A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, leading to chemical changes in the brain and sometimes stretching and damaging brain cells.
What are the symptoms of a concussion?
Some common symptoms of a concussion include:
- Headache or pressure in the head
- Nausea or vomiting
- Dizziness or balance problems
- Double or blurry vision
- Sensitivity to light or noise
- Feeling sluggish, hazy, foggy, or groggy
- Confusion
- Memory problems
- Difficulty paying attention
Symptoms can start immediately or hours after the injury. They typically peak within the first 24-48 hours but can last for days, weeks, or even longer in some cases.
Why is prompt treatment important for a concussion?
It’s crucial to treat a concussion right away because the brain is especially vulnerable to further injury while it’s recovering. Getting appropriate care quickly can help prevent further damage and minimize the duration and severity of symptoms.
Reasons prompt concussion treatment is so important include:
- Prevents reinjury – While the brain is healing, it is more prone to significant damage from even a minor secondary impact. This can lead to prolonged recovery, long-term symptoms, or rarely, even catastrophic neurological injury.
- Minimizes symptoms – Early treatment helps manage symptoms like headaches and dizziness so they resolve faster.
- Facilitates recovery – Getting cognitive and physical rest immediately after a concussion promotes healing.
- Reduces complications – Timely care can help prevent additional problems like depression, anxiety, memory issues, and post-concussion syndrome.
- Provides reassurance – Seeing a doctor right away gives peace of mind that any complications will be caught and addressed promptly.
What should be done immediately after a suspected concussion?
Here are important steps to take right after a head injury:
- Remove from activity – The player should stop playing and be removed from the field, rink, court, etc. No athlete with a suspected concussion should be allowed to return to activity that day.
- Seek medical care – See a doctor as soon as possible, ideally within the first 24 hours. The person should be evaluated and treated by a healthcare professional familiar with concussion management.
- Don’t take pain medications – Avoid over-the-counter pain relievers, as they can potentially mask symptoms and complicate evaluation.
- Monitor symptoms – Check for any symptoms like headache, dizziness, confusion over the next 24-48 hours. Symptoms may not be noticeable immediately.
- Get cognitive and physical rest – Rest is key to allow the brain to heal. Limit activities and stimuli that require concentration and focus.
Getting appropriate acute care can optimize recovery and help prevent the concussion from turning into a chronic issue.
How is a concussion diagnosed?
There is no single test that can definitively diagnose a concussion. A doctor will typically:
- Ask about symptoms – Inquire about headache, mental fogginess, sensitivity to light/noise, nausea, balance problems etc.
- Perform a neurological exam – Assess vision, balance, coordination, reflexes and memory.
- Evaluate cognition – Use sideline assessment tools to test memory, concentration and recall.
- Review medical history – Discuss any past head injuries, migraines, depression or other conditions.
- Assess mood – Check for signs of irritability, sadness, emotional lability or anxiety.
The doctor may also order imaging like a CT scan or MRI to check for skull fractures, bleeding or other brain injury. However, a concussion does not typically show up on these scans.
What is the treatment for a concussion?
The mainstays of concussion treatment involve both physical and cognitive rest. Treatment guidelines include:
- Physical rest – Reducing physical activity and exertion, gradually resuming normal activity after symptoms improve.
- Cognitive rest – Minimizing mental exertion such as schoolwork, video games, computers, phones, bright lights, and loud noises.
- Sleep – Getting regular sleep at night, taking daytime naps or rest breaks if needed.
- Medications – Over-the-counter pain relievers for headaches. Medications for sleep issues or mood disturbances if present.
- Follow-up care – Seeing a doctor periodically to monitor recovery and provide support with lingering symptoms.
The timing of return to activity including work, school and sports depends on the duration and severity of symptoms as well as the player’s age and history. Recovery usually takes 1-2 weeks but can be longer.
When can someone with a concussion return to normal activities?
It’s important to resume normal activities gradually after a concussion once symptoms start improving. Guidelines include:
- Returning to light physical activity only once symptoms have decreased at rest.
- Advancing slowly to more complex cognitive tasks before intensive concentration and study.
- Starting with shorter periods of school/work and gradually increasing tolerances.
- Taking frequent breaks during activities that exacerbate symptoms.
- Stopping an activity and resting again if symptoms flare up.
- Waiting at least 24 hours between stages if symptoms recur.
- Consulting closely with a healthcare provider about appropriate timing and progression.
The stages of graduated return to play for sports participation are:
- Light aerobic activity like walking or stationary cycling
- Moderate activity and simple movement drills
- Heavy non-contact activity and complex training
- Full contact practice once cleared by a doctor
- Return to competitive play
Each stage takes at least 24 hours. The pace depends on the severity of the injury and the player’s symptoms.
When should someone see a doctor after a concussion?
It’s advisable to consult a doctor if any of the following occur after a head injury:
- Headache that gets worse
- Repeated vomiting
- Drowsiness or inability to wake up
- Increasing confusion
- Weakness, numbness or slurred speech
- Unusual behavior or significant personality changes
- Seizures
- Loss of consciousness
Anyone with concerning or worsening symptoms should be evaluated emergently to rule out complications like a hemorrhage or more severe brain injury.
It’s also important to see a doctor if symptoms don’t start to improve after 1-2 weeks to address persistent post-concussion syndrome.
Can a concussion lead to complications?
In most cases, people recover fully after a concussion if managed appropriately. Rarely, complications can occur including:
- Post-concussion syndrome – Lingering concussion symptoms like headache, dizziness and difficulty concentrating lasting over 1 month.
- Second impact syndrome – Catastrophic brain swelling after a second concussion before the first has healed.
- Chronic traumatic encephalopathy – Progressive degenerative brain disease from repetitive head trauma over years.
- Depression and anxiety – Increased risk of psychiatric issues and suicidal thoughts after a concussion.
Prompt concussion treatment helps minimize the risks of developing long-term complications. Severe or repeated brain injuries increase the chances of permanent or progressive consequences.
What precautions should be taken after a concussion?
To facilitate recovery and avoid reinjury or other issues, concussion patients should observe the following precautions:
- Get plenty of rest and sleep.
- Avoid physically demanding activities.
- Do not drive or operate heavy machinery if impaired.
- Drink fluids and eat a balanced diet.
- Limit activities requiring extended concentration.
- Make adjustments at work/school to manage symptoms.
- Abstain from alcohol until cleared by a doctor.
- Do not take sedating medications like opioids or sleeping pills.
- Ask a doctor before taking any new prescription medicines.
Taking care of one’s brain after a concussion is critical. Making temporary lifestyle adjustments can go a long way toward facilitating recovery.
Conclusion
Concussions require prompt yet conservative management. Seeking medical care within the first 24 hours allows for proper diagnosis, symptom control, and monitoring to optimize outcomes. Cognitive and physical rest is key, followed by a gradual stepwise return to activity as tolerated. While most people fully recover within weeks with appropriate treatment, rarely concussions can result in chronic issues. Being attuned to concerning symptoms and getting follow-up care facilitates the best recovery.