What Is a Concussion?
The most common and least serious type of traumatic brain injury is called a concussion. The word comes from the Latin word concutere, which means "to shake violently." A concussion is most often caused by a sudden direct blow or bump to the head.
According to the CDC, between 2001 and 2009, an estimated 173,285 people under age 19 were treated in hospital emergency rooms for concussions related to sports and recreation activities. Other causes include car and bicycle accidents, work-related injuries, falls, and fighting.
The brain is made of soft tissue. It's cushioned by spinal fluid and encased in the protective shell of the skull. When you have a blow or bump to your head, the impact can jolt your brain. Sometimes, it literally causes it to move around in your head. Traumatic brain injuries can cause bruising, damage to the blood vessels, and injury to the nerves.
The result is your brain doesn't function as it should. If you've had a concussion, vision may be disturbed, you may lose equilibrium, or you may fall unconscious. In short, the brain is confused.
Some things increase your risk for a concussion, including:
- Falls, particularly in children and older adults
- Playing a contact sport
- Lack of proper safety gear or supervision for contact sports
- Car, motorcycle, bicycle, and other accidents that cause a blow to the head
- Being hit, struck with an object, or other physical abuse
- Military service
- An earlier concussion
Other than direct blows to the head, concussions can be caused by foreign objects. You can be struck by something such as during a sports game or get whiplash injuries or blast zone injuries in a war zone.
In both contact and noncontact sports, athletes are at risk for concussions. This is true whether you're playing Little League or in the pros. The symptoms for a sports concussion are the same as any other type of concussion. But putting an athlete back in the game too soon could be dangerous and lead to a higher chance of another concussion. If you get a second concussion, it may make it much harder to heal and you could have long-term effects such as chronic headaches or learning difficulties. Get cleared by a doctor before you return to sports.
Concussions can be tricky to diagnose. Though you may have a visible cut or bruise on your head, you can't see a concussion. Signs of a concussion may not appear for days or weeks after the injury. Some symptoms last for just seconds; others may linger.
Concussions are fairly common. Some estimates say a mild brain trauma is sustained every 21 seconds in the U.S. But it's important to recognize the signs of a concussion so you can take the proper steps to treat the injury.
There are some common physical, mental, and emotional symptoms a person may display following a concussion. Signs of traumatic brain injury include:
- Confusion or feeling dazed
- Slurred speech
- Nausea or vomiting
- Balance problems or dizziness
- Blurred vision
- Sensitivity to light
- Sensitivity to noise
- Ringing in ears
- Irritability or other behavior or personality changes
- Difficulty concentrating
- Loss of memory
- Fatigue or sleepiness
- Loss of consciousness
- Forgetfulness such as repeating yourself
- Slowed response to questions
- Problems with sleep
- Problems with taste or smell
Concussions in Children
Because their heads are large compared to the rest of their body, young children get concussions fairly often. As kids enter adolescence, they have rapid height and weight gain. Both these things make them more prone to accidents than adults.
If a child has concussion symptoms, an adult should monitor them for the first 24 hours. Don’t give medications, including ibuprofen or aspirin, which may cause bleeding, to a child without talking to a doctor first.
It's important to watch closely for behavioral changes or other signs of a concussion. Young children, especially, may not be able to fully communicate what they’re feeling. Symptoms of concussions in children include:
- Problems with balance
- Upset stomach or vomiting
- Sensitivity to light or noise
- Mental fogginess or slowed thinking
- Problems with memory, concentration, or focus
- Feeling more irritable, sad, nervous, or emotional than usual
- Problems with sleep
Concussions in Babies
The signs of a concussion in a baby or toddler may be harder to spot because they won't be able to tell you what is happening. So you'll have to be extra vigilant. Concussion symptoms in toddlers and babies are similar to those in children. But also watch out for:
- Changes in sleeping or eating patterns
- Not showing interest in their favorite toys
- Staring blankly
- If they are able to speak, their words are slurred
- Loss of consciousness
- Particularly in babies, crying without being able to be consoled
- Also in babies, not nursing or eating
- Extreme emotions
- Confusion or distraction
- Not being able to preform new skills, such as toilet training
- Large bruises or head bumps in places other than the forehead
Most people with concussions fully recover with appropriate treatment. But because a concussion can be serious, safeguarding yourself is important.
Seek medical attention. A health care professional can decide how serious the concussion is and whether you require treatment.
They’ll ask how the head injury happened and discuss the symptoms. The doctor may also ask you simple questions such as "Where do you live?," "What is your name?," or "Who is the president?" The doctor asks these questions to evaluate memory and concentration skills.
The doctor may test coordination and reflexes, which are both functions of the central nervous system. They may also order a CT scan or an MRI to rule out bleeding or other serious brain injury.
