Concussion – NHS

Concussion is a temporary injury to the brain caused by a bump, blow or jolt to the head.

It usually only lasts up to a few days or weeks, although it sometimes needs emergency treatment and some people can have longer-lasting problems.

Signs and symptoms of concussion

Signs of a concussion usually appear within a few minutes or hours of a head injury.

But occasionally they may not be obvious for a few days, so it’s important to look out for any problems in the days following a head injury.

Symptoms include:

• a headache that does not go away or is not relieved with painkillers
• dizziness
• feeling or being sick
• memory loss – you may not remember what happened before or after the injury
• clumsiness or trouble with balance
• unusual behaviour – you may become irritated easily or have sudden mood swings
• feeling stunned, dazed or confused
• changes in your vision – such as blurred vision, double vision or “seeing stars”
• being knocked out or struggling to stay awake

Symptoms in children

Concussion can be harder to spot in babies and young children. Important symptoms to look out for are changes in their normal behaviour after a head injury, such as:

• crying a lot
• differences in their feeding or sleeping habits
• a loss of interest in people or objects

What to do if you think you might have concussion

Treat a minor head injury at home

You do not usually need to get immediate medical advice if you only have mild symptoms that do not last long after a head injury, such as:

• a headache that goes away on its own or is relieved by painkillers
• slight dizziness
• feeling sick
• being a bit dazed

You probably do not have concussion, and can follow the advice about treating a minor head injury at home.

Call NHS 111 for advice if you’re not sure if you need medical help.

When to go to hospital

Go to your nearest accident and emergency (A&E) department if you’ve injured your head and have:

• woken up after being knocked out
• problems with your memory
• a headache that does not go away
• repeatedly being sick since the injury
• changes in your behaviour, such as becoming more irritable
• had an operation on your brain in the past or are taking blood-thinning medicine such as warfarin
• been drinking alcohol or taking recreational drugs

In these cases, you should be checked by a health professional trained in assessing head injuries. They’ll decide if you need a brain scan to rule out a serious brain injury.

When to call 999

Call 999 for an ambulance if someone has injured their head and has:

• been knocked out and has not woken up
• difficulty staying awake
• problems with understanding, speaking, writing, walking or balance
• numbness or weakness in part of their body
• problems with their vision
• clear fluid coming from their ears or nose
• bleeding from their ears or bruising behind one or both ears
• a black eye with no obvious damage around the eyes
• a fit (seizure)
• hit their head in a serious accident, such as a car crash

Also call for an ambulance if someone needs to go to hospital but you cannot get them there safely.

Recovering from concussion

If you’re diagnosed with concussion in hospital, you’ll be able to go home when any serious brain injury has been ruled out and you’re starting to feel better.

Most people feel back to normal within a few days or weeks of going home. But some people, especially children, can take longer to recover.

Things you can do to help your recovery include:

• getting plenty of rest and avoiding stressful situations
• asking someone to stay with you for the first 48 hours so they can look out for problems such as changes in your behaviour or difficulty concentrating or understanding
• taking paracetamol or ibuprofen if you have a headache – do not take aspirin because it could cause your injury to bleed
• avoiding alcohol
• when you’re feeling better, gradually increasing how much activity you do each day – do as much as you can without your symptoms coming back
• avoiding a return to things like work, college, school, driving or riding a bike until you feel you’ve recovered
• avoiding sports or strenuous exercise for at least a week, and avoiding contact sports for at least 3 weeks

Speak to a GP if you still have symptoms after 2 weeks or you’re unsure about returning to activities such as work or sports.

Get medical help straight away if you develop any symptoms that mean you should go to hospital or call 999.

After effects of concussion

In some people, concussion symptoms can last a few months or more. This is known as post-concussion syndrome.

Possible symptoms include:

• headaches
• dizziness
• problems with memory or concentration
• unsteadiness
• depression, anxiety and changes in behaviour

See a GP if you still have symptoms after 3 months. They may be able to recommend treatments for some of the symptoms, or they may refer you to a specialist.

The charity Headway has more information on minor head injury and concussion that you might find useful if you’re having long-term problems.

Preventing concussion

There’s no guaranteed way to prevent concussion, but there are some simple things you can do that may reduce your chance of a head injury.

These include:

• wearing the recommended equipment when taking part in a contact sport, such as rugby or boxing
• making sure any contact sport you or your child are taking part in is supervised by a properly qualified and trained person
• wearing a seatbelt when driving
• wearing a helmet when riding a motorcycle, bicycle or horse

It’s important to avoid head injuries as repeated concussions or blows to the head have been linked to serious problems, including a brain condition called chronic traumatic encephalopathy.

Read more about how to prevent head injuries.

Page last reviewed: 11 June 2020
Next review due: 11 June 2023

Johns Hopkins All Children’s Hospital

A concussion is a brain injury that causes temporary changes in the way the brain works. You might think they happen when someone is knocked unconscious while playing sports. But concussions can happen with any head injury, often without a loss of consciousness.

We often hear about head injuries in athletes, but most concussions happen off the playing field — in car and bicycle accidents, in fights, and even minor falls.

About Concussions

A concussion is a type of traumatic brain injury. The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. The brain can move around inside the skull and even bang against it. If the brain bangs against the skull — for example, in a fall on a playground or a whiplash-type of injury — blood vessels can tear and the nerves inside the brain can be injured. These injuries can cause a concussion.

Anyone who has a head injury should be watched closely for signs of a concussion, even if the person feels OK. An undiagnosed concussion can put someone at risk for brain damage and even disability. So anyone who has any symptom of a concussion should be seen right away by a doctor.

Sports-related concussions get a lot of attention. Doctors now recommend these steps after a suspected sports concussion:

1. The player should immediately stop playing or practicing.
2. The player should get checked out by a doctor before returning to practice or play.

All injured body parts take time to heal, even brains. By resting and taking certain important precautions, kids with concussions usually recover within a week or two without lasting health problems. 

Signs and Symptoms

Someone with a concussion may be knocked unconscious, but this doesn’t happen in every case. In fact, a brief loss of consciousness or “blacking out” doesn’t mean a concussion is any more or less serious than one where a person didn’t black out.

If your child might have had a concussion, go to the emergency room if you see any of these symptoms:

• loss of consciousness
• severe headache, including a headache that gets worse
• blurred vision
• trouble walking
• confusion and saying things that don’t make sense
• slurred speech
• unresponsiveness (you can’t wake your child)

Call your doctor right away to report other problems, such as vomiting, dizziness, headache, or trouble concentrating. Then you can get advice on what to do next. For milder symptoms, the doctor may recommend rest and ask you to watch your child closely for changes, such as a headache that gets worse.

Symptoms of a concussion don’t always show up right away, and can develop within 24 to 72 hours after an injury. Young children usually have the same physical symptoms as older kids and adults, but cognitive and emotional symptoms (such as irritability and frustration) can appear later, be harder to notice, and last longer. Sleep-related issues are more common in teens.

Though most kids recover quickly from concussions, some symptoms — including memory loss, headaches, and problems with concentration— may linger for several weeks or months. It’s important to watch for these symptoms and call your doctor if they last. Often, in these cases, children need further evaluation and treatment.

Diagnosis

To diagnose a concussion, the doctor will ask about how and when the head injury happened, and about your child’s symptoms. The doctor also may ask basic questions to test your child’s consciousness, memory, and concentration (“Who are you?”/”Where are you?”/”What day is it?”).

The doctor also will do a physical exam and focus on the nervous system by testing balance, coordination, nerve function, and reflexes. Sometimes a computed tomography (CAT scan or CT scan) or magnetic resonance imaging (MRI) brain scan will be done to rule out internal bleeding or other problems from the injury.

Some kids who have head injuries from playing organized sports are examined by a coach or athletic trainer immediately after they’re injured. This is known as sideline concussion testing because it might happen on the sidelines during a game. Sideline testing is common in schools and sports leagues. By watching a player’s behavior and doing a few simple tests, a trained person can see if immediate medical care is needed.

Lots of schools or sports leagues use computerized programs that test players at the start of a sports season to measure their normal brain function and ability to process information. These tests are called baseline concussion tests. After a possible injury, sideline test results are compared with baseline test results to help doctors determine if there’s been a change in brain function and to help make a diagnosis.  

Treatment

Because each concussion is unique, symptoms can differ in severity. For this reason, treatment depends on a child’s particular condition and situation.

If a concussion is not serious enough to require hospitalization, a doctor will give instructions on home care. This includes watching the child closely for the first 24 to 72 hours after the injury. It is not necessary to wake the child up while he or she is sleeping to check for symptoms.

