What is a Concussion?

What is a Concussion?

A Concussion is more than just a “bonk” on the head.  Any traumatic insult to the body or head can cause disturbance to the normal physiology or function in the brain resulting in signs and symptoms that can range from seemingly mild to severe, commonly including: fatigue, increased emotionality, headache/dizziness, confusion, lack of focus, forgetfulness, etc.  Increased awareness for unexplained changes in behavior, actions, or thinking following an incident where there may have been traumatic forces transmitted to the brain is critical to recognizing possible concussion early for the best management.  Loss of consciousness is not necessary for the diagnosis of concussion, the CDC reported that 90% of diagnosed concussions do NOT involve loss of consciousness.

Concussions are not typically diagnosed by traditional imaging such as CT or MRI scans because the injury disturbance reflects functional alteration rather than structural changes.  They are diagnosed based on medical evaluation of signs and symptoms both at the time of incident as well as over the recovery process.

In most cases, recovery from concussion occurs successfully within the first 3 weeks post injury if managed well. In acute injury, the brain is highly vulnerable to prolonged effects or permanent damage if a second insult occurs prior to complete recovery

The best form of treatment for mild traumatic brain injury comes from education to recognize the mild injury and adequate management to avoid re-injury during the recovery process.

 

Concussion Symptoms

Symptoms of concussion can be highly variable and present themselves at different times over the recovery process depending on many factors.  Individual assessment and recognition of any of the following symptoms is important to be aware of with mild head injuries.

Physical Symptoms 
Headache
Nausea
Vomiting
Balance Problems
Dizziness
Visual Problems
Fatigue
Sensitive to Light and Noise
Numbness/Tingling

Thought Processes
Mentally Foggy
Feeling Slowed Down
Difficulty Concentrating
Difficulty Remembering

Sleep Patterns 
Drowsiness
Sleeping Less than Normal
Sleeping More than Normal
Trouble Falling Asleep

Emotional Status
Irritable
Sadness
Nervousness
Feeling More Emotional

 

Often times these symptoms will be exacerbated during physical or cognitive activity.

If you are feeling any of these symptoms following a traumatic blow to the head or body, then you likely have sustained a mild head injury/concussion.  Seek medical care if these worsen or do not improve with rest over time.

Am I concussed?

Have you sustained a blow to the head or body which has caused you to suffer some confusion, difficulty remembering events surrounding the incident or you have developed some symptoms following the incident such as headache, dizziness, balance problems, over fatigue, etc.  You may have suffered a mild head injury.

If Concussed, What do I do?

Seek Immediate Medical Care if:

  • Loss of Consciousness or memory difficulties > 15 minutes

  • Neurological function deterioration, Changes in Pupils, Seizure activity

  • Deterioration of Vital signs or Mental Status

  • Any Associated Injury à bleeding, fracture, spine, neck pain

  • Persistent or worsening signs/symptoms in observation following incident (see below)

  • ANY signs or symptoms → REST and do not over exert or play sports

If symptoms are mild and improving over time:

Follow home care recommendations until symptoms improve and contact THF for evaluation and guidance in return to full life activity and/or sports.

Concussion Home Care Recommendations

  • REST is the critical factor!

  • Get plenty of sleep – as long as they are able to be awakened with recognition of people/place, it is best to let them sleep – NO late nights/keep same bedtime and naps during daytime are encouraged if overly fatigued

  • Reduce overall daily demands, physical, mental and emotional demands – energy levels are reduced with recovery and demands need to be adjusted to not OVER STRESS the body or mind

  • Limit physical activity – NO weight training, high intensity cardiovascular exercise, running/jumping, high risk activities

  • Limit mental activity, those that require focus/concentration or thinking – Computer work, homework, reading, phones, text messaging, video games, NO high stimulus environments such as movie theaters, shopping, etc. – NO driving

  • Manage emotional stressors – reduce responsibilities, choose supportive environments – SCHEDULE your stressors with plenty of recovery time following stressful activity

  • DO NOT push through fatigue – this worsens the symptoms and delays recovery

  • GOOD NUTRITION – get plenty of hydrating fluids – NO alcohol, recreational drugs, limit caffeinated drinks – eat well with adequate carbohydrates and protein to resupply energy levels by maintaining blood sugar levels

  • Your Primary GOAL is to reduce symptoms through rest, good nutrition and supportive environment

 

Red Flags to seek Emergency Care in Recovery Process:  

Worsening Headaches – Seizures - Focal neurologic signs - Neck Pain - Change in state of consciousness - Difficulty in being awakened/overly drowsy - Repeated vomiting - Slurred speech - Inability to recognize people/location - Increased confusion - Unusual behavior change - Numbness/weakness in extremities - Increased irritability