This article will consider the various aspects of concussion such as; the overview, peculiar symptoms in adults and children, the recovery timeline and what to do. We will begin with the overview.

What is Concussion?

Concussion is also known as mild brain injury, mild traumatic brain injury, mild head injury, and minor head trauma.

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.

Fast facts on concussions

• Usually, 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.

The Signs and Symptoms

Signs of concussion may not be noticeable straight away. However, the following patterns can be noticed when your looking for the symptoms:

Immediate signs

Signs of a concussion that can be noticed immediately include:

• loss of consciousness
• confusion
• a headache
• slurred speech
• dizziness
• ringing in the ears
• nausea
• vomiting
• amnesia
• tiredness

Non-immediate symptoms

The following symptoms may not be noticeable for several hours or even days:

• amnesia
• depression
• disturbed sleep
• sensitivity to sounds
• irritability
• lack of concentration or focus
• moodiness
• sensitivity to light

Serious symptoms that need immediate attention

The following signs and symptoms of concussion may be linked to a more serious injury, and immediate medical help should be sought:

• prolonged headache
• prolonged dizziness
• dilated of different-sized pupils
• prolonged nausea and vomiting
• consistent memory loss
• ringing in the ears
• loss of sense of smell or taste

In children

Concussion signs and symptoms are most difficult to detect in very young children because they cannot explain how they feel. Signs may include:

• lethargy and listlessness
• irritability
• changing sleeping patterns
• altered appetite
• walking or standing unsteadily, or any signs of balance and dizziness problems

Serious signs in children

The following signs usually mean the child needs immediate medical attention:

• loss of 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
• continuous crying
• seizure
• discharge from the ears or nose
• dizziness
• loss of appetite
• prolonged headache
• prolonged irritability
• prolonged listlessness, fatigue, and lethargy
• repeated or forceful vomiting
• slurred speech
• worsening headache

The Diagnosis

If an individual has experienced a severe jolt or blow to the head that has left them dazed, confused, or wobbly, they have concussion. Determining the severity of the concussion is more difficult because the signs may not be evident.

According to a report published in The American Journal of Sports Medicine: “athletes may have a 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 following factors:

• balance
• concentration
• coordination
• hearing
• memory
• reflexes
• vision

A CT scan may also be ordered if internal bleeding or swelling of the brain is a concern

The Treatment

Most concussion or mild traumatic brain injury (MTBI) symptoms will go away without treatment. Guidelines for managing a concussion include:

• Rest:This is vital. It takes time for the brain to recover, and recovery is quicker if the body is resting and getting good sleep each night.
• Headaches:Acetaminophen, such as Tylenol, is the best painkiller for a 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.

 

• Sports:It is important not to return to any sporting activity too soon. Ask your doctor.
• Alcohol: People should avoid consuming alcohol until all symptoms have completely disappeared because it slows healing.
• Migraine:The occurrence of a migraine after a concussion may indicate an increased risk of neurocognitive impairment.
• Worsening symptoms:If symptoms get worse, visit a doctor.

Only a small percentage of patients with MTBI require surgery.

The recovery Timeline

Ignoring symptoms can be dangerous. Recovering from a concussion can take a long time, especially in severe cases, so rest is crucial.

If physical signs return during this time, it is a strong indicator that you are overexerting yourself. Do not immediately return to driving a car, riding a bike, or operating heavy machinery after a concussion.

It is important to concentrate on one task at a time, avoiding using computers too often and writing down anything that it may be a struggle to remember.

Return to work and normal activity gradually. Be sure to avoid activities that run the risk of another concussion, such as contact sports, until all signs have stopped occurring

 

 

Simple ways to prevent concussion include wearing seat belts.

Below are other important steps:

• 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 the influence:

Never drive under the influence of alcohol, illegal drugs, or some medications.

• Mouth-guard:

A good mouth-guard 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. 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.

A concussion can be easily prevented, but accidents happen. If you do experience concussion, be sure to give it a prolonged amount of recovery time.

What to do for a Concussion

A concussion, also known as a mild traumatic brain injury, is a type of brain injury that can occur due to a direct or indirect blow to the head.

When a person receives a blow to the head or body, the impact shakes the brain and causes some internal damage. The injury disrupts the brain’s neurons, which are responsible for transmitting information to different parts of the body.

The neurons can stop functioning properly, which is what causes the symptoms of a concussion. People with a concussion may experience loss of consciousness, disorientation, and nausea.

In this next section, we will look at what to do in case of a concussion. You will find some important steps to follow after an incident (for example, a blow on the head), and down to the long-term recovery.

A direct or indirect blow to the head may cause a concussion. The time that it takes to recover from a concussion will vary depending on the severity of the injury and the health of the person, among other factors.

People can follow the steps below to aid recovery.

Immediately after the injury

The first step for someone with a concussion is to leave the area where the injury occurred. If the injury happened during sport, a coach should remove the person from the playing field.

Athletes who immediately stop play after a suspected concussion recover more quickly than those who return to play and receive an assessment later.

Next, the person should seek help from a doctor. While waiting for help, they should not be alone.

Some sports coaches use diagnostic tools to assess a player before they go to the hospital. These include Sport (or Sideline) Concussion Assessment Tool 5 and the Child SCAT-5. However, there are no set criteria for a concussion diagnosis.