If a child has a headache that gets worse quickly, becomes increasingly confused, or has other symptoms (such as continued vomiting), it may mean there is a more serious problem. Call the doctor if your child has any of these symptoms.

Otherwise, home care for a concussion may include:

• Physical rest. This means not doing things like sports and physical activities until the concussion is completely healed. While they still have symptoms, kids should do only the basic activities of day-to-day living. This reduces stress on the brain and decreases the chances of re-injuring the head in a fall or other accident.

  When all symptoms are gone, kids should return to physical activities slowly, working their way back to pre-concussion levels.

• Mental rest. This means avoiding any cognitive (thinking) activity that could make symptoms worse, such as using a computer, cellphone, or other device; doing schoolwork; reading; and watching TV or playing video games. If these “brain” activities do not make symptoms worse, kids can start them again gradually, but should stop immediately if symptoms return.
• Eating well and drinking plenty of non-caffeinated beverages.

Kids with concussions also should avoid bright lights and loud noises, which can make symptoms worse. While they have symptoms, teens should take time off from work and not drive, operate heavy machinery, or do any other activities that require quick decisions and reactions.

Healthy kids usually can return to their normal activities within a few weeks, but each situation is different. The doctor will monitor your child closely to make sure that recovery is going well, and might recommend acetaminophen, ibuprofen, or other aspirin-free medicines for headaches. Pain medicines can hide symptoms, though, so kids should not return to normal activities until they no longer need to take them.

Returning to Normal Activities

Be sure to get the OK from the doctor before your child returns to sports or other physical activities. Sometimes kids feel better even though their thinking, behavior, and/or balance have not yet returned to normal.

Even if your child pleads that he or she feels fine or a competitive coach or school official urges you to go against medical instructions, it’s essential to wait until the doctor has said it’s safe to return to normal activities. To protect kids and remove coaches from the decision-making process, almost every state has rules about when kids with concussions can start playing sports again.

It’s very important for anyone with a concussion to heal completely before doing anything that could lead to another concussion. Hurrying back to sports and other physical activities increases the risk of a condition called second-impact syndrome, which can happen as a result of a second head injury. Although very rare, second impact syndrome can cause lasting brain damage and even death.

Preventing Concussions

All kids should wear properly fitting, appropriate headgear and safety equipment when playing contact sports or biking, rollerblading, skateboarding, snowboarding, or skiing. Nothing can prevent every concussion, but safety gear has been shown to help protect against severe head trauma.

Childproofing your home will go a long way toward keeping an infant or toddler safe from concussions and other injuries. Babies reach, grasp, roll, sit, crawl, pull up, “cruise” along furniture, and walk. Toddlers may pull themselves up using table legs; they’ll use bureaus and dressers as jungle gyms; they’ll reach for whatever they can see. All of these activities can result in a head injury that leads to a concussion. Be sure your child has a safe place to play and explore, and never leave a baby or toddler unattended.

Proper child car seats, booster seats, and seatbelts can help prevent head injuries in the event of a car accident and should be used every time kids are in a car.

People are much more likely to sustain a concussion if they’ve had one before, so prevention is even more important following a head injury. Evidence shows that repeated concussions can result in lasting brain damage, even when the injuries happen months or years apart.

Concussions are serious injuries that can become even more serious if kids don’t get the time and rest needed to heal them completely. Safety precautions can help prevent concussions, and following a doctor’s advice can minimize their effects if they do happen.

Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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Concussion – Symptoms, Diagnosis and Safety Guidelines

A Neurosurgeon Explains: Concussion

Khoi D. Than, MD, FAANS

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Definition

A concussion is an injury to the brain that results in temporary loss of normal brain function. Medically, it is defined as a clinical syndrome characterized by immediate and transient alteration in brain function, including alteration of mental status or level of consciousness, that results from mechanical force or trauma.

Causes

Concussions can be caused by direct trauma to the head, such as from falling, getting hit or being in an accident. They can also occur as a result of rapid acceleration-deceleration of the head, such as in whiplash injuries or blast injuries, like in a war zone. Many people assume that concussions involve passing out or a loss of consciousness, but this is not true. In many cases, people with a concussion never lose consciousness. In several cases, external signs of head trauma, such as bleeding, may also be absent.

Symptoms

A concussion can affect memory, judgment, reflexes, speech, balance and muscle coordination. People with concussions often report a brief period of amnesia or forgetfulness, where they cannot remember what happened immediately before or after the injury. They may act confused, dazed or describe “seeing stars.” Paramedics and athletic trainers who suspect a person has suffered a concussion may ask the injured person if they know their name, what month/year it is and where they are.

Even mild concussions should not be taken lightly. Neurosurgeons and other brain injury experts emphasize that although some concussions are less serious than others, there is no such thing as a minor concussion. In most cases, a single concussion should not cause permanent damage. A second concussion soon after the first one does not have to be very strong for its effects to be permanently disabling.

Common Symptoms of Concussion

• Confusion
• Headache
• Vision disturbances (double or blurry vision)
• Dizziness or imbalance
• Nausea or vomiting
• Memory loss
• Ringing ears
• Difficulty concentrating
• Sensitivity to light
• Loss of smell or taste
• Trouble falling asleep

If any of these occur after a blow to the head, a health-care professional should be consulted as soon as possible.

When to Seek Medical Care

Most people will recover quickly and completely following a concussion. Some people can have symptoms that last for several weeks before gradually getting better. Seek immediate medical attention if:

• Headache is worse or does not go away
• Slurred speech, weakness, numbness or decreased coordination
• Significant nausea or repeated vomiting
• Seizures
• Loss of consciousness
• Inability to wake up
• Symptoms have worsened at any time
• Symptoms have not gone away after 10-14 days
• History of multiple concussions

Testing and Diagnosis

Brain imaging studies with MRI and CT scans should not be performed routinely in the diagnosis of concussions. They typically do not show any significant changes and, with CT scans, expose individuals to unnecessary radiation. While such tests are more useful for identifying structural defects, an injury from concussion is metabolic and microscopic in nature that often presents normally on neuroimaging.

The doctor asks a variety of questions about how the injury occurred, where on the head and what symptoms are shown. The patient should report any unusual experiences to the health care provider.

Prevalence and Incidence

According to the Centers for Disease Control and Prevention (CDC) surveillance report of traumatic brain injuries, about 2.87 million TBI-related ED visits, hospitalizations and deaths occurred in the United States in 2014. Each year, more than 800,000 children are treated for TBI at emergency departments in the U.S. The highest incidence of TBI occurred in people over the age of 75, children aged 0-4 years and individuals aged 15-24 years.

University of Pittsburgh’s Brain Trauma Research Center reports more than 300,000 sports-related concussions occur annually in the U.S. Additionally, the likelihood of suffering a concussion while playing a contact sport is estimated to be as high as 19% per year of play; in other words, almost all athletes of contact sports suffer from a concussion within five years of participation. It has been reported that more than 62,000 concussions are sustained each year in high school contact sports. Among college football players, 34% have had one concussion and 20% have endured multiple concussions. Estimates show that 4-20% of college and high school football players sustain a brain injury over the course of one season. The risk of concussion in football is three to six times higher in players who have had a previous concussion.

A study conducted by McGill University in Montreal found that 60% of college soccer players reported symptoms of a concussion at least once during the season. The study also reveals that concussion rates in soccer players were comparable to those in football. According to this study, athletes who suffered a concussion were four to six times more likely to suffer a second concussion. Research such as this has led to greater interest in developing protective headgear for soccer participants, but it is not clear that such headgear actually reduces the risk of concussion.

Treatment

Concussion symptoms can affect people in a variety of ways, including vision, balance and even mood. Historically, the standard treatment for concussion was to get plenty of rest. However, newer approaches involve therapy to target specific symptoms. Clinics exist that help determine the most affected system and appropriate therapy for a given symptomology. In addition, a thorough medical examination may be needed before returning to sports or activities with the potential for contact or further head injury.

Complications

Following a concussion, some people may suffer persisting symptoms, such as memory and concentration problems, mood swings, personality changes, headache, fatigue, dizziness, insomnia and excessive drowsiness for several weeks to months. This is known as post-concussive syndrome. Patients with post-concussive syndrome should avoid activities that put them at risk for a repeated concussion. Athletes should not return to play while experiencing these symptoms. Athletes who suffer repeated concussions should consider ending participation in the sport.

Second impact syndrome results from acute and often fatal brain swelling that occurs when a second concussion is sustained before complete recovery from a previous concussion. The impact is thought to cause vascular congestion and increased intracranial pressure, which can occur very rapidly and may be difficult or impossible to control. The risk of second-impact syndrome is higher in sports like boxing, football, ice or roller hockey, soccer, baseball, basketball and skiing. The CDC reports an average of 1.5 deaths per year from sports concussions. In most cases, a concussion, usually undiagnosed, had occurred prior to the final one.

