What is a Concussion?

A concussion is a type of traumatic brain injury that can alter the way the brain functions – usually temporarily. A brain injury of this type may cause pain, problems with concentration, fatigue, dizziness, memory problems and difficulty with balance or coordination.

A concussion may be caused by a fall, a blow to the head, sudden impact or another type of traumatic injury (like a car accident). In the case of concussion, the brain shakes within the skull. Some people – especially those who suffer major concussions – temporarily lose consciousness, but many do not. Concussions occur frequently in contact sports, such as football. Most cause only temporary effects, but the brain is more sensitive to further injury after a concussion so allowing it to heal before returning to risky activities is essential.

Baptist Health is known for advanced, superior care for patients with neurological conditions and the diagnosis, management and treatment of concussion. Our 24/7 inpatient neurology and neurosurgery services, as well as our outpatient and Home Health physical, occupational, cognitive and speech therapy services are available to help treat people with concussions. In addition, we have the region’s only advanced 3Tesla MRI, MRI spectroscopy and functional MRI technology to accurately diagnose all manner of neurologic disease, including concussion.

Additionally, our neurosurgery, neurology and rehabilitation center staff work together in a formal concussion recovery program to return patients to work, school and athletics quickly and safely.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Concussion symptoms can vary greatly depending on the injury’s cause and severity. Signs and symptoms of a concussion may not show up immediately and can be subtle and difficult to detect. Symptom duration can be days to weeks, or even longer.

Signs of a concussion include:

• Amnesia
• Balance or coordination problems
• Blurred vision
• Concentration and memory problems
• Confusion or foggy feeling
• Dazed appearance
• Delayed ability to respond to questions
• Depression, or mood/behavioral changes
• Dilated pupils or pupils of unequal size
• Dizziness
• Fatigue
• Headache or feeling of pressure in the head
• Inconsolable crying (in babies and young children)
• Irritability or agitation
• Nausea and/or vomiting
• Ringing in the ears
• Seizures (rare)
• Sensitivity to light and sound
• Sleep problems
• Slurring of speech
• Temporary loss of consciousness

Diagnosis

Proper diagnosis is important to assess the severity of the concussion and to take steps to avoid further injury. To determine if someone has a concussion, we ask detailed questions about the injury and any symptoms and may conduct the following tests and examinations:

• Cognitive examination: The physician may conduct several tests to evaluate a person’s memory, concentration and reasoning skills.
• Computerized tomography (CT) scan: This test uses a series of X-rays to create detailed images of the brain. CT scans can show fractures, areas of bleeding (hemorrhage), blood clots, bruised brain tissue and swelling.
• Magnetic resonance imaging (MRI): This test uses powerful radio waves and magnets to create a detailed view of the brain, which can reveal damage and injury not seen with other imaging techniques.
• Neurological examination: During this exam, the physician assesses balance, coordination, reflexes, strength, sensation, vision and hearing.
• Observation: In some cases, after a severe concussion and/or loss of consciousness, a person may need to stay in the hospital overnight for observation by physicians and nurses. If the concussion is deemed more minor, someone should stay with and check on the injured person for 24 hours to ensure symptoms aren’t getting worse.
• X-rays: A common imaging test to rapidly assess injuries to the spine, head and other bones. 

Causes

Concussion causes include: 

• Automobile, motorcycle or bicycle accidents
• Falls (especially in young children or seniors)
• Participation in a high-risk sport, such as football or boxing 

Risk Factors

Risk factors that could contribute to concussion include: 

• Accidents: Victims of motor vehicle, bicycle, motorcycle and pedestrian accidents may suffer concussions.
• Military Activities: Concussions in servicemen and women may be caused by training injuries, vehicle crashes, injuries sustained during combat or in explosions, and more.
• Physical abuse: Child and adult victims of abuse may sustain concussions from being hit or pushed by their abusers.
• Previous concussions: Those who’ve already suffered a concussion are more susceptible to future concussions, especially if they haven’t healed and rested after the first injury. 

Prevention

While some risk factors cannot be controlled, there are ways you can help to prevent some cases of concussion:

• Advocate for your child (and other children): Educating coaches, other athletes, fellow parents and caregivers about the features of a concussion, how to evaluate symptoms, what to do next, and how to determine when it’s appropriate to return to play or school can help prevent severe injuries in children.
• Avoid risky sports, or at least take proper precautions: Avoiding sports like football, hockey and boxing can help prevent concussion. But if you love the game, do not return to the field, ice or ring after injury until you are assessed by a trainer and physician and given the all-clear. Also, be sure to wear appropriate protective equipment at all times.
• Be safe in daily activities: Be careful getting in and out of the tub and use bathmats to avoid slipping. Avoid balancing on wobbly chairs or unwieldy step ladders to reach high places. If you need a cane or walker to get around, use it. Check your house for tripping hazards and remove them. And pay attention to wet floor or uneven pavement signs when you’re out and about.
• Exercise regularly: Regular exercise can improve your balance and strength and reduce your risk of falls. Ask a trainer for help with safe technique.
• Practice car, motorcycle and bicycle safety: Always wear a seatbelt in the car and a helmet on a bicycle or motorcycle. As a pedestrian, be aware of your surroundings.

Prognosis

Mild concussion symptoms may last a few hours or a day or two. Severe concussion symptoms may last six months to a year. Most people who suffer a single concussion will only have temporary symptoms and will recover quickly with rest and avoidance of risky activities until the brain is fully healed. In some severe cases, people can develop post-concussive syndrome, defined by a week or more of headaches, dizziness, cognitive problems, issues with balance and coordination and more. If symptoms last longer than a few days, follow up with a physician.

Repeated concussions can cause long-term memory loss, behavior changes, psychiatric disorders and other neurological problems.

Treatment and Recovery

In many cases, rest is all that is needed to treat a mild-to-moderate concussion, along with over-the-counter pain relievers for headache. If you’ve have a concussion, you should avoid sports and other physical exertion until symptoms disappear and your physician gives you the all-clear. All states require a person who has a concussion during a sporting event to be evaluated and cleared by a medical professional before returning to play or practice.

It’s also a good idea to limit activities that require prolonged thinking and concentration, such as schoolwork, reading, watching TV and playing video games until your symptoms disappear.

Severe concussions may require hospitalization and medications to treat symptoms like severe headache and nausea.

Complications

Possible concussion complications include:

• Effects of multiple brain injuries: Studies have shown that people who have had multiple concussive brain injuries over the course of their lives may acquire lasting, possibly progressive, mental impairment.
• Epilepsy: Suffering a concussion doubles the risk of developing epilepsy within five years.
• Post-concussion syndrome: After a severe concussion, some people develop headaches, dizziness and thinking difficulties that may continue for weeks to a few months after the injury.
• Post-traumatic headaches or vertigo: Some people experience headaches or a sensation of spinning or dizziness within a week to a few months after a brain injury.
• Second impact syndrome: Experiencing a second concussion before symptoms of a first concussion have resolved may result in rapid and usually fatal brain swelling.