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Concussion

Concussion (Traumatic Brain Injury)

A concussion occurs when the head sustains a hard blow and the impact jars or shakes the brain inside the skull, interrupting the brain's normal activities. Although there may be cuts or bruises on the head or face, there may be no other visible signs of a brain injury.

Symptoms of a concussion can include any of the following changes in the person's level of consciousness, such as:

  • Loss of consciousness.
  • Inability to remember what happened immediately before or after the injury (amnesia).
  • Confusion.
  • Asking the same question over and over.
  • Dizziness, vertigo, lightheadedness, or unsteadiness.
  • Blurred or double vision.
  • Ringing in the ears (tinnitus).
  • Changes in personality.
  • A decreased ability to talk or feed himself or herself.
  • Changes in how well a child is able to do physical activities, such as increased unsteadiness that makes it hard for the child to walk or stand.
  • In a small child, increased fussiness or lack of energy.
  • Ongoing headaches.

Symptoms of a concussion can be mild to severe, depending on the severity of the injury. If the injury is more serious, symptoms will usually develop within the first 24 hours after the accident. Symptoms may last for days, weeks, or even months following the injury.

  • Symptoms

    What are the symptoms of a concussion?

    It is not always easy to know if someone has a concussion. You don't have to pass out (lose consciousness) to have a concussion.

    Symptoms of a concussion range from mild to severe and can last for hours, days, weeks, or even months. If you notice any symptoms of a concussion, contact your doctor.

    Symptoms of a concussion fit into four main categories:

    Thinking and remembering.
    • Not thinking clearly
    • Feeling slowed down
    • Not being able to concentrate
    • Not being able to remember new information
    Physical.
    • Nausea and vomiting
    • Headache
    • Fuzzy or blurry vision
    • Dizziness
    • Sensitivity to light or noise
    • Balance problems
    • Feeling tired or having no energy
    Emotional and mood.
    • Easily upset or angered
    • Sad
    • Nervous or anxious
    • More emotional
    Sleep.
    • Sleeping more than usual
    • Sleeping less than usual
    • Having a hard time falling asleep

    Symptoms in young children

    Young children can have the same symptoms of a concussion as older children and adults. But sometimes it can be hard to tell if a small child has a concussion. Young children may also have symptoms like:

    • Crying more than usual.
    • Headache that does not go away.
    • Changes in the way they play or act.
    • Changes in the way they nurse, eat, or sleep.
    • Being upset easily or having more temper tantrums.
    • A sad mood.
    • Lack of interest in their usual activities or favorite toys.
    • Loss of new skills, such as toilet training.
    • Loss of balance and trouble walking.
    • Not being able to pay attention.

    Symptoms in older adults

    Concussions in older adults can also be dangerous. This is because concussions in older adults are often missed. If you are caring for an older adult who has had a fall, check him or her for symptoms of a concussion. Signs of a serious problem include a headache that gets worse, increasing confusion, or both. See a doctor right away if you notice these signs. If you are caring for an older adult who takes a blood thinner and who has had a fall, take him or her to a doctor right away, even if you don't see any symptoms of a concussion.

    Postconcussive syndrome

    Sometimes after a concussion you may feel as if you are not functioning as well as you did before the injury. This is called postconcussive syndrome. New symptoms may develop, or you may continue to be bothered by symptoms from the injury, such as:

    • Changes in your ability to think, concentrate, or remember.
    • Headaches or blurry vision.
    • Changes in your sleep patterns, such as not being able to sleep or sleeping all the time.
    • Changes in your personality such as becoming angry or anxious for no clear reason.
    • Lack of interest in your usual activities.
    • Changes in your sex drive.
    • Dizziness, lightheadedness, or unsteadiness that makes standing or walking difficult.

    If you have symptoms of postconcussive syndrome, call your doctor.

  • Causes

    What causes a concussion?

    Your brain is a soft organ that is surrounded by spinal fluid and protected by your hard skull. Normally, the fluid around your brain acts like a cushion that keeps your brain from banging into your skull. But if your head or your body is hit hard, your brain can crash into your skull and be injured.

    There are many ways to get a concussion. Some common ways include fights, falls, playground injuries, car crashes, and bike accidents. Concussions can also happen while participating in any sport or activity such as football, boxing, hockey, soccer, skiing, or snowboarding.

  • Prevention

    How can you help prevent a concussion?

