dazed, confused, or wobbly - they have concussion.
Determining the severity of the concussion is more difficult because the signs and symptoms may not become evident until later.
A report published in The American Journal of Sports Medicine explains that athletes may have severe concussion without becoming unconscious.
According to the authors, amnesia and confusion on the field after injury may be as important, if not more important, in making a return-to-play decision.
A doctor will ask the patient details about the trauma. It may be necessary to question the people who accompanied the patient. A neurological examination will also be done, which will include evaluating the patient's:
A CT scan may also be ordered if internal bleeding or swelling of the brain is a concern.
Treatment for concussion
Guidelines for managing a concussion include:
- Rest - rest is vital. It takes time for the brain to recover, and recovery is quicker if the body is resting and getting a good night's sleep each night.
- Headaches - acetaminophen (paracetamol, Tylenol) is the best painkiller for headache due to a head injury. Drugs such as aspirin, ibuprofen, and other NSAIDs should be avoided because they thin the blood and increase the risk of internal bleeding (hemorrhage).
- Sports - it is important not to return to any sporting activity too soon. A doctor must be consulted.
- Alcohol - patients should avoid consuming alcohol until all symptoms have completely disappeared because it slows healing.
- Migraine - migraine after concussion may indicate an increased risk of neurocognitive impairment.
- Worsening symptoms - if symptoms worsen, patients should see their doctor.
Prevention of concussion
- Helmets and other protective headgear - it is important to buy new protective headgear, not second-hand ones. Headgear will need to be replaced periodically.
- Seat belt - wearing a seat belt has been proven to significantly reduce the risk of head injury during vehicle accidents.
- Driving under influence - never drive under the influence of alcohol, illegal drugs, or some medications.
- Mouthguard - a good mouthguard can help prevent concussion in contact sports.
- At home - consider adding lighting to areas that may be hazardous. Be alert for clutter that could cause people to fall over. Most head injuries among very young children and older people occur in the home. If there are toddlers in the house, place pads on sharp edges of furniture, use a stair gate, install window guards.
- Playgrounds - there should be an underlay of soft material, either sand or special matting.
- Jogging in busy streets - wear bright colored clothing and use eyes and ears when crossing the road. Keep to the sidewalk.
- Cycling at night - make sure the bicycle has good lighting in front and behind. Wear bright clothing with reflectors.
- Nutrition and exercise - a well-balanced diet and plenty of exercise can help maintain good bone mass and bone density. This is especially important for older individuals and post-menopausal women. Stronger bones may reduce the severity of brain injury following a blow to the head.