concussion is a type of traumatic brain injury that is caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull. Although there may be cuts or bruises on the head or face, there may be no other visible signs of a brain injury.
You don't have to pass out (lose consciousness) to have a concussion. Some people will have obvious
symptoms of a concussion, such as passing out or forgetting what happened right before the injury. But other people won't. With rest, most people fully recover from a concussion. Some people recover within a few hours. Other people take a few weeks to recover.
In rare cases, concussions cause
more serious problems. Repeated concussions or a severe concussion may require
surgery or lead to long-lasting problems with movement, learning, or speaking.
Because of the small chance of permanent brain problems, it is important to
contact a doctor if you or someone you know has symptoms of 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.
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.
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
Symptoms of a concussion fit into four main categories:
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:
If your child has had a head injury, call your doctor for advice on
what to do.
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 and/or increasing confusion. See a doctor right away if you notice these signs. If you are caring for an older adult who takes blood thinners—warfarin (Coumadin) is an example—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.
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:
If you have symptoms of
postconcussive syndrome, call your 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
Any person who may have had a concussion needs to see a doctor. Some people have to stay in the
hospital to be watched. Others can go home safely. People who go home still need to be watched closely for warning signs or changes in behavior. Call a doctor or seek emergency care right away if you are watching a person after a concussion and the person has:
Warning signs in children are the same as those listed above for adults. Take your child to the emergency department if he or she has any of the warnings signs listed above or:
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.
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:
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
Reduce your chances of getting a
Reduce your child's chances of getting a concussion:
The website FamilyDoctor.org is sponsored by the American Academy of Family Physicians. It offers information on adult and child health conditions and healthy living. There are topics on medicines, doctor visits, physical and mental health issues, parenting, and more.
The mission of the Brain Injury Association of America is to create a better future through brain injury prevention, research, education, and advocacy. The organization has a network of state and local chapters and support groups across the United States. Its website also has information on traumatic brain injury and a national directory of brain injury services.
BrainLine offers information and resources about preventing, treating, and living with traumatic brain injury. This group's website includes many multimedia options including "Ask the Expert," personal stories and videos, and webcasts about traumatic brain injury. BrainLine is also available in Spanish.
This branch of the CDC seeks to
prevent injuries and violence and to reduce their consequences. The website has information on injuries, accidents, and situations that can lead to injuries. Topics include home and recreational safety, motor vehicle safety, violence prevention, and traumatic brain injury.
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
Other Works ConsultedAmerican Academy of Neurology (1997). Practice parameter: The management of concussion in sports (summary statement). Neurology, 48(3): 581–585.American College of Emergency Physicians (ACEP) and Centers for Disease Control and Prevention (CDC) (2008). Clinical policy: Neuroimaging and decisionmaking in adult mild traumatic brain injury in the acute setting. Annals of Emergency Medicine, 52(6): 714–748.American College of Sports Medicine (2006). Concussion (mild traumatic brain injury) and the team physician: A consensus statement. Medicine and Science in Sports and Exercise, 39(2): 395–399.Department of Veterans Affairs, Department of Defense (2009). Clinical practice guideline summary: Management of concussion/mild traumatic brain injury. Available online: http://www.healthquality.va.gov/mtbi/concussion_mtbi_sum_1_0.pdf.Halstead ME, et al. (2010). Sport-related concussion in children and adolescents. Pediatrics, 126(3): 597–615.McCrory P, et al. (2009). Consensus statement on concussion in sport: 3rd international conference on concussion in sport held in Zurich, November 2008. Clinical Journal of Sports Medicine, 19(3): 185–200.Meehan WP, Bachur RG (2009). Sport-related concussion. Pediatrics, 123(1): 114–123.Smith BW (2010). Head injuries. In SJ Anderson, SS Harris, eds., Care of the Young Athlete, 2nd. ed., pp. 185–191. Elk Grove Village, IL: American Academy of Pediatrics.
November 29, 2011
Anne C. Poinier, MD - Internal Medicine & William H. Blahd, Jr., MD, FACEP - Emergency Medicine
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