Concussion

Concussion Overview

Concussion describes an injury to the brain following trauma. Doctors use the term concussion to describe an injury to the brain that results from an impact to the head. By definition, a concussion is not a life-threatening injury, but it can cause both short-term and long-term problems. In medical terms, a concussion might be described as a closed head injury or head trauma.

Concussions do not include injuries where there is bleeding under the skull or into the brain. Another type of brain injury is present if bleeding is visible on a CT scan (commonly called a CAT scan) of the brain.

• A mild concussion may involve no loss of consciousness (being "dazed") or a very brief loss of consciousness (being "knocked out").
  
  
• A severe concussion may involve prolonged loss of consciousness with a delayed return to normal.

Concussion Causes

A concussion can be caused by any significant blunt force trauma to the head such as a fall, a car accident or being struck over the head with an object.

Concussion Symptoms

Loss of consciousness after any trauma to the head

• Confusion
  
  
• Headache
  
  
• Nausea or vomiting
  
  
• Blurred vision
  
  
• Loss of short-term memory (you may not remember the actual injury and some time before and after the impact)
  
  
• Perseverating (repeating the same thing over and over, despite being told the answer each time, for example, "Was I in an accident?")

When to Seek Medical Care

Call the doctor to ask about any of the following situations. The doctor will recommend home care, set up an appointment to see you, or direct you to go to a hospital's emergency department.

• A person was pushed to the ground or struck a hard object with the head (for example, tile floor, ice, bathtub) but did not lose consciousness

• Vomiting more than once after a head injury

• Confusion

• Extreme drowsiness

• Weakness or inability to walk

• Severe headache

• Loss of memory of the event (amnesia)

• Perseverating (saying the same thing over and over)

• Someone who takes warfarin (Coumadin) for a medical problem and suffers a blow to the head

Go to an emergency department by ambulance in the following situations. For people with less severe injuries not requiring ambulance transport, a car may be taken to the hospital.

• Severe head trauma, a fall from more than the height of the person or a hard fall onto a hard surface or object

• Prolonged loss of consciousness (longer than 5 minutes)

• Any delayed loss of consciousness (for example, the injured person was knocked out only momentarily, then was awake and talking, then lost consciousness again)
  
• Vomiting more than once

• Confusion

• Extreme drowsiness, weakness, or inability to walk

• Severe headache

• Loss of memory of the event (amnesia)

• Perseverating (saying the same thing over and over)

• Someone who takes warfarin (Coumadin) for a medical problem suffers a significant blow to the head

• If the person fails to regain consciousness after 5 minutes, or the injury was very severe even if 5 minutes has not passed, do not move the person. Special care must be given to prevent movement of the neck that may cause spinal injuries. If the person needs to vomit, carefully roll the person onto his or her side without turning the head.

• Should an injured person be allowed to fall asleep? Many people mistakenly believe that it is important to keep a person, especially children, awake after they have been struck on the head. Children are often more emotionally upset than they are physically injured after a minor fall. They will cry and be upset, but as the parent rushes them to the hospital, children may begin to calm down. Because they have expended a lot of physical and emotional energy crying, they will often want to fall asleep.
  • You do not need to keep the child awake. In many cases it maybe helpful to the emergency doctor to be able to awaken the child who is now more calm and rested and will be able to behave normally. This gives the doctor a much better assessment of the severity of the head injury.

  • If, however, a child who was initially normal after a head injury cannot be awakened, or is extremely difficult to awaken, then the child may have a more serious head injury and should be evaluated by a doctor.