Head Injury Prevention Tips

Buy and use helmets or protective headgear approved by the American Society for Testing and Materials (ASTM) for specific sports 100% of the time. The ASTM has vigorous standards for testing helmets for many sports; helmets approved by the ASTM bear a sticker stating this. Helmets and headgear come in many sizes and styles, and must properly fit to provide maximum protection against head injuries. In addition to other safety apparel or gear, helmets or headgear should be worn at all times for:

• Baseball and softball (when batting)
• Cycling
• Football
• Hockey
• Horseback riding
• Powered recreational vehicles
• Skateboards/scooters
• Skiing
• Wrestling

Headgear is recommended by many sports safety experts for:

• Martial arts
• Pole vaulting
• Soccer

Sports Tips

• Supervise younger children at all times, and do not let them use sporting equipment or play sports unsuitable for their age.
• Do not dive in water less than nine feet deep or in above-ground pools.
• Follow all rules at water parks and swimming pools.
• Wear appropriate clothing for the sport.
• Do not wear any clothing that can interfere with vision.
• Do not participate in sports when ill or very tired.
• Obey all traffic signals, and be aware of drivers when cycling or skateboarding.
• Avoid uneven or unpaved surfaces when cycling or skateboarding.
• Perform regular safety checks of sports fields, playgrounds and equipment.
• Discard and replace sporting equipment or protective gear that is damaged.

General Tips

• Wear a seat belt every time, whether driving or riding in a motor vehicle.
• Never drive while under the influence of drugs or alcohol, or ride as a passenger with anybody who is under the influence.
• Keep unloaded firearms in a locked cabinet or safe, and store ammunition in a separate, secure location.
• Remove hazards in the home that may contribute to falls. Secure rugs and loose electrical cords, put away toys, use safety gates and install window guards. Install grab bars and handrails for the frail or elderly.

Concussions and Head Injuries

The skull protects the brain against penetrating trauma, but does not absorb all the impact of a violent force. The brain is cushioned inside the skull by the surrounding cerebrospinal fluid. Despite this, an abrupt blow to the head, or even a rapid deceleration, can cause the brain to contact the inner side of the skull. There is a potential for tearing of blood vessels, pulling of nerve fibers and bruising of the brain.

Sometimes the blow can result in microscopic damage to the brain cells without obvious structural damage visible on a CT scan. In severe cases, the brain tissue can begin to swell. Since the brain cannot escape the rigid confines of the skull, severe swelling can compress the brain and its blood vessels, limiting the flow of blood. Without adequate blood flow, the brain does not receive the necessary flow of oxygen and glucose. A stroke can occur. Brain swelling after a concussion has the potential to amplify the severity of the injury.

A blow to the head can cause a more serious initial injury to the brain. A contusion is a bruise of the brain tissue involving bleeding and swelling in the brain. A skull fracture occurs when the bone of the skull breaks. A skull fracture by itself may not necessarily be a serious injury. Sometimes, however, the broken skull bones cause bleeding or other damage by cutting into the brain or its coverings.

A hematoma is a blood clot that collects in or around the brain. If active bleeding persists, hematomas can rapidly enlarge. Like brain swelling, the increasing pressure within the rigid confines of the skull (due to an enlarging blood clot) can cause serious neurological problems, and can even be life-threatening. Some hematomas are surgical emergencies. Hematomas that are small can sometimes go undetected initially, but may cause symptoms and require treatment several days or weeks later.

Warning Signs of a Serious Brain Injury

• Pain: Constant or recurring headache
• Motor dysfunction: Inability to control or coordinate motor functions or disturbance to balance
• Sensory: Changes in ability to hear, taste or see; dizziness; hypersensitivity to light or sound
• Cognitive: Shortened attention span; easily distracted; overstimulated by environment; difficulty staying focused on a task, following directions or understanding information; feeling of disorientation, confusion and other neuropsychological deficiencies
• Speech: Difficulty finding the “right” word; difficulty expressing words or thoughts; dysarthric speech

Seek immediate medical attention if any of these warning signs occur

Managing Concussions: The NFL Protocol

Because each player and each concussion is unique, there is no set timeframe for recovery and return to participation under the NFL’s current guidelines. The decision to return a player who has a concussion back to practice and games resides with the team physician managing the concussion protocols and is confirmed by an independent neurological consultant (INC), who is consulted specifically for the player’s neurological health.

After a player is diagnosed with a concussion, the protocol calls for a minimum of daily monitoring. The player’s past concussion exposure, medical history and family history are considered, creating a more complete picture of his health. The protocol progresses through a series of steps, moving to the next step only when all activities in the current step are tolerated without recurrence of symptoms. Communication between the player and the medical staff during the protocol is essential.

The first step is rest. During this time, in addition to avoiding physical exertion, the player is to avoid electronics, social media and even team meetings until he returns to his baseline level of signs and symptoms. The next step introduces light aerobic exercise, which takes place under the direct oversight of the team’s medical staff. If aerobics are tolerated, the team physician will reintroduce strength training. The fourth step includes some non-contact football-specific activities, and the fifth step, which is clearance to resume full football activity, comes only after neurocognitive testing remains at baseline and there is no recurrence of signs or symptoms of a concussion.

When the team physician gives the player final clearance, the player has a final examination by the INC assigned to his team. As part of this examination, the INC will review all reports and tests documented through the player’s recovery. Once the INC confirms the conclusion of the team physician, the player is considered cleared and is eligible for full participation in the next game or practice.

This protocol allows for players to heal at their own individual rates, includes the expertise of both the team physicians and a neurological consultant and specifically includes an assessment of not only the most recent concussion, but also takes into account the medical history of the player.

NCAA Concussion Update

The National Collegiate Athletic Association (NCAA) 2011-2012 Sports Medicine Handbook includes a section called “Concussion or Mild Traumatic Brain Injury (mTBI) in the Athlete,” which notes:

“In the years 2004 to 2009, the rate of concussion during games per 1,000 athlete exposures for football was 3.1; for men’s lacrosse, 2.6; for men’s ice hockey, 2.4; for women’s ice hockey, 2.2; for women’s soccer, 2.2; for wrestling, 1.4; for men’s soccer, 1.4; for women’s lacrosse, 1.2; for field hockey, 1.2; for women’s basketball, 1.2; and for men’s basketball, 0.6, accounting for between four and 16.2% of the injuries for these sports, as reported by the NCAA Injury Surveillance Program by the Datalys Center.”

The NCAA defines concussion or mild traumatic brain injury as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.”

The handbook also states, “NCAA member institutions must have a concussion management plan for their student-athletes on file with specific components as described in Bylaw 3.2.4.16 (see Guideline 2i).”

The NCAA Plan

• Requires that student-athletes receive information about the signs and symptoms of concussions. They also are required to sign a waiver that says they are responsible for reporting injuries to the medical staff.
• Mandates institutions to provide a process for removing a student-athlete that exhibits signs of a concussion. Student-athletes exhibiting signs of concussions must be evaluated by a medical staff member with experience in the evaluation and management of concussions before they can return to play.
• Prohibits a student-athlete with concussion symptoms from returning to play on the day of the activity.
• Requires student-athletes diagnosed with a concussion be cleared by a physician or a physician’s designee before they are permitted to return.

The signs of a concussion, according to the NCAA, are as follows:

• Amnesia
• Confusion
• Headache
• Loss of consciousness
• Balance problems
• Double or fuzzy vision
• Sensitivity to light or noise
• Nausea
• Feeling sluggish
• Concentration or memory problems
• Slowed reaction time
• Feeling unusually irritable

The NCAA handbook includes much more information on concussions starting on page 55. The NCAA also recommends viewing the National Athletic Trainers’ Association’s Heads Up video, which takes a closer look at the types of head injuries incurred and how they happen.

Additional Notes

Sports-related neurosurgical injuries were the focus of the November 2011 issue of the Journal of Neurosurgery. It included the results of a study of 451 patients about the mechanisms and consequences of head injuries referencing an anonymous survey that found that more than 46% of university soccer players experienced a concussion in just one fall season, and almost two-thirds of the same group experienced a concussion over the 12-month period while playing soccer. Another article described a new smartphone app designed for on-the-field concussion testing.

Help Fund Current and Future Research

The Neurosurgery Research and Education Foundation (NREF) is the philanthropic arm of the AANS. The NREF funds research into new and existing neurosurgical treatments, helping neurosurgeons save and improve lives every day.

