Concussion

Overview

A concussion is a type of traumatic brain injury caused by a bump, violently shaking, or blow to the head that interferes with normal brain function. Headaches and issues with focus, memory, balance, and coordination are common effects. 

Concussions involve the stretching and bruising of nerves and blood vessels, leading to chemical alterations in the brain that result in a temporary disruption of typical brain activity. While some concussions can lead to a brief loss of consciousness, they are generally not considered life–threatening. It’s important to note that a single concussion typically does not lead to permanent brain damage. Experiencing multiple concussions throughout one’s life could lead to alterations in the structural composition of the brain.

Falls are the primary cause of concussions. Concussions frequently result from impacts to the head or forceful shaking of the head and upper body. Additionally, contact sports such as football or soccer often lead to concussions. The symptoms can vary in severity and may endure for days, weeks, or even months. The majority of individuals typically achieve complete recovery following a concussion.

Symptoms

Signs and symptoms of a concussion mostly become evident shortly after a head injury. In some cases, it might take several hours for some symptoms to manifest. Symptoms can evolve in the days following the injury, and others may emerge when the brain is under stress. 

Frequent indications of a traumatic brain injury from a concussion encompass headaches, amnesia, and confusion. These symptoms have the potential to persist for a span of days, weeks, or even months.

Common symptoms of a concussion may include:

• Headache 
• Nausea and vomiting 
• Ringing in the ears 
• Confusion 
• Problems with balance, dizziness, and lightheadedness 
• Tiredness
• Blurry vision 
• Amnesia related to the tragic event 
• Feelings of “just not right” or being in a “fog” 

Symptoms that may appear immediately, or days later include:

• Being irritated, nervous, and worried 
• Having difficulty concentrating 
• Memory problems 
• Light and noise sensitivity 
• Sleep pattern changes, such as sleeping considerably more or less than normal or being unable to sleep 
• Issues with psychological adjustment, sadness, and depression 
• Taste and smell disorders 

Some signs and symptoms may be observed by other people, such as:

• Brief loss of consciousness 
• Forgetfulness, such as asking the same question repeatedly 
• Delay in responding to conversations 
• Dazed appearance 
• Slurred speech

Symptoms in children

Head injuries are common occurrences among infants and toddlers. Diagnosing concussions in these young children can prove challenging due to their limited ability to communicate discomfort. Signs of concussions in children might encompass: 

• Bumps on the back of the head 
• Vomiting
• Seizures 
• Being irritated and grumpy 
• More fussy than normal, won’t stop crying even when calmed
• Dazed appearance
• Change in sleep pattern, sleepy at unusual times 
• Listlessness and easily get tired
• Unsteady walking and loss of balance 
• Change in eating habits 
• Disinterest in favorite toys 

Generally, a person who suffered a head injury whether a symptom occurred or not, should see a doctor within 1 to 2 days. If any of the signs and symptoms occur after a head injury, consult a healthcare provider immediately. 

Urgent medical care is necessary when a head injury comes with signs and symptoms such as:

• A severe headache or a headache that worsens over time 
• Frequent vomiting or nausea
• A loss of consciousness that lasts more than 30 seconds
• Convulsions and seizures
• Confusion is increasing, such as difficulties recognizing individuals or places
• Severe dizziness, loss of balance, or walking difficulties 
• Weakness
• Nose or ear discharge that is clear and watery
• Bloody discharge from the ears 
• Ear ringing that does not go away
• Vision or eye problems, such as larger–than–normal pupils or uneven in size 
• Slurred speech
• Being pale for more than an hour
• Behavior that is unusual, odd, or irritable 
• Symptoms that intensify over time 
• Large head bumps or bruises on locations other than the forehead in youngsters, particularly in infants under the age of 12 months
• Clearly impaired mental function or physical coordination 
• Extreme sleepiness, difficulties waking up, or fainting 

If a child displays no notable indications of a major head injury, maintains consciousness, exhibits regular movement, and remains responsive, it’s likely that the injury is minor and does not demand further testing. Nonetheless, if there’s a concern that symptoms could manifest later, it’s advisable to seek immediate medical attention.

Athletes

It is highly recommended that individuals participating in sports, encompassing children, adolescents, and adults, abstain from resuming activities on the same day as a concussion occurrence, irrespective of the presence of signs and symptoms. 

Athletes suspected of having a concussion should avoid engaging in activities that heighten the risk of subsequent concussions. It is crucial that children and adolescents be evaluated by a healthcare professional proficient in assessing and addressing pediatric concussions.

Following the completion of the hands–on neurological examination, various neuropsychological tests can be utilized to determine a student–athlete’s capacity to return to school and sport. 

Causes

Brain tissue is soft and pliable. Cerebrospinal fluid surrounds it, acting as a cushion between it and the hard protective exterior, the skull.

A concussion occurs when the brain bounces or twists inside the skull, or when it experiences rapid, whiplash–like back–and–forth movement, causing it to crash with the interior of the skull. This movement of the brain stretches and destroys brain cells and causes chemical changes in the brain.

These injuries disrupt brain function for a short period of time, resulting in concussion signs and symptoms. The injury can cause bleeding in or around the brain, resulting in symptoms including drowsiness and confusion. These symptoms could appear immediately or later. 

In most cases, concussions are frequently attributed to car accidents, falls, and sports–related incidents. Among children, the majority of concussions arise during play on the playground, while cycling, or while engaged in sports like football, basketball, ice hockey, wrestling, or soccer. 

Risk factors

Adolescents are more likely than any other age group to sustain a concussion. Researchers believe that this heightened risk is attributable to the ongoing development of their brains. During this phase, the brain is actively constructing its neural connections, and, concurrently, adolescents tend to have relatively weaker necks in comparison to both young adults and older individuals. 

Other factors and activities known to make a person more susceptible to concussion include:

• Being involved in a car or traffic accident 
• Falls, particularly in young children and the elderly 
• Engaging in high–risk sports without adequate safety equipment and supervision 
• Playing a high–risk sport such as football, hockey, soccer, rugby, boxing, or another contact sport 
• Serving as a combat soldier
• Experiencing physical abuse
• Having previously suffered a concussion