Definition and Overview

A concussion is a minor form of traumatic brain injury that results in abnormal brain functioning. It usually occurs after the head gets hit, if it suffers a blow, or if the upper body gets shaken violently. It causes symptoms such as headache, loss of consciousness, and problems with memory, concentration, balance, and coordination. It is common for concussions to go unnoticed because in some cases, the symptoms do not manifest until a few days after the accident. However, a concussion is a mild injury and it only takes some time for people with a concussion to fully recover.

Concussion is a common injury in sports, especially contact sports such as football, hockey, soccer, rugby, and boxing. Participating in risky sports such as these increases the risk of a concussion. Being involved in a motor vehicle collision, physical combat, being abused physically, falling, and other accidents are some of the more common ways that people can get their heads hit hard.

Cause of Condition

Concussion results from an injury to the head. Getting the head hit is not unusual, but there may be times when being hit on the head can cause serious damage to the brain. It may cause a concussion, which results in a temporary change in the way the brain functions. Symptoms such as headache, dizziness, loss of consciousness, loss of memory, and problems in concentration are some of the sensations that may be felt because of an injury to the brain.

The brain is a soft organ that has the same consistency as a gelatin. It is protected by cerebrospinal fluid that surrounds it inside the skull. Violent and sudden blows to the head and neck, however, may hurt the brain despite its built-in protection. The brain can hit against the inner walls of the skull and suffer an injury, which may affect the way the brain functions. This is what happens in the event of a concussion.

Key Symptoms

A concussion changes the way the brain functions and causes it to work abnormally for a temporary period of time. It causes symptoms related to brain functioning, sensory functioning, as well as the functioning of organs related to the nervous system. It may take some time for the symptoms to show, with some taking a few weeks after the accident before they feel something different. The most common symptoms of a concussion include the following:

  • Headache
  • Loss of consciousness
  • Feeling of confusion
  • Loss of memory
  • Dizziness
  • Nausea
  • Ringing in the ears
  • Vomiting
  • Slur in speech
  • Feeling of being dazed
  • Fatigue
  • Loss of concentration
  • Irritability and personality changes
  • Sensitivity to light and noise
  • Sleep disturbances
  • Depression
  • Taste and smell disorders

Who to See and Types of Treatment Available

The symptoms of a concussion are subtle and may only be obvious after a while. It is important for people who have bumped their heads violently to consult a general practitioner or their family doctor and get a check-up once the symptoms start to manifest themselves. The doctor will first ask questions about the signs and symptoms as well as the patient’s medical history. The doctor will then proceed to conduct a neurological examination involving several parts of the body. The doctor’s evaluation of the patient will include the following:

  • Hearing
  • Vision
  • Balance
  • Reflexes
  • Coordination
  • Strength

Also part of the neurological examination is a cognitive test. A concussion may have symptoms relating to some cognitive functions such as memory and concentration, so the doctor will also evaluate the patient’s ability relating to these cognitive functions. This cognitive evaluation will assess the patient’s condition in terms of:

  • Concentration
  • Memory
  • Recall

For people with more serious symptoms that include seizures, vomiting, and extreme headache, the doctor may also suggest a brain imaging test, which can help gauge the severity of the injury and determine if it involves bleeding inside the head. There are a few different kinds of brain imaging scan that may be conducted. The most common is the CT scan or cranial computerized tomography, which is considered as the standard brain scan that takes cross-sectional images of the brain using an x-ray technology. Another option is the MRI or magnetic resonance imaging, which makes use of a magnetic field and pulses of radio wave energy to take images of internal organs of the body. This type of brain imaging is helpful in observing whether there is bleeding inside the head. This type of scan is also used after the concussion to check for further complications.

A patient with a concussion may need to stay in the hospital overnight so that symptoms can be continuously monitored. However, if the doctor gives permission to discharge the patient, it is important that the patient be continuously supervised in his own home for at least 24 more hours.

The best way to recover from a concussion is to have plenty of rest physically and mentally. It is best to avoid participating in activities that may require physical exertion. This break from physical activities must continue until symptoms have stopped showing. Aside from avoiding physical activities, the patient must also avoid activities that require mental concentration such as reading, watching television, playing video games, using the computer or a mobile phone, and doing tasks for school or work.

People who have had a concussion once have a greater risk of suffering from another one and developing a serious and possibly long-lasting brain injury. It is important, therefore, to be more careful after a concussion. Those who do heavy physical activities on a regular basis or as part of their job should get clearance from their doctors before returning to said activities. While it is generally safe to return to normal activities, it is best to wait until all the symptoms have disappeared.

The goal of the treatment after a concussion is to relieve the symptoms and keep the patient comfortable and safe while waiting for the symptoms to pass and the brain to recover. Patients experiencing headaches as a symptom may ease the pain with medication. However, it is advisable to take acetaminophen, while ibuprofen and aspirin must be avoided because they may trigger or worsen bleeding in the brain. Other complications such as bleeding will be dealt with individually.

References:

  • Heegaard WG, Biros MH, Head injury. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Elsevier Mosby; 2013:chap 41.

  • Kerr HA. Closed head injury. Clin Sports Med. 32;(2013) 273-287. Landry GL. Head and neck injuries. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 680.

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