If you would like to share a story of how your neurosurgeon helped you, please contact the NREF at [email protected]. To make a donation that supports neurosurgery research and education, visit www.nref.org.

Author Information

This page has been edited by Nitin Agarwal, MD, Rut Thakkar and Khoi Than, MD, FAANS

The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific neurosurgical advice or assistance should consult his or her neurosurgeon, or locate one in your area through the AANS’ Find a Board-certified Neurosurgeon”online tool.

Returning to Work After a Concussion

Lori Mercer is an Occupational Therapist who has been working with InMotion Health Centre since 2013. One of the skills that sets Lori apart is her extensive training and certification in concussion management. She is extremely passionate about promoting Brain Injury awareness and is dedicated to helping clients with a concussion get back work, school, and sports. Lori currently coordinates the concussion clinic at InMotion.

Lori shares her knowledge in this detailed post in order to better help direct those looking to return to work while recovering from a concussion.

“When can I go back to work?” This is typically the first question I get when I meet a client who has experienced a concussion. The answer to this question is different for everyone and depends on several factors which can include:

• The severity of your injury
• The type and severity of your symptoms
• The type of work you do
• The type of environment you work in 
• How well you manage your symptoms 

First, what is a concussion?

June is Brain Injury Awareness Month, so before I discuss returning to work, let’s chat about concussion (Spread the awareness!). A concussion is an injury to the brain, caused by a blow to the head or body, that causes the brain to bounce or twist within the skull. This sudden movement can damage cells and create chemical changes within the brain. These changes lead to a short-term disruption in how the brain normally functions. It is common to experience physical, cognitive, emotional, and/or sleep-related changes due to this disruption.

While your brain is recovering you may have less energy to be able to do the things you need and want to do. Some common symptoms you may experience after a concussion are:

• Fatigue
• Headache
• Nausea
• Dizziness
• Lightheadedness
• Sensitivity to noise or light
• Fogginess
• Feeling irritable or easily agitated
• Feeling nervous or anxious
• Sleep disruption
• Blurry vision
• Balance issues
• Poor concentration and memory

What do I do first? 

If you have experienced a concussion, the first thing you should do is follow up with your family doctor for medical evaluation. If any of your symptoms worsen, you experience vomiting, seizures, or notice an unusual change in your behavior then go to the hospital immediately.

After an injury, it is best to take 1-2 days off of work in order to allow your brain to rest and recover! Within the first 24-48 hours, both physical and cognitive rest are important. In the past, it was common to prescribe complete rest for up to a week for individuals who had experienced a concussion. The evidence for sustained periods of complete rest, however, is insufficient. Research is now identifying that avoiding stimulation and activity after a concussion may actually prolong your recovery. The most recent, evidence-based, recommendation that I follow for rest after a concussion comes from the 2017 consensus statement on concussion. This consensus was issued after the 5th international conference on concussion held in Berlin in October 2016: 

“After a brief period of rest during the acute phase (24–48 hours) after injury, patients can be encouraged to become gradually and progressively more active while staying below their cognitive and physical symptom-exacerbation thresholds (i.e., activity level should not bring on or worsen their symptoms)” (McCrory et al., 2017).

This is the approach that I recommend to my clients. After 1-2 days of rest, focus on slowly and gradually getting back into your day to day activities. When considering a return to work make sure you take it slow. Are your symptoms manageable? Are you able to complete tasks such as self-care, light housework, or use the computer at home? If yes, then try starting back to work on reduced hours and duties (provided you have medical clearance from your family doctor). I typically recommend starting at part time or less (e.g. 2-4 hours, 2-3 days per week) and progress as tolerated.

Starting back on reduced hours/duties will help you to work within your symptom-exacerbation threshold. Be sure to discuss possible ease back options and accommodations with your doctor and employer. When you do return to work remember to not overdo it or try to push through your symptoms. This will only hinder your recovery. 

How can I manage my symptoms once I return to work? 

Once you and your doctor have decided that you are ready to return to work, managing your symptoms and energy level should be your top priority. For my clients, I stress the importance of energy conservation. Learning to conserve energy is about finding a balance between work and rest that allows you to gradually increase your tolerance for activity. One way to remember how to conserve energy is to use the 4 P’s technique.

The 4 P’s are: Prioritize, Pace, Plan, and Position.

Here are some tips and things to consider when using the 4P’s to help with your return to work!

Prioritize – After a concussion your tolerance for activity may be decreased. When it comes to gradually returning to work, you need to think about how to prioritize the things you need to do during your day in order to manage your symptoms and energy effectively. Think about: 

• What absolutely needs to get done? 
• What tasks can wait for another day (e.g. responding to an urgent email vs cleaning out your desk)
• What tasks can wait until you are better?
• Can someone help you with what needs to get done, at work or at home?

Pace – Take your time! After a concussion, everyday tasks use up more of your energy than they did before. You may now need to pace the things you need and want to do throughout your day by balancing rest and activity. When pacing, some things to consider would be to:

• Take frequent rest breaks – A strategy I suggest is if you are completing a task and you experience an increase in symptoms (e.g. a headache, dizziness) stop and take a short break. Allow your symptoms to settle, and then try again. 
• Break it down! – Can the activity be broken down into smaller parts or spread throughout the work week? For example, instead of entering the entire company’s payroll Friday morning, consider completing a few entries here and there over the entire week? 
• Establish a daily routine that works best for you

Plan – Think ahead! What needs to be done? can I do it? how much time and energy will it take?. When planning your day: 

• Consider that it may take you longer to complete activities after a concussion than it did before. Give yourself extra time to get things done. 
• Plan to complete activities that require more energy during times when you feel at your best 
• Write it down – sometimes having a daily schedule or to-do list is helpful when planning out rest and activity (It can also be helpful for anyone experiencing issues with concentration and memory after a concussion) 
• Can heavier tasks be spread throughout the week?
• Ask for help! – Until you are back to full-time work you may need a co-worker to give you a hand with certain tasks. Sharing the workload will help you to conserve energy and manage your symptoms more effectively. Gradually increase your share of the work as tolerated. 

Position – Two important things to consider when returning to work are posture and your environment. After a concussion, sitting or standing for long periods of time, being hunched over a computer, or working in a loud, noisy environment can use up your energy quickly and cause increased symptoms. Some ways to reduce the impact of positioning are to: 

• Take frequent postural breaks throughout the day – Alternate between sitting and standing if possible. Get up and stretch, take an extra walk to the water cooler!
• Switch it up! – After a concussion, you may experience sensitivity to light, noise, or find it difficult to concentrate in busy environments. It is important to gradually build up your tolerance for these types of stimuli. To start building your tolerance, while managing your symptoms, try working at your desk for a while then switching to a quiet space. Alternate back and forth, gradually increasing the amount of time you spend at your desk. 
• Ask your employer if an ergonomic assessment is a possibility to ensure your posture and workspace set up is not impacting your recovery.
• If your job requires repetitive tasks such as lifting, carrying, bending or squatting, use the strategies above to manage your symptoms. Consider what tasks could be completed on another day or spread out over the work week. Could another employee assist you with the task until you are able to complete it on your own? Is there a way to simplify the task (e.g. using a wheeled cart to transport items instead of carrying them?)

What if I am not ready to return to work or I have returned and I am not feeling any better? 

As outlined above there may be several factors that impact your ability to return to work.  A concussion is a unique injury that affects everyone differently. Recovery times may vary but the majority of people will notice that their symptoms are gone after a few days. Some people, however (approximately 10 – 15%) may experience prolonged recovery and take longer to get back to work. 

If after the acute stage of recovery, 24-48 hours, you are not able to get out of bed, a return to work is not going to be your first priority. Start slow and set small goals for yourself (e.g. getting up and getting dressed, making breakfast, or going for a short walk). Progressing towards a return to work is more realistic when you can tolerate light activity at home. If you are struggling to manage your symptoms or to progress at work you may need further evaluation and intervention from a health professional who is trained in concussion assessment and rehabilitation. 

Feel free to contact our concussion clinic at InMotion to learn how an occupational therapist can help facilitate your return to work, help to treat/manage your symptoms and assist you on the road to recovery. 

Any other advice? 

Recovery at times may not be easy but it can be done. Set small realistic goals to achieve every day and you will begin to see a difference. Most of all be patient with yourself. Use energy conservations strategies and try to get a good night’s sleep! (Keep an eye out for a future blog on sleep hygiene after a concussion!)

June is Brain Injury Awareness month! #BIAM17

For more information on brain injury follow the Newfoundland Brain Injury Association on Facebook and Twitter (@nlbia)

You can also follow Lori Mercer on Twitter (@LoriMercer87) for posts on concussion management, acquired a brain injury, and mental health awareness/recovery.