During the first assessment, a doctor will ask questions about:

• the accident
• the symptoms
• when the symptoms began
• the severity of the symptoms

The doctor will then perform a physical examination of the head and neck area for injuries. A neurological exam will test a person’s:

• strength
• sensation
• reflexes
• vision
• balance

The doctor will also run cognitive tests and assess the person’s emotional state. A neuropsychologist may supplement the doctor’s examinations with their own assessment.

Some doctors may order a CT scan or MRI scan if they suspect other injuries. If the person is stable, they will be able to go home.

24–48 hours after the injury

The person should restrict cognitive and physical activity for 24–48 hours after the injury.

Again, it is important that they are not alone during this time, as symptoms can appear days after the injury. If the symptoms worsen or become severe, a person should report these changes to a doctor.

If a person has pain or a headache, they may wish to take pain relievers to manage it. However, doctors may encourage people to avoid the prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (Tylenol), as this overuse can also cause headaches.

Overuse can also cause serious complications, so it is important to only take medication according to the directions on the label or a doctor’s instructions.

A week after the injury

There is not enough evidence to suggest that complete rest is the best option for concussion recovery. Due to this, doctors encourage people to return gradually to their usual activities, being careful to avoid any that make their symptoms worse.

Once the symptoms start to resolve, a person may notice that they are able to do more. However, they should only return to sports when they are completely symptom-free.

Before returning to normal cognitive and physical activities, people with a recent concussion should speak to a doctor.

Long-term prevention

Once a person returns to sport and other activities, they should practice concussion prevention strategies.

These may include wearing protective gear, such as helmets or mouth guards. However, there is a limited amount of evidence to prove that this gear is effective against concussion.

For sports, other safety strategies, such as stricter body-checking policies, may help prevent concussions.

When to seek medical attention

People with the symptoms of a concussion should always see a doctor.

However, there are additional signs of danger that require emergency care. If a person has any of these symptoms, they must seek help immediately:

• one pupil appearing larger than the other
• drowsiness or inability to wake up
• a headache that gets worse and does not go away
• slurred speech
• weakness
• numbness
• decreased coordination
• repeated vomiting or nausea
• convulsions or seizures
• unusual behavior
• confusion
• restlessness
• agitation
• loss of consciousness

Second-impact syndrome

Another serious complication is second-impact syndrome (SIS). Second-impact syndrome occurs when someone with a concussion receives another blow to the head or body before the first injury has resolved.

People with SIS may have rapid and severe swelling in the brain. In some cases, SIS may cause brain herniation and death.

Researchers are still unclear about the long-term consequences of concussions.

How long does recovery take?

Typically, people with a concussion start to feel better within 1–2 weeks of the injury.

Some research suggests that recovery from a concussion usually lasts about 10 days. However, the 5th International Conferences on Concussion in Sports stated that: “most athletes recover in about 1 month”.

The severity of the concussion symptoms in the first few days can be a good indicator of how well the person may recover, although this may not help predict complications. There is no definitive way of knowing how long recovery will take.

Treatment for Postconcussive syndrome (PCS)

This condition describes the network of symptoms that commonly occur after mild traumatic brain injury (TBI). The higher risk group, are patients who had more than one brain injury.

Treatment for PCS focuses on providing symptom relief to help a person manage the condition. Rest is one of the most important components of PCS treatment as it allows the brain to recover and heal from a concussion.

Where possible, doctors often avoid using medication to treat PCS symptoms, because an injury to the head can make the brain more sensitive to drug use and possible side effects.

Doctors may advise people to wait several weeks before starting an active treatment, such as an exercise plan or another type of therapy. In addition, suffering multiple concussions in short span of time can significantly worsen symptoms and delay recovery.

People can try a range of different therapies that may help their recovery from PCS. For all of these therapies, a person will work with a medical professional who will monitor their progress and can adjust the treatment plan as necessary to suit them.

Vision therapy

Vision therapy uses a range of exercises to help people who have vision problems due to PCS. The exercises can help repair damage to the visual system or help the brain adapt to changes in connectivity.

Neuro-optometric rehabilitation

Neuro-optometric rehabilitation also works to target any vision problems that people may be experiencing. A treatment plan will combine the use of lenses, prisms, and filters to help stimulate parts of the brain that are not working as usual.

Balance therapy

Balance, or vestibular, therapy can help people if they are experiencing a lot of dizziness as a symptom of PCS. Exercises to encourage balance and stability can help reduce this disorienting symptom.

Physical therapy

If PCS causes physical pain in the body, physical therapy can help relieve symptoms. This therapy might include massage, gentle exercise, and heat therapy to relax the body and aid recovery.

Exertion therapy

Exertion therapy uses gentle aerobic exercise to help the body recover. People might use a pool or a piece of gym equipment, such as a treadmill, that carries minimal risk of head injury.

A medical professional will monitor the individual carefully during this therapy to make sure that they are not overdoing the exercise, which may slow down recovery.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) may help people who have mood-related PCS symptoms, such as depression, anxiety, or mood swings.

CBT helps people become aware of negative thought patterns and behavior and provides them with practical tools to overcome these issues.

The Summary

People with a concussion can experience a wide range of symptoms that affect their cognition, physical health, emotions, and sleep. Anyone with a suspected concussion should consult a doctor immediately.

After experiencing a concussion, a person should rest for 2 days and then gradually return to normal activities. Most people begin to feel better within 1–2 weeks.

The book to connect: Traumatic brain injury – some facts your doctor wouldn’t tell you