Concussions

A concussion is a type of traumatic brain injury caused by a blow or jolt to the head that disrupts the normal functioning of the brain. It can result in physical, cognitive and emotional symptoms, such as headache, dizziness, confusion, nausea, memory loss and difficulty concentrating and speaking clearly. Other long-term effects may include trouble with balance and coordination, depression, sleep disturbances and changes in personality.

The most common cause of a concussion is a direct blow to the head or body that results in rapid acceleration or deceleration forces on the brain. Activities that can cause concussions include falls, motor vehicle collisions and sports-related injuries.

To prevent a concussion, wear proper protective gear during contact sports or any physical contact activity. Additionally, reducing risk factors for falls, such as removing tripping hazards in the home and wearing appropriate footwear, can help. Falls can occur anywhere and are the leading cause of concussions among children. Parents play a crucial role in preventing falls by using window guards or stops, stair gates and handrails. Supervision is essential around potential fall hazards, whether at home, at school or in the community.

Here are some proven safety tips for parents that can help prevent concussions:

• Ensure your child always wears the right type of helmet for each activity and that the helmet fits correctly. Helmets help reduce the risk of a severe brain injury or skull fracture during activities such as bicycling, skateboarding, skiing, snowboarding, riding a scooter, or playing high-contact sports like tackle football. Replace damaged helmets and be cautious of products that may overstate injury-prevention benefits, such as those claiming they can prevent all concussions.
• Ensure your child is always properly buckled into a car seat, booster seat or seat belt, whichever is appropriate for their age and size. Avoid reusing a car seat that shows signs of damage, has been recalled or expired, has been involved in a crash or lacks essential information, such as an expiration date, model number or instructions.
• Have your child use playgrounds with soft underlayments, like mulch or sand, not grass or dirt.
• Speak up and be a good example. Your actions can create a safe sports culture and lower an athlete’s chance of getting a concussion or serious injury.

The following are guidelines for sports programs to help players of every age avoid concussions and other brain injuries:

• Educate coaches, sports officials, parents and athletes about concussion policies and about strategies to reduce head impacts and concussions.
• Enforce the rules of the sport for fair play, safety and sportsmanship.
• Ensure athletes avoid unsafe actions such as hitting another athlete in the head or using their head to tackle or hit another athlete.
• Expand opportunities for youth in all communities to participate in low-cost, non-contact football programs, such as flag and touch football.
• Limit the number of contact practices for contact and collision sports.

For older adults:

• Wear a seatbelt when you drive or ride in a car.
• Improve lighting and remove area rugs, clutter and other trip hazards, especially in hallways.
• Use non-slip mats and install grab bars next to the toilet, tub, or shower.
• Install handrails on stairways.
• Improve balance and strength with regular physical activity.

Symptoms of a concussion can range from mild to severe and may become worse over time if not properly managed. Common symptoms include headache, dizziness, confusion, memory loss, sensitivity to light or noise, nausea and vomiting. Other physical symptoms may include blurred vision, ringing in the ears, slurred speech and balance problems. Cognitive symptoms include difficulty concentrating, slowed reaction time or remembering new information. Emotional symptoms can include agitation, irritability or depression.

Many people with concussions may notice visual and balance problems that can make reading, writing and using electronic devices challenging.

Healthcare providers will conduct a thorough physical examination to diagnose a concussion and review any medical history and current symptoms. A neurological exam may also assess vision, hearing, balance and coordination.

Most people with a suspected concussion don’t need excessive tests. However, people with more serious concussions may have bleeding or other damage in the brain and may need imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, to assess for additional damage. A recently approved blood test can help doctors identify adults needing imaging. Researchers are studying whether these blood tests can better and more quickly diagnose concussions.

People with a concussion will need follow-up care. However, a recent study showed that fewer than half of people diagnosed with concussion in the ER receive the extended treatment required. This lack of follow-up can prevent people from maintaining their quality of life. 

Medication
Drugs don’t yet exist to treat concussions, but they can be used to treat the side effects of concussions. These include medications to help with headaches, depression and sleep problems.

Rest
After a concussion, the brain needs rest. Research has shown that children and adults benefit from reducing their mental and physical activity for a short time and should return to those activities gradually. People who have experienced a head injury shouldn’t be surprised if it takes up to a month to feel normal. To support healing, they are encouraged to try light physical activity and use their brain in ways that don’t make concussion symptoms worse.

Rehabilitation
Physical rehabilitation programs can also help those with longer-lasting symptoms. Talk with your doctor about returning to your regular activity after a concussion. If symptoms persist, ask about physical therapy.

Most people recover fully after a concussion, but it can take some time. In addition to rest, you may need to limit physical activities or activities that involve a lot of concentration, such as studying, using a computer or playing video games. These activities may cause concussion symptoms (such as headache or tiredness) to come back or get worse. You can slowly return to your normal activities, as your care team recommends.