What to do if you suspect a concussion: After Hours Kids: Physician Assistants

What is a concussion?

A concussion is a type of TBI (traumatic brain injury). They can be referred to as a “mild TBI” because they are not usually life-threatening.  Concussions occur when a hard hit to the head or body causes the brain to move in the skull.  The movement of the brain in the skull can cause injury to nerve cells within the brain.  This injury is an injury to the brain cells, and thus it is a microscopic injury.  This is why x-rays, CT scans, and MRI’s, are usually normal even when the child or teen has suffered a concussion.  X-rays are designed to look at bone and could help show a skull fracture, which is rarely present in a typical concussion. CT’s and MRI’s are helpful to look for brain swelling and bleeding, and these are also rarely ever present in a typical concussion.  Occasionally a CT or MRI would be indicated after a head injury, but thankfully, are not needed often.  When the brain cells are injured, it causes a cellular change.  This cellular change causes chemicals that are typically inside cells to leak out and those that are outside cells to come in.  There are also changes in the energy requirements and nerve transmission in these cells.  Basically, it causes the injured cells not to work as well, which in turn leads to the symptoms of a concussion worsening with activities that cause you to “use your brain” (i.e. thinking , communicating, physical activity, etc).

What symptoms would I see to indicate a concussion?

Below is what we tell our patients so that they can recognize a possible concussion after a head injury and remove themselves from the activity or play.  As we all know, after a head injury it is normal to have a headache or soreness to the site of a head injury.  Though pain at the site of the hit/injury is normal, it is NOT normal to have any of these symptoms:  feeling “dazed,” “seeing stars,” feeling like his/her “bell was rung,” dizziness, nausea or vomiting, feeling slowed down and foggy, feeling disoriented, having balance difficulty or trouble walking, having light or noise sensitivity, a headache that persists or worsens with cognitive effort, or difficulty with concentration or memory.  If any of these symptoms are present (even only momentarily) after a head injury (or injury to the body where the head moves back and forth rapidly), they should stop the activity or play and discuss symptoms with a parent, school nurse, coach, or athletic trainer.  These symptoms (one or more) are indicative of a concussion and evaluation is needed.

Watch for “red flags.”

Red flags should prompt a visit to the emergency room and include the following:

• Loss of Consciousness for greater than 1 minute
• Uneven muscle weakness or sensory loss
• Severe loss of balance (staggering or unable to stand/walk)
• Repeated vomiting
• Continued amnesia or confusion for over one hour
• Continued worsening and worsening of symptoms, such as headache, despite rest

Who can help?

After a potential concussion, it is very helpful to talk to a medical professional trained in concussions.  At school, this may be a school athletic trainer or nurse.  It is also important to consult your pediatrician’s office.   After Hours Kids (open every evening, including weekends, from 6:30-10:30 PM) is a great evening option for evaluation of a potential concussion.  After the concussion diagnosis is made, we often recommend follow-up with our concussion clinic, SportsSafe.  More concussion specific information can be found on their website at www.sportssafect.com 

How should we handle the first few days?

It is best to stay home from school until symptoms are improved in the morning and your child can awaken without a headache.  Also, we recommend no contact activities; it is very important to avoid any activity that may cause a re-injury.  A provider that specializes in pediatric concussions can offer guidance as to when it is safe to return to contact activities and can offer patient specific academic accommodations.  Until evaluated, it is important to get plenty of sleep at night, but it is not necessary to stay in a dark room and avoid all contact with people and activities.  Once symptoms are improved, keeping a usual routine as much as possible, is helpful to facilitate concussion recovery.  Quiet, non-contact activities, that do not worsen symptoms, are recommended (art, playing with legos, doing a puzzle, reading, etc).

More concussion specific information can be found on the SportsSafe blog at: www.sportssafect.com/blog

Author

AHK Advanced Practice Provders
Our AHK APP’s include: Annie Croft, Pam Dietrich, Erin Moore, and Nikki Nutter,

Is It Safe or Risky?

It’s common advice that you should not go to sleep if you have had a concussion. You may also have heard that you should wake up someone with a concussion every hour to check on them. But are those things true, or is it OK to sleep with a concussion?

Doctors say not allowing someone to fall asleep after a concussion and needing to wake someone hourly after one are myths. However, surveys have shown that many people still believe you should stay awake for 24 hours after hitting your head. In reality, sleep may be the best remedy.

Prostock-Studio / Getty Images

What Is a Concussion?

A concussion is a traumatic brain injury (TBI). When you take a blow to the head—from a fall, a hit, or being whipped back and forth in a car accident—your brain moves suddenly inside your skull, and it can actually twist or bounce around.

That kind of trauma stretches and changes neurons (types of brain cells) and can lead to disruptions in brain chemicals (neurotransmitters) that make it hard for your neurons to communicate with each other.

The Dangers of Repeat Concussions

A single concussion rarely causes permanent brain damage, but a second one soon after can be disabling, even if it’s not a strong concussion.

As far as TBI goes, concussions are considered mild. That’s primarily because they’re rarely life-threatening. Even so, they should always be considered a serious medical event because they cause an immediate, but temporary, change in mental status or level of consciousness.

Common symptoms of a concussion are:

• Headache
• Nausea or vomiting
• Confusion
• Temporary loss of consciousness
• Dizziness
• Blurred or double vision
• Ringing in the ears (tinnitus)
• Noise or light sensitivity
• Sleepiness
• Trouble concentrating
• Irritability or anxiety
• Mental fog
• Feeling “off” or “not right”
• Attention or memory problems

When Can You Sleep After a Concussion?

The concern about sleeping after you get a concussion comes from the belief that while you are asleep, you could slip into a coma or die. Sleeping itself can’t cause those things to happen, but it’s also impossible for anyone to notice signs of serious brain damage while you’re asleep.

So, while sleeping isn’t necessarily dangerous, it’s probably best to get medical attention before heading to bed for the night. That way, you’ll know for certain whether you have a concussion or if it could be something more serious.

Some doctors say you can let a potentially concussed person fall sleep if they are awake and able to hold a conversation and are not showing signs of a concussion, such as dilated pupils or trouble walking.

Others say you should get them checked out before letting them sleep, and some also recommend checking in a few times overnight to see if they’re breathing regularly, which doesn’t require waking them up.

Sleep-Related Symptoms

Concussions can cause some symptoms that are directly related to sleep. It’s common for someone with a concussion to feel tired or have a hard time staying awake within minutes of the injury, and symptoms may linger while they recover. 

Other symptoms may take a few days to show up or become apparent. One of those potential symptoms is a change in sleep patterns. Some people, after a concussion, will sleep a lot more than usual, and it may be hard to wake them up. Others may have a hard time falling asleep at all, or they may wake up frequently.

If you can’t rouse someone from sleep after a head injury, it could be a sign of something serious. Get immediate medical attention.

Tips for Getting Rest After a Concussion

Sleep is an important part of the healing process, so you should get plenty of rest after a concussion. However, after headaches, sleep problems are the most commonly reported symptoms of a concussion.

If you have sleep issues that linger after the first few days of healing, you may want to try the following to get better sleep:

• Keep a consistent schedule, even on days off.
• Have a bedtime routine that helps you relax.
• Set aside at least eight hours to sleep each night.
• If you’re not sleepy at bedtime, do something relaxing.
• Avoid naps or keep them short and early in the day so they don’t interfere with sleeping that night.
• Avoid caffeine, especially late in the day.
• Don’t use electronics right before bed or in the bedroom.

If your sleep problems don’t go away within a few weeks of the concussion, be sure to talk to your doctor about it.

When to See a Doctor

After any head injury, especially in a child or someone who’s had prior concussions, it’s a good idea to get checked out by a medical professional. If symptoms are absent or mild, you may want to go to urgent care or see if you can get an appointment with your regular doctor that day. Symptoms that are more serious warrant a trip to the emergency room.

When to Get Emergency Help

Call 911 or get the person to a hospital immediately after a head injury if they:

• Can’t be awakened
• Have one pupil that’s larger than the other
• Have a worsening or persistent headache
• Slur their speech
• Have weakness, numbness, or impaired coordination
• Vomit repeatedly
• Have convulsions or seizures
• Act confused or agitated
• Lose consciousness for any amount of time
• Behave in bizarre or unusual ways
• Become irritable or increasingly confused
• Feel tingly in their arms and legs
• Have a watery discharge from the nose or ears
• Have bloody discharge from the ears

Frequently Asked Questions

Why can’t you sleep after a concussion?

