Symptoms of Concussions

Many people who suffer a concussion don't actually get "knocked out" and never lose consciousness---or lose consciousness so briefly that they are unaware of it. They---and the people around them---may not even realize they had a concussion until after the fact when the person cannot remember the incident or even the entire day of the incident. Here's what to watch for if someone you know experiences a blow to the head or is involved in a car accident, two of the leading causes of concussions.

Definition

• A concussion is an injury to the brain, usually caused by external trauma to the head or skull resulting from a fall, something striking the head, or even a sudden jerking motion to the head and neck such as that which occurs in a car accident or when a baby is shaken, even if there is no direct impact to the outside of the head or skull. The human brain essentially floats gently in a cushiony cerebrospinal fluid within the bones of your skull. Any impact or sudden jerking can cause your brain to violently hit the inside of your skull and may tear nerve fibers within the brain or result in bleeding in or around the brain. A concussion can affect speech, judgment, memory, coordination, balance, reflexes and other normal functions---short term and/or long term.

Cause

• Slips and falls, traffic accidents or near accidents, impacts to the head incurred during a contact sport, falls from a bicycle or a horse, falls from a ladder or high place, or even falls from a short distance can result in a concussion.

Symptoms

• Loss of consciousness may or may not accompany a concussion. There may be no sign of bleeding or any other injury. However, amnesia of the incident that caused the head injury and/or confusion are the two most common symptoms of a concussion. Other symptoms include feeling disoriented, slurred speech or words that do not come out correctly or in the proper order, other difficulty speaking, difficulty understanding, repeating the same thing over and over, dizziness, headache, seeing stars, ringing in the ears, bleeding from the ears or nose, loss of taste or smell, nausea and/or vomiting, fatigue and/or extreme tiredness. A person does not need to exhibit all these signs to have a concussion.
  Other symptoms, such as depression, irritability, difficulty concentrating, difficulty sleeping or sleep disturbances, difficulty waking the affected individual, seizures, difficulty walking or balancing, changes in behavior, and/or sensitivity to noise and/or light may show up immediately or may not be evident at all until hours, days or weeks later.

Danger

• Any brain injury is potentially serious, and a traumatic brain injury can be fatal. Also, once you've had a concussion, you are at a higher risk for incurring a concussion again in the future. In addition, people who suffer multiple concussions have increased risk of developing epilepsy and other neurological damage, disorders and diseases later in life.

Diagnosis

• A physician in the emergency room will examine the patient, ask questions about the incident resulting in the head injury (either from the person or from anyone who was with that person if the person cannot remember or is unconscious), get a medical history, find out if the patient has ever had a concussion before, do a neurological exam, test reflexes and balance, assess vision and hearing, check concentration and comprehension, and may also order a computerized tomography (CT) scan of the head to determine the extent of the trauma. The doctor may wish to keep the person overnight for observation, or if the person is sent home, someone should be with that person for the next 24 hours and wake the person every couple of hours to be sure she can easily be awakened to a normal state of consciousness.

  Symptoms of a concussion can last for hours, days, weeks or even months depending on the severity of the brain injury. Lingering symptoms are referred to as post-concussion syndrome and can include long-term, persistent headaches, dizziness, nausea, and difficulty reading or concentrating.

Treatment

• If any the symptoms of a concussion are present following a blow to or trauma to the head, seek medical attention for proper evaluation. If you are the one with the head injury, do not drive. Have someone else drive you to the walk-in clinic or emergency care facility nearest you.

  If the injury appears serious, the person has lost consciousness, the person fell from more than three feet, or there is excessive bleeding or continuous vomiting or long-term amnesia, or any other sign that the concussion could be severe, call for an ambulance immediately.

  The main treatment for a concussion is rest and taking acetaminophen for the pain. Do not use aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or ibuprofen, as they may increase risk of bleeding.

  Follow up with your personal physician a few days after the injury, and always check with your doctor before resuming regular activities, especially sports.