A concussion is a mild brain injury in which
to the head results in a temporary disruption of normal brain function. The injury may involve subtle pulling, tugging, or shearing of brain cells without causing any obvious structural damage. After a concussion, the brain does not work right for a while. Loss of consciousness may or may not occur, but confusion or problems with awareness or memory are usually present. Three grades of concussions were developed by the Brain Injury Association and Academy of Neurology:
Grade one—temporary confusion, but conscious
Symptoms usually clear up in less than 15 minutes.
Grade two—confusion and amnesia, but conscious
Symptoms last for more than 15 minutes.
Grade three—loss of consciousness for a few seconds or longer
Anything that makes the brain bounce around and against the side of the skull can cause a concussion. For example:
Concussion often results from accidents that involve:
Skates, skateboards, and scooters
Sports and recreation
Assault and battery
These factors increase your chance of developing a concussion. Tell your doctor if you have any of these risk factors:
A previous concussion or head injury
Certain age groups:
Children aged five years or younger
Teens and young adults aged 15-24
Persons over 75 years old
Contact sports, such as football or boxing
Work that involves farming, logging, or construction
Traveling by vehicle at a high rate of speed
Use of alcohol
Lack of sleep
Medications that cause drowsiness
A concussion causes symptoms that may last for days, weeks, or even longer.
Loss of memory about the accident
Low-grade headache or neck pain
Paying attention or concentrating
Organizing daily tasks
Making decisions and solving problems
Slowness in thinking, acting, speaking, or reading
Feeling fatigued or tired
Change in sleeping pattern:
Sleeping much longer than usual
Loss of balance
Feeling light-headed or dizzy
Increased sensitivity to:
Blurred vision or eyes that tire easily
Loss of sense of taste or smell
Ringing in the ears
Feeling sad, anxious, or listless
Becoming easily irritated or angry for little or no reason
Symptoms that may appear in a child with a concussion include:
Listlessness or tiring easily
Irritability or crankiness
Eating or sleeping patterns
Lack of interest in favorite toys or activities
Loss of new skills, such as toilet training
Loss of balance, unsteady walking
The doctor will ask you and others who were present at the time of injury about your symptoms and how the injury occurred. The physical exam usually includes checking for strength, sensation, balance, reflexes, and memory.
Tests may include:
—a type of x-ray that uses a computer to make pictures of structures inside the head
—a test that uses magnetic waves to make pictures of structures inside the head
The goal of treatment is to allow the brain injury to heal.
Treatment may include:
Rest—providing adequate time for recovery
This means not rushing back into daily activities, such work or school.
Observation by a responsible adult—someone to awaken you every few hours as advised by your doctor
The doctor will explain how to watch for complications, such as bleeding in the brain.
Limiting exposure to drugs—not taking medicines without your doctor's permission
This is especially true for aspirin, blood thinners, and drugs that cause drowsiness. Avoid use of alcohol and illicit drugs.
Preventing re-injury—avoiding activities that might jolt or jar your head
Never return to a sports activity until your doctor has given you permission. This is generally when signs and symptoms are gone (during rest and activity) and your neurological exam is normal. Ask when it's safe to drive a car, ride a bike, work or play at heights, or use heavy equipment. Re-injury can lead to more severe or long-term symptoms. It is recommended that athletes gradually return to sports.
If you are diagnosed as having a concussion, follow your doctor's
Preventing second impact syndrome—avoiding a second head injury in children and adolescents who have had a concussion
Even a mild second injury in children and adolescents can rapidly increase swelling, causing unconsciousness and even death. Opinions vary regarding when it is safe to return to contact sports or other activities. Talk to your child's doctor.
Neuropsychological testing—to determine the stage of recovery and readiness for activities, such as Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)
The following safety measures may help you avoid getting a concussion:
Don't drink and drive.
Avoid use of sedating drugs, especially when driving or using heavy equipment.
Obey speed limits and other driving laws.
Always use child safety seats, seatbelts, and shoulder harnesses in cars. Also learn how to safely use air bags.
Wear a helmet when:
Riding a bike or motorcycle
Playing a contact sport such as football, soccer, or hockey
Using skates, scooters, and skateboards
Catching, batting, or running bases in baseball or softball
Riding a horse
Skiing or snowboarding
Make sure your child's playing surface is soft and free of rocks, holes, and debris.
Reduce falling hazards at home for children and adults.
Wear mouth guards, face guards, pads, and other safety gear during sports.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a