This brain injury causes symptoms such as headaches, dizziness and difficulty concentrating that usually improve within days to weeks.
A concussion is a traumatic brain injury that affects your brain function. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination.
Concussions are usually caused by a blow to the head. Violently shaking of the head and upper body also can cause concussions.
Some concussions cause you to lose consciousness, but most do not.
Falls are the most common cause of concussion. Concussions are also common if you play a contact sport, such as football or soccer. Most people usually recover fully after a concussion.
The signs and symptoms of a concussion can be subtle and may not show up immediately. Symptoms can last for days, weeks or even longer.
Common symptoms after a concussive traumatic brain injury are headache, loss of memory (amnesia) and confusion. The amnesia usually involves forgetting the event that caused the concussion.
Physical signs and symptoms of a concussion may include:
Other signs and symptoms of a concussion include:
A witness may observe these signs and symptoms in the concussed person:
You may have some symptoms of concussions immediately, and some can occur for days after the injury, such as:
Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they can't describe how they feel. Concussion clues may include:
See a doctor within 1 to 2 days if:
If your child doesn't have signs of a serious head injury, remains alert, moves normally and responds to you, the injury is probably mild and usually doesn't need further testing.
In this case, if your child wants to nap, it's OK to let him or her sleep. If worrisome signs develop later, seek emergency care.
Seek emergency care for an adult or child who experiences a head injury and signs and symptoms such as:
Never return to play or vigorous activity while signs or symptoms of a concussion are present.
Experts recommend that an athlete with a suspected concussion not return to activities that are associated with a higher risk of another concussion while still showing concussion symptoms.
Children and adolescents should be evaluated by a health care professional trained in evaluating and managing pediatric concussions.
Experts also recommend that adult, child and adolescent athletes with concussions not return to play on the same day as the injury.
Your brain has the consistency of gelatin. It's cushioned from everyday jolts and bumps by cerebrospinal fluid inside your skull.
A violent blow to your head and neck or upper body can cause your brain to slide back and forth forcefully against the inner walls of your skull.
Sudden acceleration or deceleration of the head, caused by events such as a car crash or being violently shaken, also can cause brain injury.
These injuries affect brain function, usually for a brief period, resulting in signs and symptoms of concussion.
This type of brain injury may lead to bleeding in or around your brain, causing symptoms such as prolonged drowsiness and confusion. These symptoms may develop immediately or later.
Such bleeding in your brain can be fatal. That's why anyone who experiences a brain injury needs monitoring in the hours afterward and emergency care if symptoms worsen.
Activities and factors that may increase your risk of a concussion include:
Potential complications of concussion include:
Second impact syndrome. Rarely, experiencing a second concussion before signs and symptoms of a first concussion have resolved may result in rapid and usually fatal brain swelling.
It's important for athletes never to return to sports while they're still experiencing signs and symptoms of concussion.
Some tips that may help you to prevent or minimize your risk of head injury include:
Wearing protective gear during sports and other recreational activities. Make sure the equipment fits properly, is well maintained and is worn correctly. Follow the rules of the game and practice good sportsmanship.
When bicycling, motorcycling, snowboarding or engaging in any recreational activity that may result in head injury, wear protective headgear.
Your doctor will evaluate your signs and symptoms, review your medical history, and conduct a neurological examination. Signs and symptoms of a concussion may not appear until hours or days after the injury.
Tests your doctor may perform or recommend include a neurological examination, cognitive testing and imaging tests.
After your doctor asks detailed questions about your injury, he or she may perform a neurological examination. This evaluation includes checking your:
Your doctor may conduct several tests to evaluate your thinking (cognitive) skills during a neurological examination. Testing may evaluate several factors, including your:
Brain imaging may be recommended for some people with signs and symptoms such as severe headaches, seizures, repeated vomiting or symptoms that are becoming worse. Brain imaging may determine whether the injury is severe and has caused bleeding or swelling in the skull.
A cranial computerized tomography (CT) scan is the standard test in adults to assess the brain right after injury. A CT scan uses a series of X-rays to obtain cross-sectional images of your skull and brain.
