Many people have suffered from or suspect they have suffered from a concussion. Though it is a form of traumatic brain injury, concussions are common enough that they are not always treated seriously- however, they can be just as harmful as any other brain injury and it is important to understand how they work. Concussions should always be diagnosed and treated by a medical professional, even when you “feel okay” after a blow to the head, as they are more complicated than you may expect.
Concussions are a form of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head. They can also be caused by a hit to the body that causes the head and brain to move back and forth rapidly as the sudden movement can cause the brain to bounce into the skull or twist unnaturally, leading to chemical changes in the brain or stretching and damaging the brain cells. You will see concussions described as a “mild” traumatic brain injury in most literature because they are usually not life-threatening compared to other emergent brain injuries. However, they can still be dangerous.
It is important to distinguish a concussion from a contusion. Concussions specifically impact the brain, while contusion is a general term for bruises. A contusion can occur on your head or in the brain but tend to not be serious and resolve quickly.
The primary causes of concussions are one-time events such as a sports injury, fall, car accident injury, or another traumatic injury to the head. This is generally broken down into the categories of sports-related and non-sports-related concussions, though the injury itself is the same in both these cases. Non-sports-related concussions may include other instances of injury, such as one acquired by a military service member or other active individuals.
Any person can sustain a concussion at any time, though there are a number of groups of people at higher risk. The biggest risk factor is actually having suffered a previous concussion, as the impact on the brain can be cumulative. For this reason, athletes are generally considered extremely high risk as they are the most likely people to suffer repeated blows, especially in contact sports like football, hockey, or boxing. In addition to professional athletes, this repeated exposure also puts adolescents at risk, as they are the next most likely demographic to participate in contact sports on a regular basis.
Similarly, anyone at risk of constant falls or injuries is at higher risk of a concussion. The elderly are prone to falls and therefore concussion risks, and babies or toddlers without good coordination may also be at an elevated risk. Women also appear to have a lower threshold for concussion injury than men, though men are more likely to sustain concussions overall.
Because the brain is impacted, it may be difficult to identify a concussion in yourself. Additionally, signs may vary widely based on the severity of the injury, the person injured, and whether it is a first concussion or a subsequent one. If there is a chance you sustained a concussion, it is critical to not only look for symptoms, but also to have loved ones help to identify any changes in your behavior or personality.
You may experience physical symptoms of a concussion in addition to cognitive and behavioral symptoms- and these may all take days to become apparent.
Physical signs of a concussion may include:
In addition, you may see the following changes:
If you are particularly impaired cognitively, you may not notice any of these symptoms in yourself so it is important to ask loved ones to monitor you. In addition, small children who suffer a concussion may not be able to articulate some of these symptoms and will require close monitoring.
Monitoring symptoms after any blow to the head or fall will be important, and as soon as you suspect a concussion you should begin by making a doctor’s appointment to confirm. If symptoms are appearing, you shouldn’t sleep for long periods of time without someone nearby in order to distinguish sleep from a loss of consciousness. You can also avoid worsening symptoms by staying away from screens like your phone or TV. If there are no other signs of injury, it can be okay to monitor symptoms at home until your appointment.
When a concussion is accompanied by an injury, especially to the neck or back, more immediate treatment may be necessary. Avoid movement if this is the case and seek treatment from an ambulance or other team of first responders who can stabilize the head and neck to avoid spine damage.
In most cases, a doctor will be able to diagnose concussions through a description of the inciting event, symptoms, and some simple physical examinations like eye tests. Diagnostic imaging like MRIs or CT scans may be used to rule out other serious injuries to the brain.
The treatment for a concussion will depend on how severe your symptoms are. If concussions are accompanied by bleeding in the brain, swelling in the brain, or a serious brain injury, emergency treatment like surgery may become necessary. However, in most cases, no major medical treatment is recommended.
Pain and headaches will likely be managed using over-the-counter pain medication that includes anti-inflammatory properties. Along with that, you will be told to rest extensively. This means not only physical rest and avoiding too much movement, but resting your brain as well. You may need to take off work or school, avoid driving, and limit screen time as much as possible in order to reduce stimuli and allow the brain to recover. If your concussion occurred during a sport or physical activity, a break from that hobby will be necessary as well in order to prevent second-impact syndrome, in which a new concussion occurs before the first one has healed and can cause severe brain swelling. A first concussion will resolve fairly easily with rest and care.
Some people will suffer more long-term complications like post-concussion syndrome, which causes symptoms to last for weeks or months. Post-traumatic headaches are also a common chronic occurrence. These long-term complications, including more severe brain injuries or chronic vertigo, become more likely the more concussions a person has sustained in their lifetime.
While you can choose to avoid certain sports or activities, it is not possible to completely rule out the possibility of a concussion. However, certain measures can be taken to avoid them, especially if you have already suffered from a concussion before.
Always wear your helmet and any other athletic safety gear during sports activities, and ensure this gear is properly fitted and worn appropriately at all times. A coach or sports professional can advise on safe techniques for playing as well.
Wearing your seatbelt while in a vehicle is also critical. If you do happen to fall, try to brace yourself with your calves or forearms to avoid falling onto your head.