Actually, you can sleep after a concussion. It’s a mistaken belief that you have to stay awake for the first 24 hours.

How long should you wait to sleep after a concussion?

There’s no set time that you should wait to sleep after a concussion. However, it’s a good idea to stay awake long enough to get checked out by a doctor. It is important to catch signs of serious brain damage quickly, and that can’t happen while you’re asleep.

What happens if you sleep with a concussion?

Most likely, sleeping after you get a concussion will just mean you will get some rest that will help you recover. People used to believe you could slip into a coma or die if you went to sleep with a concussion, but we now know that’s not true.

Is difficulty sleeping a symptom of a concussion?

Yes, it can be hard to sleep after a concussion. It’s the second most frequently reported side effect, after headaches. Most of the time, it’s not an immediate symptom but one that may crop up during your recovery.

Summary

Sleeping isn’t dangerous when you have a concussion. You won’t slip into a coma or die if you go to sleep after getting a concussion. It’s safe for a concussed person to sleep if they are awake and can hold a conversation, and they don’t have obvious concussion symptoms.

A Word From Verywell

Any injury to your brain should be taken seriously. While the old beliefs about the dangers of sleep after a concussion are false, it is true that sleeping could conceal signs of a serious brain injury. If you suspect a concussion, it’s a good idea to get medical attention so you know for certain what’s going on and can start the proper treatment right away.

Once it’s confirmed that you’ve had a concussion, though, it’s time to allow for plenty of sleep so the body’s natural healing process can begin.

Think You Have a Concussion? What To Do Here Is What To Do

A concussion is a type of brain injury that occurs when excessive force or trauma is applied to the head. Millions of concussions occur in children, adolescents, and adults every year in the United States. Concussions can occur when engaging in strenuous physical activities, such as high-contact sports, or from a vehicle accident. However, concussions also frequently occur from falling during normal life activities. Concussions can be mild or quite severe, and if left untreated, can cause further health problems. While most people fully recover from the effects of a concussion, it is always important to take it seriously and receive professional medical care.

What Are the Symptoms of a Concussion?

The exact symptoms of a concussion will vary by person and the severity of the injury. It is important to note that some symptoms may not manifest right away and could take up to several days to appear. If you suspect you or a loved one may have a concussion, look for signs of the following symptoms:

• Headache
• Blurred vision
• Dizziness
• Confusion and/or memory loss
• Fatigue
• Nausea and/or vomiting
• Increased sensitivity to light and sound
• Poor balance
• Sleep disruption
• Slurred speech
• Ringing in the ears
• Numbness in limbs
• Unusual behavior

What to Do If You Suspect a Concussion

If you or a loved one has received a potentially traumatic blow to the head and you suspect a concussion is possible, there are several important first steps to take. First, it is important to cease any activities that could cause further harm or put you at risk, such as continued physical activity or driving a car. Second, you should not be left alone during the first 24 hours after the injury. Many symptoms will not manifest right away and it is important not to risk the loss of consciousness or sudden illness while alone.

It is always wise to seek out an evaluation by a medical professional after a head injury, even if you suspect the damage is mild. A medical professional will be able to evaluate and determine any potential complications you may face based on your personal medical history. Intentional rest and a break from everyday activities should begin even before seeking medical help. If symptoms appear to be more severe, seek emergency medical care immediately. Receiving a medical evaluation is especially important for young children as they may not be able to accurately communicate symptoms they are experiencing.

How Is a Concussion Diagnosed?

There is no singular test to determine a concussion. Your doctor will evaluate your particular injury, symptoms, and medical history to determine a diagnosis and treatment. In the case of a more traumatic injury, the doctor may request an MRI or CT scan to ensure there is no severe damage to the brain. If there is any bleeding or swelling of the brain, surgery or other more intense treatment may be required. A doctor may also examine your neck and spine to rule out any additional injuries.

How Is a Concussion Treated?

Just as there is no singular test for a concussion, there is no singular treatment. Your doctor will outline a treatment plan to address your specific injury and symptoms. Follow up with your doctor during your recovery if symptoms worsen or you are not seeing improvement.

Rest, both physical and mental, is one of the primary treatments for any concussion. Your brain needs time to recover and heal. Allow for plenty of sleep at night and takes naps during the day, if needed. Minimize any mental strain by avoiding activities such as reading, looking at screens, studying, and driving. Stay in tune with your body and work to identify and minimize triggers that cause your symptoms to increase or worsen. If you are working or a student, your doctor may recommend taking some time off to recover. If a repeat injury occurs before your original concussion has healed, the symptoms and lasting damage may increase. Athletes should be cleared by a doctor before resuming participation in training or playing.

Medications may be used to control headaches or nausea. However, it is crucial to consult with your doctor before taking any over-the-counter medication, as some medications may cause symptoms to worsen.

How Can You Prevent the Risk of Concussion?

Image via Flickr by RRaiderstyle

There are many simple things you can do to prevent the risk of concussion. If you are participating in sports or recreational activities that could lead to an injury, make sure you are wearing all appropriate protective equipment. You should always wear helmets or other protective headgear for activities like cycling or snowboarding. Wearing a seatbelt, utilizing childproof gates around stairwells, maintaining proper lighting, and keeping floors clean and free of obstructions are a few examples of basic things you can do in everyday life to reduce the risk of accidents and injury. Many concussions are due to falling, so reducing distractions, such as headphones or screens, and being aware of your surroundings may reduce your risk of an accident occurring. Regular exercise, adequate sleep, and staying hydrated are always a good idea for increasing body strength, mental focus, and overall health.

What Are the Long-Term Effects of a Concussion?

Most concussions heal within a few days or weeks, but sometimes lasting complications may occur. Post-concussive syndrome is when symptoms of the concussion, such as headaches, nausea, fatigue, or trouble sleeping continue past the typical point of recovery. Vertigo is another common side effect of a concussion or head injury that may last for several months. A person experiencing post-concussive syndrome may show signs of change in temperament, such as anxiety, depression, or irritability. Mental health is as important as physical health, so it is imperative not to ignore these symptoms and seek professional help.

If you are concerned that you or a loved one are experiencing signs of post-concussive syndrome, contact us today for an evaluation. The experts at NeuroHealth Arlington Heights are experienced in evaluating and treating concussions and are ready to help you reach a full recovery.

90,000 Concussion – (Clinic Di Center)

Traumatic brain injury: danger, consequences, treatment

Concussion ranks first among all brain injuries. Moreover, in women, it is more common. Although, perhaps, they seek professional help more often than men.

It would seem that there is little threat to our brain, because it is protected like no other organ. It is washed by a special fluid, which not only provides the brain with additional nutrition, but also serves as a kind of shock absorber.The brain is covered with several membranes. After all, it is safely “hidden” in the skull. However, head injuries very often result in serious brain problems for a person.

All traumatic brain injuries are divided into open and closed .

Opened
Injuries that damage the soft tissues of the head (skin, subcutaneous tissue, fascia) and the bones of the skull are called. Closed
injuries are somewhat less dangerous, but still unpleasant.They, in turn, are divided into concussion , its contusion and compression . Concussion ranks first among all brain injuries. Moreover, according to the observation of traumatologists, it is more common in women. Although, perhaps, they simply seek professional help more often than men.

Reasons

Concussion can occur as a result of impacts, bruises and sudden movements such as acceleration or deceleration, such as falling.Concussions are usually caused by road traffic accidents, domestic, sports and work injuries, as well as injuries resulting from street fights.

What’s going on?

What exactly happens as a result of a concussion to our brain, doctors still find it difficult to answer unequivocally. After all, if you examine the injured brain with the help of computed tomography, then practically no organic disorders can be detected.Most likely, as a result of a concussion, certain problems arise with the functioning of the nerve cells of the brain. In this case, their nutrition may deteriorate, there may be a slight displacement of the layers of brain tissue and the connection between some brain centers may go wrong.

A severe concussion can rupture blood vessels and severely injure certain parts of the brain. The main danger in traumatic brain injuries is intracranial bleeding, since the leaked blood is capable of squeezing and saturating the brain structures, disrupting their work and vitality.In addition, trauma can lead to another formidable complication – cerebral edema. Brain injuries complicated by shock and injuries affecting the brainstem, where breathing and blood pressure are regulated, are especially severe.

How to recognize?

After an injury, a person often loses consciousness. This can last from a few seconds to several minutes. The time spent in this condition can be one indicator of the severity of the concussion.The extreme degree of loss of consciousness is a coma.

With a concussion, a person often does not understand where he is, what happened, and hardly recognizes the people around him. Another important sign by which one can judge the severity of brain damage is memory loss: does a person remember the moment of injury, and if not, how much of the time before the injury fell out of his memory. The larger the memory lapse, the more serious the injury.

