Concussion

A concussion is an injury to the brain. It’s caused when something hits you on the head, or when you hit your head against something. This action causes the brain to knock against the hard bony surface inside the skull. Concussion is also sometimes called a mild traumatic brain injury, or TBI.

Symptoms

A concussion can sometimes cause a loss of consciousness, but not always. You may not remember the event, or what happened before or after the event.

You may also have confusion or difficulty concentrating. You may have dizziness, headache, nausea, and vomiting. You may feel a loss of balance or have mild problems with your coordination.

Symptoms last for a few days at most and show steady improvement over a short time.

Diagnosis

Loss of consciousness, memory loss, or confusion after a head injury may be enough to diagnose concussion. But many people have a concussion without ever losing consciousness. Your healthcare provider will ask you some questions about how the injury happened and where you hit your head.

In the emergency room, a measure called the Glasgow Coma Scale can help to predict the level of brain injury after a head trauma. This scale looks at your status by checking how awake you are, if you are able to speak and answer questions correctly, and whether you can move various parts of your body on command.

Diagnosis of a head injury usually includes a neurological exam. Your healthcare provider will check to see how well your nervous system is working. You may have tests to check see how well you are thinking and to check your balance. Some people with a concussion will have normal results.

If your exam shows certain problems, such as trouble with your vision, your provider may recommend other tests. These can include imaging studies such as a C-T scan or M-R-I scan. Some people with a concussion will have normal C-T or M-R-I results. If your symptoms get worse, C-T and M-R-I scans may help to guide your treatment.

Treatment

Treatment for concussion includes plenty of rest and careful observation. You should not be left alone for the first day or so. You need to be checked on every couple of hours for the first 24 hours or until you are feeling normal again. Most people with a concussion can be safely watched at home.

You will need to be watched for signs and symptoms such as:

  1. A headache that gets worse
  2. Repeated vomiting
  3. Confusion that gets worse
  4. Increasing drowsiness
  5. An inability to be wakened from sleep
  6. Muscle weakness on one or both sides of your body
  7. Difficulty walking
  8. Unequal pupil size or abnormal eye movements, or
  9. Violent movements of the body known as convulsions

These symptoms may be evidence of a head injury with increasing pressure from swelling and bleeding. Have someone call 9-1-1 right away if you have any of these signs or symptoms.

While you are resting at home, certain treatments can help. Medications like acetaminophen can be helpful for headache. Your healthcare provider may tell you not to take pain relievers such as aspirin or other nonsteroidal anti-inflammatory drugs like ibuprofen because they can increase the risk for bleeding in the brain. Putting an ice pack on the injured area may also help with pain. If you are nauseated, stick to small amounts of food or fluids.

Vigorous activity can make a headache worse.  Keep your activity light and get plenty of rest. Avoid medicines or substances that cause drowsiness or changes in your level of consciousness. These include narcotic pain medicines, alcohol, sleeping pills, muscle relaxants, tranquilizers, or recreational drugs. They can hide important symptoms that may show that you’re getting worse after a concussion.

Things to Remember

  • A concussion does not always cause loss of consciousness.
  • Symptoms should get better within a short time.
  • Most people with a concussion can be safely watched at home.

What We Have Learned

  1. Concussion can sometimes cause memory loss. True or False?
    The answer is True. There may be no memory of the event, or before or after it.

  2. Concussion is a kind of traumatic brain injury (TBI). True or False?
    The answer is True. Another name for concussion is mild TBI.

  3. It is safe to be alone after a concussion. True or False?
    The answer is False. Someone should check on you every few hours for the first 24 hours or until you start feeling back to normal.