    To reduce your chances of getting a concussion:

    • Wear a seat belt every time you drive or ride in a car or other motor vehicle.
    • Never drive when you are under the influence of drugs or alcohol.
    • Make your home safer to prevent falls.

    Wear a helmet for any activity that can cause a fall or impact to the head or neck. Examples include bike riding, football, baseball, ATV riding, skateboarding, skiing, snowboarding, inline skating, and horseback riding. Helmets help protect your skull from injury. But brain damage can occur even when a helmet is worn.

    To reduce your child's chances of getting a concussion:

    • Use child car seats and booster seats correctly.
    • Teach your child bicycle safety.
    • Teach your child how to be safe around streets and cars.
    • Keep your child safe from falls.
    • Teach your child playground safety.
    • Help your child prevent injury from sports and other activities.
  • Diagnosis

    How is a concussion diagnosed?

    Any person who may have had a concussion needs to see a doctor. If a doctor thinks that you have a concussion, he or she will ask questions about the injury. Your doctor may ask you questions that test your ability to pay attention and your learning and memory. Your doctor may also try to find out how quickly you can solve problems. He or she may also show you objects and then hide them and ask you to recall what they are. Then the doctor will check your strength, balance, coordination, reflexes, and sensation.

    Neuropsychological tests have become more widely used after a concussion. These tests are only one of many ways that your doctor can find out how well you are thinking and remembering after a concussion. These tests can also show if you have any changes in emotions or mood after a concussion.

    Sometimes a doctor will order imaging tests such as a CT scan or an MRI to make sure your brain is not bruised or bleeding.

  • Treatment

    How is a concussion treated?

    Right away

    After being seen by a doctor, some people have to stay in the hospital to be watched. Others can go home safely. If you go home, follow your doctor's instructions. He or she will tell you if you need someone to watch you closely for the next 24 hours or longer.

    In the days or weeks after

    Some people feel normal again in a few hours. Others have symptoms for weeks or months. It is very important to allow yourself time to get better and to slowly return to your regular activities. If your symptoms come back when you are doing an activity, stop and rest for a day. This is a sign that you are pushing yourself too hard. It is also important to call your doctor if you are not improving as expected or if you think that you are getting worse instead of better.

    Rest is the best way to recover from a concussion. You need to rest your body and your brain. Here are some tips to help you get better:

    • Get plenty of sleep at night, and take it easy during the day.
    • Avoid alcohol and illegal drugs.
    • Do not take any other medicines unless your doctor says it is okay.
    • Avoid activities that are physically or mentally demanding (including housework, exercise, schoolwork, video games, text messaging, or using the computer). You may need to change your school or work schedule while you recover.
    • Ask your doctor when it's okay for you to drive a car, ride a bike, or operate machinery.
    • Use ice or a cold pack on any swelling for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
    • Use pain medicine as directed. Your doctor may give you a prescription for pain medicine or recommend you use a pain medicine that you can buy without a prescription, such as acetaminophen (for example, Tylenol).

    Concussion and sports

    A person who might have a concussion needs to immediately stop any kind of activity or sport. Being active again too soon increases the person's risk of having a more serious brain injury. Be sure to see a doctor before returning to play.

  • Self-Care

    How can you care for a concussion?

    Pain control

    • Put ice or a cold pack on the part of your head that hurts for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
    • Be safe with medicines. Read and follow all instructions on the label.
      • If the doctor gave you a prescription medicine for pain, take it as prescribed.
      • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

    Recovery

    • Follow your doctor’s instructions. He or she will tell you if you need someone to watch you closely for the next 24 hours or longer.
    • Rest is the best way to recover from a concussion. You need to rest your body and your brain:
      • Get plenty of sleep at night. And take rest breaks during the day.
      • Avoid activities that take a lot of physical or mental work. This includes housework, exercise, schoolwork, video games, text messaging, and using the computer.
      • You may need to change your school or work schedule while you recover.
      • Return to your normal activities slowly. Do not try to do too much at once.
    • Do not drink alcohol or use illegal drugs. Alcohol and illegal drugs can slow your recovery. And they can increase your risk of a second brain injury.
    • Avoid activities that could lead to another concussion. Follow your doctor’s instructions for a gradual return to activity and sports.
    • Ask your doctor when it’s okay for you to drive a car, ride a bike, or operate machinery.

    Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.