Concussions range in severity from mild to severe, but they all share one common factor —
they temporarily interfere with the way your brain works. They can affect memory, judgment,
reflexes, speech, balance and coordination.
Usually caused by a blow to the head, concussions don't always involve a loss of
consciousness. In fact, most people who have concussions never black out. Many people have
had concussions and not realized it.
Concussions are common, particularly if you play a contact sport like football. But every
concussion, no matter how mild, injures your brain. This injury needs time and rest to heal
properly. Luckily, most concussions are mild and people usually recover fully.
Signs and symptoms
The signs and symptoms of a concussion can be subtle and may not appear immediately.
Symptoms can last for days, weeks or longer.
The two most common concussion symptoms are confusion and amnesia. The amnesia, which
may or may not be preceded by a loss of consciousness, almost always involves the loss of
memory of the impact that caused the concussion.
Other immediate signs and symptoms of a concussion may include:
Ringing in the ears
Nausea or vomiting
Some symptoms of concussions don't appear until hours or days later. They include:
Mood and cognitive disturbances
Sensitivity to light and noise
Head trauma is very common in young children. But concussions can be difficult to recognize in
infants and toddlers because they can't readily communicate how they feel. Nonverbal clues of
a concussion may include:
Listlessness, tiring easily
Change in eating or sleeping patterns
Lack of interest in favorite toys
Loss of balance, unsteady walking
Your brain has the consistency of gelatin. It's cushioned from everyday jolts and bumps by the
cerebrospinal fluid that it floats in, inside your skull. A violent blow to your head can cause your
brain to slide forcefully against the inner wall of your skull. Even the sudden stop of a car crash
can bounce your brain off the inside of your skull. This can result in bleeding in or around your
brain and the tearing of nerve fibers.
Any blow to the head can cause a concussion. Falls and traffic accidents often involve
concussions, with or without other injuries. Without proper safety equipment and supervision,
student athletes may be at increased risk of concussions when playing football and other
contact sports. And anyone who has had a concussion in the past is at higher risk of having
concussions in the future
When to seek medical advice
While most concussions get better on their own, some blows to the head can cause more
serious injuries. You should seek medical advice if you have any of the following symptoms:
Prolonged headache or dizziness
Nausea or vomiting
Prolonged memory loss
Ringing in the ears
Loss of smell or taste
Any child who has lost consciousness after a blow to the head should be seen by a doctor.
Other warning signs of a potentially serious injury include persistent vomiting, seizures or a
large bruise on the scalp. In general, a bruise on the front of the head is less dangerous than
one on the side or back of the head.
Screening and diagnosis
Diagnosing a concussion is usually straightforward. If a blow to your head has knocked you out
or left you dazed, you've had a concussion. It's more difficult, however, to determine whether
the blow has caused potentially serious bleeding or swelling in your skull. Signs and symptoms
of these injuries may not appear until hours or days after the injury.
Your doctor may start your evaluation with questions about the accident, then proceed to a
neurological exam. This exam includes checking your memory and concentration, vision,
hearing, balance, coordination and reflexes.
The standard test to assess post-concussion damage is a computerized tomography (CT) scan.
A CT scanner takes multiple cross-sectional X-rays and combines all the resulting images to
produce detailed, two-dimensional images of your skull and brain. During the procedure, you lie
still on a table that slides through a large, doughnut-shaped X-ray machine. The scan is
painless and generally takes less than 10 minutes.
Not every concussion requires a CT scan, but the test is usually done as a precaution if there's
a chance your injury is more severe than your immediate condition suggests. You're more likely
to need a scan if you:
Are younger than 16 or older than 64
Fell from a height of more than three feet
Had a motor vehicle accident
Are under the influence of alcohol or drugs
Are unable to recall the accident for more than 30 minutes after it occurred
Have persistent trouble with short-term memory — that is, retaining new information —
after you've completely regained consciousness
Had a seizure
Suffered bruises, scrapes or cuts on your head and neck
Fractured your skull
You may need to be hospitalized overnight for observation after a concussion. If your doctor
says it's OK for you to be observed at home, someone should check on you periodically for at
least 24 hours. You may need to be awakened every two hours to make sure you can be
roused to normal consciousness.
Postconcussion syndrome, a poorly understood complication, causes concussion symptoms to
last for weeks or months. People who have had a concussion also double their risk of
developing epilepsy within the first five years after the injury.
There also is evidence that people who have had multiple concussions over the course of their
lives suffer cumulative neurological damage. A link between concussions and the eventual
development of Alzheimer's disease also has been suggested.
Rest is the best recovery technique. Healing takes time. For headaches, acetaminophen
(Tylenol, others) or ibuprofen (Advil, Motrin, others) can be used. Avoid aspirin, as it can
increase the risk of bleeding.