Concussions: Causes, Symptoms, and Prevention
A concussion is a type of mild traumatic brain injury (mTBI) that affects brain function. While generally short-term, its effects can include headaches, difficulties with concentration, memory, balance, mood, and sleep. Concussions are typically caused by an impact to the head or body that leads to a change in brain function, although not everyone who experiences such an impact will suffer a concussion. Although some concussions result in a temporary loss of consciousness, most do not. Falls are the most common cause of concussions, and they are also prevalent among athletes in contact sports like American football and soccer. Despite the potential severity, most individuals recover fully from a concussion.
Symptoms of a Concussion
Concussion symptoms can be subtle and might not appear immediately, lasting for days, weeks, or even longer. Common symptoms after a mild traumatic brain injury include headache, confusion, and memory loss (amnesia), typically concerning the event that caused the concussion.
Physical Symptoms
- Headache
- Ringing in the ears
- Nausea
- Vomiting
- Fatigue or drowsiness
- Blurry vision
Cognitive and Emotional Symptoms
- Confusion or feeling as if in a fog
- Amnesia surrounding the event
- Dizziness or "seeing stars"
Observable Symptoms
A witness might observe the following symptoms in someone with a concussion:
- Temporary loss of consciousness
- Slurred speech
- Delayed response to questions
- Dazed appearance
- Forgetfulness, such as asking the same question repeatedly
Delayed Symptoms
Some symptoms may not appear until days after the injury, such as:
- Trouble with concentration and memory
- Irritability and personality changes
- Sensitivity to light and noise
- Trouble with sleep
- Emotional changes or depression
- Changes in taste and smell
Symptoms in Children
Recognizing concussions in infants and toddlers can be challenging as they cannot describe how they feel. Clues to a concussion in young children include:
- Dazed appearance
- Listlessness and tiring easily
- Irritability and crankiness
- Loss of balance and unsteady walking
- Excessive crying
- Changes in eating or sleeping patterns
- Lack of interest in favorite toys
- Vomiting
When to See a Doctor
It is important to consult a healthcare professional within 1 to 2 days if you or your child experiences a head injury, even if emergency care isn't required. Children and adolescents should see a healthcare professional trained in pediatric concussion evaluation and management.
Emergency Care
Seek emergency care if any of the following symptoms occur after a head injury:
- Repeated vomiting or nausea
- Loss of consciousness lasting more than 30 seconds
- Headache that worsens over time
- Fluid or blood drainage from the nose or ears
- Vision changes or unequal pupil sizes
- Persistent ringing in the ears
- Weakness in the arms or legs
- Behavioral changes
- Confusion or disorientation
- Slurred speech
- Seizures or convulsions
- Dizziness that doesn't subside
- Large head bumps or bruises
Concussions in Athletes
Athletes should never return to play or vigorous activity immediately following a concussion. Experts recommend that athletes with concussions do not return to play on the same day as the injury and avoid activities that risk another concussion. A gradual return to learning and physical activity should be supervised by a healthcare professional.
Causes of Concussions
During a concussion, the brain slides back and forth against the inner walls of the skull. This forceful movement can result from a violent blow to the head, neck, or upper body or from sudden acceleration or deceleration, such as during a car crash or a fall.
These movements injure the brain and temporarily affect brain function. In some cases, a mild traumatic brain injury can cause bleeding in or around the brain, leading to prolonged drowsiness, confusion, and sometimes death. Monitoring is crucial in the hours following a brain injury, and emergency care should be sought if symptoms worsen.
Risk Factors
Several factors and events can increase the risk of a concussion:
- Falls, especially in young children and older adults
- High-risk sports, such as American football, hockey, soccer, rugby, boxing, and other contact sports
- Auto accidents
- Pedestrian or bicycle accidents
- Military combat
- Physical abuse
- Previous concussions
Complications
Potential complications of a concussion include:
- Post-traumatic headaches: Headaches that persist for days to weeks
- Post-traumatic vertigo: A sense of spinning or dizziness lasting for days to weeks
- Persistent post-concussive symptoms: Multiple symptoms such as headaches, dizziness, and trouble with thinking that last longer than expected (beyond three months)
- Effects of multiple brain injuries: Ongoing research on the effects of repeated head injuries that don't cause symptoms (subconcussive injuries)
- Second impact syndrome: Rare but severe brain swelling that occurs if a second concussion happens before the first one heals, potentially leading to death
Prevention
To prevent or minimize the risk of a concussion:
- Wear protective gear during sports and recreational activities. Ensure the equipment fits properly, is well-maintained, and is worn correctly. Follow game rules and practice good sportsmanship.
- Use a helmet when bicycling, motorcycling, snowboarding, or engaging in any activity that may result in a head injury.
- Buckle your seat belt to prevent serious injuries, including head injuries, during traffic accidents.
- Make your home safe by keeping it well-lit and free of tripping hazards. Falls around the home are a leading cause of head injuries.
- Protect your children by blocking off stairways and installing window guards.
- Exercise regularly to strengthen leg muscles and improve balance.
- Educate others about concussions by raising awareness among coaches, athletes, parents, and others. Encourage good sportsmanship and safety practices.
Conclusion
Concussions, though often mild, are significant injuries that require careful attention and management. Understanding the symptoms, risk factors, complications, and preventive measures can help mitigate their impact and promote full recovery. Whether in sports, at home, or during daily activities, taking steps to protect the head and seeking appropriate care when necessary are crucial in preventing and managing concussions.
Sources
- Mayo Clinic Staff. (n.d.). Concussion. Mayo Clinic. Retrieved from Mayo Clinic
- Centers for Disease Control and Prevention (CDC). (2020). Traumatic Brain Injury & Concussion. Retrieved from CDC
- National Institute of Neurological Disorders and Stroke (NINDS). (2020). Concussion Information Page. Retrieved from NINDS
- American Association of Neurological Surgeons (AANS). (2021). Concussion. Retrieved from AANS
- Brain Injury Association of America (BIAA). (2021). Concussion. Retrieved from BIAA