For children with suspected concussion, CT scans are only used if there are specific criteria met, such as the type of injury or signs of a skull fracture. This is to avoid radiation exposure in young children.
Magnetic resonance imaging (MRI) may be used to identify changes in your brain or to diagnose complications that may occur after a concussion.
An MRI uses powerful magnets and radio waves to produce detailed images of your brain.
You may need to be hospitalized overnight for observation after a concussion.
If your doctor agrees that you may be observed at home, someone should stay with you and check on you for at least 24 hours to ensure that your symptoms aren't worsening.
Your caregiver may need to awaken you regularly to make sure you can awaken normally.
There are steps you can take to help your brain heal and speed recovery.
In the first few days after a concussion, relative rest is the most appropriate way to allow your brain to recover. Your doctor will recommend that you physically and mentally rest to recover from a concussion.
Relative rest, which includes limiting activities that require thinking and mental concentration, is recommended for the first two days after a concussion. However, complete rest, such as lying in a dark room and avoiding all stimuli, does not help recovery and is not recommended. In the first 48 hours, you should overall limit activities that require high mental concentration — such as playing video games, watching TV, doing schoolwork, reading, texting or using a computer — if these activities cause your symptoms to worsen.
You also should avoid physical activities that increase any of your symptoms, such as general physical exertion, sports or any vigorous movements, until these activities no longer provoke your symptoms.
After a period of relative rest, it's recommended that you gradually increase daily activities such as screen time if you can tolerate them without triggering symptoms. You can start both physical and mental activities at levels that do not cause a major worsening of symptoms. Light exercise and physical activity as tolerated starting a few days after injury have been shown to speed recovery; however, you should avoid any activities that have a high risk of exposure to another head impact until you are fully recovered.
Your doctor may recommend that you have shortened school days or workdays, take breaks during the day, or have modified or reduced school workloads or work assignments as you recover from a concussion. Your doctor may recommend different therapies as well, such as rehabilitation for vision, rehabilitation for balance problems, or cognitive rehabilitation for problems with thinking and memory.
As your symptoms improve, you may gradually add more activities that involve thinking, such as doing more schoolwork or work assignments, or increasing your time spent at school or work.
Your doctor will tell you when it's safe for you to resume light physical activity. Usually after the first few days after injury, you're allowed to do light physical activity — such as riding a stationary bike or light jogging — before your symptoms are completely gone, so long as it doesn't significantly worsen symptoms.
Eventually, once all signs and symptoms of concussion have resolved, you and your doctor can discuss the steps you'll need to take to safely play sports again. Resuming sports too soon increases the risk of another brain injury.
Headaches may occur in the days or weeks after a concussion. To manage pain, ask your doctor if it's safe to take a pain reliever such as acetaminophen (Tylenol, others). Avoid other pain relievers such as ibuprofen (Advil, Motrin IB, others) and aspirin, as these medications may increase the risk of bleeding.
It's important for anyone who has a head injury to be evaluated by a doctor, even if emergency care isn't required.
If your child has received a head injury that concerns you, call your child's doctor immediately. Depending on the signs and symptoms, your doctor may recommend seeking immediate medical care.
Here's some information to help you get ready for and make the most of your medical appointment.
For a concussion, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions that come up during your appointment.
Being ready to answer your doctor's questions may reserve time to go over any points you want to talk about in-depth.
You or your child should be prepared to answer the following questions about the injury and related signs and symptoms:
The most important thing to do before your appointment is to avoid activities that significantly increase your symptoms and those that have an increased risk of another head impact. This includes avoiding sports or other physical activities that increase your heart rate, such as running, or require vigorous muscle contractions, such as weightlifting.
Gradually resume your normal daily activities, including screen time, as you're able to tolerate them without significantly worsening symptoms.
If you have a headache, acetaminophen (Tylenol, others) may ease the pain. Avoid taking other pain relievers such as aspirin or ibuprofen (Advil, Motrin IB, others) if you suspect you've had a concussion. These may increase the risk of bleeding.
December 24th, 2020
