Concussion

Overview

What is a concussion?

A concussion is a brain injury that is caused by a sudden blow to the head or to the body. The blow shakes the brain inside the skull, which temporarily prevents the brain from working normally.

Some people have obvious symptoms of a concussion (such as passing out or feeling lightheaded), while others do not. With rest, most people fully recover from concussions within a few hours to a few weeks.

On rare occasions, concussions cause more serious problems. Repeated concussions or a severe concussion may require surgery or lead to long-lasting problems with movement, learning, or speaking. Because of the small chance of permanent brain problems, it is important to contact a doctor if you or someone you know has symptoms of a concussion.

What causes a concussion?

Your brain is a soft organ that is surrounded by spinal fluid and protected by your hard skull. Normally, the fluid around your brain acts like a cushion that keeps your brain from banging into your skull. But if your head or your body is hit unexpectedly hard, your brain can suddenly crash into your skull and temporarily stop working normally.

There are many ways to get a concussion. Some common ways include fights, falls, playground injuries, car crashes, and bike accidents. Concussions can also happen while participating in rough or high-speed sports such as football, boxing, hockey, soccer, skiing, or snowboarding.

What are the symptoms?

It is not always easy to know if someone has a concussion. Not everyone who has a concussion passes out. A person who might have a concussion should immediately stop any kind of activity or sport. Becoming active again before the brain returns to normal functioning increases the person's risk of having a more serious brain injury.

Symptoms of a concussion range from mild to severe and can last for hours, days, weeks, or even months. If you notice any symptoms of a concussion, contact your doctor.

Symptoms of a concussion include:

  • Passing out.
  • Not being able to remember what happened after the injury.
  • Acting confused, asking the same question over and over, slurring words, or not being able to concentrate.
  • Feeling lightheaded, seeing "stars," having blurry vision, or experiencing ringing in the ears.
  • Not being able to stand or walk; or having coordination and balance problems.
  • Feeling nauseous or throwing up.

Sometimes it can be hard to tell if a small child has a concussion. If your child has had a head injury, call your doctor for advice on what to do.

Occasionally a person who has a more serious concussion develops new symptoms over time and feels worse than he or she did before the injury. This is called post-concussive syndrome. If you have symptoms of post-concussive syndrome, call your doctor. Symptoms of post-concussive syndrome include:

  • Changes in your ability to think, concentrate, or remember.
  • Headaches or blurry vision.
  • Changes in your sleep patterns, such as not being able to sleep or sleeping all the time.
  • Changes in your personality such as becoming angry or anxious for no clear reason.
  • Lack of interest in your usual activities.
  • Changes in your sex drive.
  • Dizziness, lightheadedness, or unsteadiness that makes standing or walking difficult.

How is a concussion diagnosed?

If a doctor thinks that you have a concussion, he or she will ask questions about the injury. The doctor may also ask you simple questions such as “What day is it?” to see if your brain is working normally. Then the doctor will check your strength, balance, coordination, reflexes, and sensation. Sometimes a doctor will order imaging tests such as a CT scan or a MRI to make sure your brain is not bruised or bleeding.

How is it treated?

Initial treatment for a concussion is to watch a person closely for any changes in behavior or for any new symptoms. Some people have to stay in the hospital to be watched while others can go home safely.

If the concussion happened during a sports event, be sure to see a doctor before returning to play.

If you have any swelling on your scalp, your doctor may recommend using cold packs to reduce the swelling. He or she may also prescribe a pain medicine or recommend a pain medicine that you can buy without a prescription, such as acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil or Motrin).

At home, rest is the best way to recover from a concussion. Get plenty of sleep at night and take it easy during the day. To prevent a second brain injury, avoid alcohol, illegal drugs, and any activities that could lead to another head injury for a few days or even a few weeks. Your doctor may also tell you not to drive or swim for a while.

Some people feel normal again in a few hours while others have symptoms for weeks or months. It is very important to allow yourself time to get better and to slowly return to your regular activities. It is also important to call your doctor if you are not improving as expected or if you think that you are getting worse instead of better.

How can I prevent a concussion?

You can reduce your chances of getting a concussion if:

  • You wear helmets and safety equipment when you are biking, blading, skateboarding, snowboarding, or skiing.
  • You wear your seat belt in a car, pay attention while driving, and do not drive if you have been drinking or using drugs.
  • You make your home as accident-proof as possible. This can be done by adding lighting to dark areas, fixing uneven surfaces, blocking off stairways, or padding edges of sharp objects.

Credits

Author Monica Rhodes
Editor Kathleen M. Ariss, MS
Associate Editor Denele Ivins
Associate Editor Pat Truman, MATC
Primary Medical Reviewer William M. Green, MD - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Last Updated August 13, 2008

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