Emergency symptoms of a concussion include:
- Weakness in the arms or legs
- Being very pale for more than an hour
- Changes in behavior
- Becoming easily confused, such as not being able to recognize places or people
- Slurred speech
- Problems with mental function
- Stumbling or clumsiness
- Vomiting or nausea
- Dilated pupils
- Ringing in the ears that doesn't go away
- Seizures or convulsions
- Dizziness that won't go away
- No improvement in your condition
- Being unconscious for longer than 30 seconds
- Worsening headache
- Fluid or blood draining from the nose or ears
If you don’t need hospitalization, the doctor will give you instructions to follow. Concussions very rarely require an overnight stay in the hospital, and typically you can return home to rest and recover. Experts recommend follow-up medical attention within 24 to 72 hours if symptoms worsen. To recover at home, you should:
- Take a break. If your concussion was sustained during athletic activity, stop play and sit it out. Your brain needs time to properly heal, so rest is key. Definitely do not resume play the same day. Coaches should closely monitor athletes and children upon resuming play. If you resume play too soon, you risk a greater chance of having a second concussion, which can compound the damage. The American Academy of Neurology has issued guidelines about resuming activities after a concussion. For the first 2 days after your injury, you should take plenty of time to relax and avoid anything too straining on your brain such as heavy loads of work, loud noises, and bright lights. You can gradually increase physical and mental activities as your symptoms improve.
- Guard against repeat concussions. Repeat concussions cause cumulative effects on the brain. They can have devastating consequences, including brain swelling, permanent brain damage, long-term disabilities, or even death. Don't return to normal activities if you still have symptoms. Get a doctor's clearance so you can return to work or play with confidence.
- Treat pain with aspirin-free medications. Your doctor will prescribe a medication to relieve pain or recommend an over-the-counter option. Avoid anything that will thin the blood such as ibuprofen, and stick to acetaminophen.
It's important to give yourself the time to properly heal from a concussion. Don't push yourself. It's normal to need more sleep than you typically do, but that doesn't mean you should stop all activities. Recognize what triggers your symptoms. Maybe it's watching TV or texting, and try to avoid those things until you're feeling better. In the meantime, drink plenty of water and avoid alcohol.
There are three phases of concussion recovery:
- Phase one: Acute symptomatic phase. This is the time from injury until symptoms begin to clear up. This phase usually lasts less than 3 days. During this phase, if you have any of the emergency symptoms mentioned above, get medical help right away. The most important thing during this phase is rest. Stay hydrated and eat as you normally would.
- Phase two: Recovery. By this phase your symptoms should be improving. You can gradually start to increase your physical and mental activities, but if they trigger you, take a break. Your doctor will tell you on when it's safe to return to sports. You may need accommodations at school or work.
- Phase three: Recovered phase. Full recovery for those under 18 is normally considered 30 days, and for those over 18 is 14 days. But the severity of your symptoms play a role in how quickly you'll be back to yourself. Milestones include being able to return to school or work and getting back to physical activity.
Post-concussive syndrome is when issues from a concussion linger after you should have recovered. These symptoms can include trouble concentrating, problems with memory, headaches, changes in personality, mood swings, dizziness, fatigue, and insomnia for weeks to months. Delayed concussion symptoms, in which you don't have symptoms until several days or weeks after the event, can play a role in this as well. If this happens to you, it's extra important to avoid activities that put you at risk of another concussion.
By following concussion protocol -- the set of rules and guidelines for caring for those with brain injuries -- your doctor may suggest small increases in activity and a gradual return to your normal activities. Concussion protocol for kids may call for shorter school days and fewer assignments.
A concussion is unexpected, so it is tough to prevent. But there are several commonsense precautions you can take to lessen the possibility of traumatic brain injury.
- Wear protective equipment. Playing high-contact, high-risk sports such as football, hockey, boxing, and rugby increases the odds of a concussion. Skateboarding, snowboarding, horseback riding, and inline skating are also a threat to your brain's health. Wearing headgear, padding, and mouth and eye guards can help safeguard against traumatic head injuries. Wearing a bike helmet can lower the risk of traumatic head injury by 85%. There's also a new collar-like device called Q-Collar that can be worn by athletes. It applies compression to the neck and increases blood volume to help reduce brain movement due to hits to the head. Make sure any equipment fits you correctly and is well-maintained.
- Drive and ride smart. Always wear a seatbelt, obey speed limits, and don't use drugs or alcohol because they can impair reaction time.
- Don't fight. Fighting is a common cause of concussions.
- Reduce trip and fall hazards in your home. Clear clutter from floors and hallways, and make sure your home is well-lighted.
- Exercise regularly. It can give you stronger leg muscles and better balance, which can prevent falls.
- Use home safety measures to protect your children. Install window guards and block stairways.
A concussion is the least serious type of injury to the brain. Any kind of blow or jolt to the head, such as a fall or sports injury, can cause a concussion. In certain cases, such as if you lose consciousness for more than 30 seconds, are continuously vomiting, or have a worsening headache, this could be an emergency and you should go to a doctor right away. The best way to recover from a concussion is rest and slowly getting back to your routine.
- What are five signs of a concussion?
Some signs of a concussion include nausea, feeling confused, clumsiness, slurred speech, and headache.
- What are the early signs of concussion?
Early signs of a concussion include double or blurry vision, forgetfulness, and sensitivity to light.
- How long will a mild concussion last?
Symptoms tend to improve within 3 days, but for a full recovery it will typically take about 30 days for those under 18 and 14 days for those over 18.