A concussion is a type of traumatic brain injury that occurs when forces on the head cause the brain to shake within the skull. This may occur due to a direct blow to the head, but may also occur if contact to other parts of the body result in the force of impact being transmitted to the head. These forces acting upon the brain result in chemical changes that interfere with the brain’s typical functioning, and may result in changes in alertness, a loss of consciousness, amnesia, or a variety of other symptoms associated with concussions.
A concussion can result from a fall, sports activities, car accidents, or other forms of trauma to the brain. Shaking or jarring of the brain within the skull can cause a person to experience some outwardly observable signs of a concussion, including loss of consciousness, amnesia for the events before or after the injury, or disorientation/confusion. However, concussions do not always lead to these outwardly observable signs of injury, with an estimated 90% or more involving no loss of consciousness. An injured individual may experience a variety of symptoms associated with their injury, and these symptoms can sometimes take time to develop.
Each concussion is unique and may be associated with a variety of different symptoms. Some of the commonly experienced symptoms include:
- Headache or “pressure” in head
- Nausea or vomiting
- Balance problems or dizziness
- Double or blurry vision
- Light or noise sensitivity
- Feeling sluggish, foggy or groggy
- Concentration or memory problems
- “Feeling off” or “feeling down”
- Sleep disturbances
- Clumsy movements
- Slow to answer questions
- Loss of consciousness (even briefly)
- Mood, behavior or personality changes
In rare cases, a dangerous collection of blood may form on the brain after a blow to the head. If one or more of the following occur after a head injury, you should call 9-1-1 right away or go directly to your nearest emergency department.
- One pupil larger than the other
- Unusual eye movements
- Severe drowsiness or inability to wake up
- Worsening headache that does not go away
- Altered speech / coordination, weakness / numbness
- Repeated vomiting or nausea, convulsions or seizures
- Unusual behavior, confusion, restlessness or agitation
- Muscle weakness on one or both sides
Head injuries that cause a concussion can sometime occur with injury to the neck and spine. Take special care when moving people who have had a head injury.
Each concussion represents a unique injury and must be evaluated in a comprehensive manner to determine the specific difficulties being faced by the patient. The health care provider will perform an evaluation that may include detailed interview, neurocognitive testing, and physical evaluation of different affected systems. This may include evaluation of the vestibular system (a system related to balance, motion sensitivity, and dizziness), the ocular system (the eyes and how they move), and the neck.
Our Comprehensive Concussion Program at Northside Hospital Sports Medicine Network takes an individualized approach to the treatment of each injury. Based on a thorough clinical evaluation, our concussion experts will determine what specific deficits, or what type of concussion the athlete is dealing with. This allows for the creation of specific and targeted treatment plans designed to rehabilitate and retrain problems caused by the head injury. We will also provide individualized academic and/or work accommodations as needed to help the patient successfully return to these settings. An underlying goal is to provide the patient with care that returns them to their pre-injury functional activities as quickly and safely as possible. As part of this, we also offer detailed plans for returning the athlete to sports activity.
Recent expert consensus and research data suggests that 70% to 80% of individuals will not experience significant difficulties beyond 1 to 3 months after sustaining a concussion. Appropriate medical evaluation and treatment is a key aspect of a safe and efficient recovery from concussion. Because each concussion is unique, recovery time may vary between individuals. Your medical professional can identify risk factors for lengthy recovery and also begin treatment when appropriate to address concussion-related difficulties that could prolong recovery if not addressed.
Appropriate medical evaluation is an essential aspect of concussion management following injury, as this allows for the early identification of deficits so that treatment may be initiated when needed. This also allows the medical provider to explain the injury to you and offer reasonable expectations for how it is likely to progress. Early medical evaluation also offers the opportunity for detailed academic, work, and exercise planning so that the athlete can be provided support and guidance in returning to their functional activities in a manner that meets their needs, while also preventing them from getting too far behind or becoming excessively deconditioned.
Not all head injuries can be prevented. In general, you should increase safety for you and your child by following these steps:
- Always use safety equipment during activities that could cause a head injury. These include seat belts, bicycle or motorcycle helmets, and hard hats.
- Learn and follow bicycle safety recommendations.
- Athletes should be immediately removed from play/activity if a concussion has occurred or if it is suspected.
- Athletes should not return to play until their injury has resolved fully and they have been cleared by a medical professional.