When the victim regains consciousness, he may vomit and vomit.Often he turns pale, his head is spinning and aching, his ears are noisy, it is difficult for him to focus his gaze, his breathing becomes rapid, and his pulse jumps. In the first hours after a concussion, the victim’s pupils are dilated or narrowed – a traumatic brain injury of any severity leads to disruption of the nerve pathways responsible for the functioning of the eyes. Surely in the movies you have seen more than once how, when examining a person who is unconscious, the doctor directs the flashlight beam into the victim’s eyes. This is done to determine the reaction of the pupils.With a mild concussion, the pupils react to light, but sluggishly, and with a severe concussion, there is no reaction at all. At the same time, the expansion of only one of the pupils and the lack of reaction in the second is a formidable symptom and may indicate severe damage to one of the cerebral hemispheres.

What to do?

If a concussion is suspected, first aid should be given to the victim. To begin with, you need to provide the person with complete peace, put him on a bed in a quiet darkened room.It is better to slightly raise the head. It is very helpful to apply cold compresses to the head. Drinking a lot in case of concussion is not recommended. If the victim is thirsty, make him sweet tea. Alcohol is strictly contraindicated for him!

And, of course, be sure to call a doctor, as it is possible that the brain damage is more severe than meets the eye. If the patient is in shock, carefully monitor his breathing and pressure before the ambulance arrives. In an emergency, start artificial respiration and chest compressions.

Diagnosis

With a concussion, you need to see a traumatologist. He will examine and interview the patient, check reflexes, prescribe an X-ray of the skull and, if a more complex brain damage is suspected, refer him to a neurologist for consultation. There the patient will have a full-scale examination: electroencephalography (EEG), echoencephalography, computed or magnetic resonance imaging of the brain, Doppler ultrasonography of the cerebral vessels, spinal puncture.Magnetic resonance imaging of the spine may be needed to rule out spinal problems.

Treatment

Patients with concussion should stay in bed for at least a few days. In this case, you cannot read, listen to loud music and watch TV. It is necessary to follow all the instructions of the doctor, carefully take the medications prescribed by him. With a concussion, the general condition of the victims usually returns to normal during the first, less often – the second week after the injury.

It must be remembered that a person who has suffered even a mild concussion may develop post-traumatic neurosis or other more serious complications, such as epilepsy. Therefore, some time after recovery, you should definitely visit a neurologist and undergo electroencephalography. Treatment for more serious head injuries depends on the severity of the injury. In some complicated cases, the help of neurosurgeons may be required.

How to recognize a concussion?

14 July 2019

Concussion can be obtained from an unsuccessful fall or impact.With such an injury, the work of the reticular activating system, which is responsible for consciousness, information processing, for sleep and awakening, is disrupted.

A person may not immediately understand that a concussion has occurred – symptoms may appear after a few days or even weeks, so it is imperative to provide first aid and consult a doctor to rule out brain contusion, hemorrhage and edema, which are more dangerous consequences of a head injury.

Degrees of concussion

Depending on the severity of the blow and the circumstances, the degree of concussion is determined:

1. Concussion of the first degree – already 20 minutes after the injury, the person feels well.
2. Concussion of the second degree – after the impact, the person is disoriented for more than 20 minutes.
3. Concussion of the third degree – a person loses consciousness and does not remember the moment of injury.

Possible shaking symptoms

• Brief confusion or loss of consciousness.With a strong blow, the moment of injury falls out of memory.
• Dizziness, even at rest, and when turning, bending or other changes in body position, the symptom intensifies.
• Severe headache, nausea and vomiting.
• Double vision, inability to concentrate on one point.
• Increased sensitivity to light and sound.
• Movement coordination disorder.
• Inhibition of reaction – the victim gives an answer to the question after a while.
• Skin pallor, weakness, sweating.

Important! Concussion is not always accompanied by visible damage to the head, so the absence of wounds does not exclude brain injury.

First aid for concussion

1. If you have one or more symptoms, immediately call an ambulance or take the victim to a doctor.
2. Treat a head wound if it appeared on impact.
3. For an hour or before the doctor arrives, it is important not to fall asleep, but to be at rest.
4. In case of loss of consciousness, lay the person on his side, bend his knees, and put his hands under his head.
5. If concussion symptoms do not appear immediately, it is recommended to rest and not engage in vigorous activity.

Recommendations for concussion treatment

If hospitalization is not required, mild concussion can be treated at home with medical approval:

1. Bed rest and rest, no work required. A long sleep is very important.
2. You cannot read, watch TV, play computer games or use gadgets.
3. Under no circumstances should you go in for sports.
4. It is allowed to listen to music, but not through headphones.
5. Herbal sedative drops or herbal infusions can be used.
6. In the diet, it is worth giving preference to dairy and plant products, limiting salt intake – to prevent an increase in pressure, including intracranial pressure.

If the patient has promptly sought medical help, and all recommendations have been followed, recovery will come quickly and without complications.

90,000 How do doctors define a concussion?

A concussion is a mild traumatic brain injury. After a concussion, the tissues remain intact, but there are violations of the brain at the chemical level. As a result, a person’s consciousness becomes confused – he can forget the very moment of the impact or what came before it.

Usually, a concussion is accompanied by severe dizziness, soreness, loss of orientation in space, nausea, and even vomiting.In the future (after hours or even days), problems with speech, balance, memory, concentration, reaction, sleep, vision, changes in mood and behavior may appear, an increased sensitivity to light and noise may appear.

How is a concussion defined?

If you suspect a concussion, you need to seek medical help. He will conduct tests that will show the presence of a pathological condition. To determine whether the injury affected the coordination of movement, a finger-nose test is performed.To do this, the person must extend his hand forward, and then touch his nose with his index finger.

If a person is unconscious, he is not moved until a special protective bandage is put on. Since he may have a serious injury to the spine or neck.

In some cases, it is necessary to perform a computed tomography or magnetic resonance imaging to understand if there is serious damage.

Tomography is prescribed in the following cases:

• for suspected skull fracture
• vomiting more than 2-3 times
• Memory loss affects extended episodes
• injury received as a result of a road traffic accident
• there was a fall from at least a meter height or more than 5 steps
• severe headache

90,087 people are intoxicated with drugs or alcohol

You can make an appointment with a doctor in Krasnoyarsk by calling the private clinic “Medyunion” 201-03-03.

Head injuries

Head injury occurs when the head is struck against a surface and is often accompanied by damage to the skull and brain. Closed craniocerebral trauma is subdivided into:

• brain injury
• concussion
• brain compression

There are many symptoms of traumatic brain injury. Minor injuries cause mild or no symptoms, while severe injuries will cause serious bodily distress.If the patient does not observe any consequences after a blow to the head, then it is enough for him to rest at home. In some cases, the symptoms do not appear immediately, so you need to observe yourself for the first 2 days. At this time (at least 24 hours), try to give up physical exercise, driving a car, and operating equipment. You should also refrain from drinking alcoholic beverages and taking medications with a sedative effect.

For a minor head injury, the patient can take pain medication (if prescribed by the doctor) and be at rest.The first 24 hours, as described above, are very important and indicative of the patient’s condition. Others need to carefully observe changes in the patient’s behavior, and during sleep, wake him up every 2-3 hours, asking questions. This, at first glance, inhumane measure will help to check how confused his mind is.

Symptoms after TBI, in which an urgent need to see a doctor:

• Loss of consciousness
• Anxiety, slurred speech
• Convulsions
• Weakness in the legs and arms
• High temperature
• Frequent vomiting
• Increased headache (despite taking analgesics)
• The appearance of fluid or blood from the nose, mouth, ears (it is recommended not to blow your nose)
• Neck pain and stiffness (increased tone) of the occipital muscles
• Dizziness, blurred vision
• And others

If, after a head injury, the symptom indicates an increase in intracranial pressure, then the patient must be urgently hospitalized, in case of serious injuries, he can also be taken to the intensive care unit (ICU).

90,000 Concussion in a child

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Young children love active games: run, jump, ride bicycles, spend time on fun rides and climb interesting places. However, these activities can turn into danger if children accidentally and carelessly hit their heads.Unfortunately, falls often result in a concussion.

How to define a concussion in a child?

Key features to look out for:

• Memory impairment and loss of consciousness. A school-age child has forgotten the events that happened to him before or after the injury, as well as the incident itself, which resulted in a concussion.In babies, this symptom is more difficult to identify, or it remains unnoticed. Recovery of consciousness can lead to screaming or crying.
• Nausea and vomiting. This manifestation does not depend in any way on food intake. In small children, sudden repeated regurgitation is observed.
• Headache. The child complains of dizziness, regardless of the position of the body. In the toddler category, there may be tearfulness, mood swings, and irritability. Children become very sensitive to noise and light.
• Sleep disturbance. The child experiences increased or decreased sleepiness and insomnia.

