In recent years there has been an increase in research dedicated to investigating concussions and their effects on the brain. Sports related concussions tend to generate the most interest in the media, but concussions can occur in everyday activities that pose a risk of impact, such as motor vehicle accidents or slip and falls. As research has accumulated and advanced especially over the last decade, researchers have been able to make more definite conclusions on the subject, yet much more research is required to fully understand the effect concussions have on the brain and its function. This three-part series over the next several weeks will discuss the following: What are the causes of a concussion and symptoms, assessment of a concussion, and finally recovering from a concussion injury and protocols for returning to sport/activity.
What is a concussion?
A concussion is a form of brain injury that can be caused either by a direct hit to the head or indirectly via another body part such as the neck or face that can transmit forces to the head. A concussion occurs when there is an acceleration, deceleration, or rotation force that causes the brain tissue to shift within the skull. This movement causes the brain tissue to brush against boney protrusions of the skull bone. Although researchers have yet to determine the exact effect of these forces on brain cells, they have determined that concussions result in an impairment of neurological function rather than structural damage. Therefore, diagnostic imaging, such as CT or MRI scans, will most likely not show any brain tissue abnormalities in concussed individuals. Concussion symptoms typically resolve within 7 to 10 days in 80 to 90% of individuals. Children and adolescents may require longer periods of recovery.
Symptoms of a concussion
Severity of concussion symptoms can be determined with an assessment tool called the SCAT 3 (Sport Concussion Assessment Tool – 3rd Edition). This assessment tool will be discussed further in my next column. There are several subcategories or domains of concussion symptoms that can help determine the severity. These include: clinical symptoms, physical signs, cognitive impairment, behavioral changes, as well sleep disturbances. It is also important to note any previous history of concussions.
Symptoms may include: Amnesia (loss of memory), headaches, a feeling of “pressure in the head”, neck pain, nausea, vomiting, dizziness, blurred vision, balance problems, sensitivity to noise and light, feeling “in a fog”, difficulty concentrating or remembering, low energy, insomnia, or being more emotional, irritable, or nervous than usual.
What to do if you suspect a concussion
Seek medical attention immediately after an impact to the head that results in the above symptoms. Often concussions go untreated as symptoms tend to go unnoticed by others. Symptoms can be aggravated by an increase in physical activity or exertion. Although symptoms are often present immediately after a blow to the head, physical, cognitive, or emotional changes may occur later that day or even the following day after impact. Therefore, it is important to seek help from your primary care provider as soon as possible. Stay tuned information on assessing concussions in my next column.