Concussion and Traumatic Brain Injury

WHAT ARE COMMON CAUSES OF CONCUSSIONS?

According to the Centers for Disease Control and Prevention (CDC), an estimated 1.6 to 3.8 million sports and recreation-related concussions occur in the U.S. each year. Falls account for the greatest incidence of traumatic brain injury or concussions, followed by motor vehicle accidents.

The brain is cushioned in the skull by spinal fluid that gently absorbs the impact that occurs during the normal motions of everyday activities. A concussion is the most common type of traumatic brain injury and is generally the result of a sudden, significant blunt-force trauma to the head or body. A concussion may have a moderate to severe impact on brain function. Vision may be altered, the sense of balance may be lost, and a loss of consciousness may occur. Signs and symptoms of a concussion may not appear until hours or days after the event.

Concussion may cause physical, cognitive, emotional, and/or behavioral deficits although it is not usually life-threatening. However, all concussions should be taken seriously.

WHAT ARE SYMPTOMS OF CONCUSSIONS?

Symptoms of a concussion may be mild to severe and should be suspected in the presence of any one or more of the following symptoms or abnormal behavior.

• Loss of consciousness
• Seizure or convulsions
• Amnesia/ Memory loss
• Headache
• “Pressure in the head”
• Neck pain
• Nausea/vomiting
• Dizziness
• Blurred vision
• Balance problems
• Ringing in ears
• Light sensitivity
• Noise sensitivity
• Changes in taste and smell
• Feeling slowed down
• Feeling like “in a fog”
• “Don’t feel right”
• Difficulty concentrating
• Difficulty remembering
• Fatigue or low energy
• Confusion
• Drowsiness
• More emotional
• Irritability
• Sadness
• Nervous or anxious

WHEN TO SEEK MEDICAL ATTENTION

• Altered level or loss of consciousness
• Convulsions
• Muscle weakness on one or both sides
• Persistent confusion
• Persistent vomiting
• Unusual eye movements
• Walking difficulty

An initial baseline neurological evaluation should be done by a physician. Normally, treatment involves monitoring the patient by a physician over a period of time and rest from physical activity. Special care should be taken to avoid additional injury during this time. Repeat head injuries or cumulative concussions can have long-term implications. Recovery, which may be prolonged, is usually complete.

HOW WILL MY PHYSICIAN DIAGNOSE A CONCUSSION?

The evaluating physician will base their diagnosis on the details of the injury, a cognitive evaluation and neurological examination.

Tests to evaluate thinking (cognitive) ability include several factors, such as:

• Memory
• Concentration
• Recall of information

Neurological exams look at:

• Vision
• Hearing
• Strength
• Sensation
• Balance
• Coordination
• Reflexes

If a patient is experiencing severe headaches, seizures, repeated vomiting or worsening symptoms, brain imaging tests such as MRI or CT scan may be recommended.

Serious concussions may require overnight observation in a hospital. Patients with milder concussions should still be under observation for at least 24 hours at home to monitor symptoms in case they worsen.

WHAT TREATMENT OPTIONS EXIST FOR CONCUSSIONS?

Rest allows the brain to recover from concussion. Concussed patients are advised to avoid physical exertion and vigorous movements for a period of time. Further, mental rest from thinking, concentration, reading or using a digital device is also important. Shortened school or work days may be necessary.

As symptoms improve, patients can gradually introduce activities that require concentration, such as schoolwork or assignments. Light physical activity can be resumed after the physician determines it is safe, as long as it does not worsen the symptoms. However, it is important for the doctor to decide the timeline for the patient to resume pre-concussion levels of activity. Returning to sports too soon increases the risk of a second concussion and potentially fatal brain injury.

HOW TO PREVENT BRAIN INJURIES

• Always wear a seatbelt when riding or driving a car.
• Never drive under the influence of drugs or alcohol.
• Remove falling and tripping hazards in the home like curled rugs, loose electrical cords and misplaced toys.
• Install grab bars and handrails if you are elderly or have a physical limitation.
• Use helmets or protective head gear approved by the ASTM for specific sports.
• Always supervise younger children, and do not let them use sporting equipment or play sports that are not age appropriate.
• Do not permit children to play on playgrounds with hard surfaces.
• Don’t dive into water less than 9 feet deep.
• Do not participate in sports when you are tired or not well.
• Cyclists and in-line skaters should obey all traffic signals and traffic laws.
• Replace damage sporting equipment or protective gear

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