Signs of concussion on close examination:

• increase in body temperature to 38 degrees
• pallor
• chills
• increased sweating
• heart rate fluctuation
• blurry vision

Symptoms of a concussion do not appear immediately, but only after 1–1.5 hours.At such times, it is extremely important to monitor your baby after hitting his head or falling.

First aid for concussion

• Place the child on a horizontal surface: sofa, bed, etc. If you suspect a spinal injury, the patient should be left alone and in no case should he be moved, picked up or tried to sit down!
• If damage to the soft tissues of the head is observed, a bandage should be applied and cold applied for a few minutes.It is forbidden to give medications on your own!
• It is very important to remember whether the child had loss of consciousness after the concussion, how long it lasted and what symptoms appeared later. This will make it easier to make a correct diagnosis.

If you suspect a concussion, call an ambulance immediately! Do not expect the child’s condition to deteriorate!

What to do after the child is discharged from the hospital?

Once the child is at home, parents should follow these guidelines:

• take medications at the prescribed dosage;
• prevent your child from playing on the computer or watching TV;
• Provide maximum rest in physical and emotional terms for two to three weeks;
• Follow a light food diet
• to feed the baby in small portions about five times a day.
• Do not hit your head again.

If concussion symptoms recur again, seek medical attention!

Was 90,000 or not? Read 9 main signs

Diagnosing a concussion is quite difficult

Photos: GLOBAL LOOK PRESS

We know that a concussion can result in structural damage to the brain, causing depression afterwards, chronic headaches, difficulty with concentration and attention and more serious consequences.

However, its danger lies not only in this. The problem is that the signs of brain concussion may not always be obvious. They do not make themselves felt for days or even weeks, exacerbating the condition.

Concussion is difficult to diagnose and cannot be detected by MRI or CT. Symptoms play a key role here.

Noticing them in time, you can count on getting the fastest qualified assistance. In some cases, this can not only save you the unwanted effects of a concussion, but it can also save your life.

What symptoms should you look out for? The international portal Health has published the main ones.

YOU LOST CONSCIOUSNESS

If you faint even for a moment, you have a concussion. If you were alone and did not even realize that you passed out, but cannot remember how you ended up on the floor, you have a concussion. True, loss of consciousness does not mean that you received a severe concussion – and vice versa, even while remaining conscious, you could receive extremely dangerous injury.

BTW

In one of the surveys of three thousand men and women, 23% of them admitted that at least once in their life they had received a concussion.

YOU HAVE A HEADACHE THAT DOESN’T GO BY ITSELF

Does even a slight turn of the head cause severe pain? You must have a concussion. In this case, the headache is felt somewhat differently than usual: most often it is of a constant pressing character. The pain may increase in a horizontal position.

Conversely, when you get up, it becomes a little easier for you. Also, the headache can worsen during moments of mental or mental activity.

YOU HAVE SPINNING, LOSING BALANCE AND Nausea

Dizziness and loss of balance can be signs of a concussion – this is one of the symptoms that doctors can most easily diagnose.

If you feel dizzy and stumble when walking, you have a concussion.But even the slight feeling that you are not very stable on your feet can indicate brain damage.

In some cases, you may feel sick. After being hit, you may even be vomited. And these are also signs of a concussion.

YOUR CONSCIOUSNESS IS CLOSED

Feeling confused and clouded can be a sign of a concussion. This condition can be very pronounced. For example, you cannot find your way around where you are or how to get home.But it can also be implicit. You just may have problems comprehending any information.

If you are having trouble remembering or concentrating, or having difficulty planning your day, solving a simple problem, or making a decision, this may indicate brain damage.

OBJECTS SEE BLUR, AND BRIGHT COLORS CAUSE PAIN

If you find it difficult to focus, you probably have a concussion. Double vision and photosensitivity may be other symptoms.

If bright colors irritate you, it may also indicate concussion.

YOU ARE CONCERNED, ANGRY OR ARE UNUSUAL

Irritability, like other mental changes, can be signs of a concussion. They are not always easy to spot. After an injury, this reaction of the psyche may seem natural, because you are scared and shocked, but do not underestimate such conditions.

Watch yourself. Or ask someone close to you.If you are behaving in an unusual way, too aroused or, on the contrary, withdrawn, this can be a wake-up call.

YOU WANT TO SLEEP CONSTANTLY

Rebuilding the brain requires a lot of energy. Therefore, you can feel drowsiness, lethargy, you are constantly falling asleep. Now doctors no longer believe that a patient with a concussion should not be allowed to sleep. On the contrary, in the first 24 – 48 hours the brain simply needs rest.

But don’t be alone, ask someone close to be with you in case you develop signs of a life-threatening hematoma, such as loss of consciousness, difficulty waking up, severe headaches.

YOU SUFFER FROM SLEEP

One of the consequences of a concussion may be the inability to fall asleep, even if you are extremely tired.

Research shows that up to 90% of people with concussion suffer from insomnia.

AT THE END OF ENDS, YOU JUST FEEL YOU HAVE A CONCUSSION OF THE BRAIN

Trust your feelings and do not dismiss any symptoms when it comes to the brain. If you hit your head and think you have a concussion, you probably are.See a doctor immediately!

COMMENTARY OF THE SPECIALIST:

Leonid Plotsky, PhD, neurologist, doctor of the highest category:

– Any concussion is already a traumatic brain injury. A mild concussion is usually not a cause for concern. At best, after a couple of days, the workaholic rushes to work. On the offer to visit a doctor, she gives “weighty” arguments, such as “I don’t even have a lump.” Six months later, the weakened hero creeps up to the neurologist with complaints of a terrible headache, irritability and poor memory, unexplained fainting, and in special cases – epileptic seizures.

This is due to the adhesion processes in the cerebral cortex – they impede the uniform blood flow and oxygen delivery. A common complication is hypertensive syndrome. All of these may have to be treated for years. The most harmless consequence of trauma is that a person turns into a “barometer” and reacts to any natural fluctuations, suffers from pressure drops. In order not to bring the matter to a sad end – to the doctor at the first symptoms (details)

90 000 If a child is injured at school.

All children love to frolic, and if in the company, then injuries are guaranteed. If a student is active, then he will definitely not sit still and will lure others into his game. School injuries are not uncommon, but an abrasion on the knee is one thing, and a concussion is another. It is sometimes very difficult to determine who is to blame for the fight, and the punishment is not clearly prescribed by the legislation.

If a student is injured in an educational institution, then representatives of the school are responsible for this, but is it easier for the parents.Situations are different, as are bodily harm.

If a student has a bruise on his arm, do not call an ambulance and make a scandal. Your child will reconcile with the offender tomorrow, but your relationship will already be ruined both with the administration and with the parents of the mischievous person. You need to insist on an ambulance if the injuries are really serious, teeth are knocked out, the student is bleeding, or you see that he is behaving sluggishly.

In accordance with the Federal Law “On Education”, school employees are responsible for the life and health of a minor during his stay in an educational organization (in a lesson – a teacher, at recess – a teacher or administrator on duty).The principal is responsible for all students in the school.

In the event of injury to a child on school grounds or during the educational process, the share of the blame lies not only with the school staff, but also with the child himself.
Parents have the right to sue the school administration, but in this case they will need to prove that there was no direct fault in the actions of their child.

What should be the teacher’s actions if a student is injured in an educational institution?

• The first thing to do is report the incident and the nature of the injury to the school physician, school administration, and parents.Once everyone is notified, the child should be sent to the hospital if the injury is serious.

• The medical institution must issue a certificate of the nature of the damage, but this is not always the case, sometimes at the request of the police. In turn, the school administration must draw up an incident report and send it to the education department.

• It is worth noting that the medical staff of the educational institution should take all the care of the victim. First aid should be provided, the fact of injury is recorded and a preliminary diagnosis made if the injury is a serious physician calls an ambulance.Also, the physician must report the incident to the department of internal affairs.

As soon as information about the incident has arrived at the Department of Internal Affairs, the information is recorded in a special journal.

Parents should check this moment, if the school staff did not report the injury, then this should be done to the parents. Next, the police officer interviews the victim. It is established who caused the injuries, after that, the employee clarifies whether the parents of the victim want to bring the fighter to justice.After the interviews, the police officer sends a notification to the education department. The notification asks to take measures that will prevent child injuries and eliminate shortcomings in the work of the staff of the educational institution.