Concussion refers to a type of traumatic brain injury caused by a hit, bolt, bump or jolt to the head. It is extremely common and mild but affects normal brain functioning.
What Is A Concussion?
A concussion usually happens due to a direct blow to the head. The term “Concussion” is derived from the Latin word “Concutere” which means “to shake violently”. A concussion is a very common and temporary traumatic brain injury (TBI) that occurs when our head hits or strikes a moving object. In medical science, it is defined as a clinical syndrome with immediate and transient alteration of normal brain functions. A recent 2021 research paper 1 defines it as a “ traumatically induced transient disturbance of brain function.“Concussions are a subset of the neurologic injuries known as traumatic brain injuries.”, the study further added. Injuries due to falls, contact sports, car accidents, or any other daily activities increase the risk of developing a concussion. A 2019 study 2 found that this kind of injury temporarily prevents our brain from functioning naturally. Though some medical professionals consider it a less severe type of brain injury, the symptoms of a concussion can be serious. One can experience several cognitive, physical, and emotional symptoms that include difficulties in:
The recovery period depends on the amount and the severity of the concussion. The severity of the symptoms ranges from mild to transient to an extended period of altered consciousness. A 2014 research 3 suggests that most of the symptoms are not extremely severe and often last for a few days or weeks. But they may require emergency medical attention in major instances. The wounded person may appear physically and mentally fine at first but may experience the symptoms hours and even days later. Most people usually recover after a concussion. However, such brain injuries are not life-threatening, but the condition can have severe consequences if not treated within a specific time.
Research 4 claims that 19.5% of US adolescents reported at least one diagnosed concussion during their lifetime and 5.5% reported being diagnosed with more than one concussion. This study explains that competitive sports involvement is associated with a greater odds of lifetime diagnosis of traumatic brain injury.
A concussion is considered a mild brain injury and occurs when a sudden pressure is transmitted to our brain. It forces our brain to move quickly within the skull. During a contact sport, an accident, the sudden movement makes our head and brain move back and forth inside the skull. It disrupts how certain parts of our brain communicate with each other and perform different body functions. Studies 5 have shown that it may make our brain bounce around, cause a twist in the skull, and violently shake the upper body. Research 6 says that these abnormal brain movements lead to certain harmful chemical changes in the brain including :
- Release of excitatory neurotransmitters
- Changes in glucose metabolism
- Abrupt neuronal depolarization
- Altered cerebral blood flow
- Impaired axonal function
The force or strike to the brain leads to internal and external bruising, bleeding, and even tearing. A 2018 research paper 7 explains that the injured person may find it difficult to remember what happened or experience loss of consciousness, dizziness, blurry vision, and nausea. People may also experience similar symptoms when a hit or blow to their body transfers the force to their head causing the brain to violently move inside the skull.
Symptoms Of A Concussion
The signs and symptoms of a concussion are mostly subtle and may not appear immediately after the head injury. The symptoms largely depend on the individual and the severity of the injury. Though this mild clinical syndrome is not life-threatening, the symptoms of this traumatic brain injury can be serious if not treated. A single concussion usually does not cause any permanent damage while the second one, even if extremely mild, may cause certain permanent disabilities. Different symptoms may appear in children and adults as well as certain symptoms require immediate medical attention.
According to studies 8 , the most common post-concussive signs and symptoms include:
- Headache 9
- Ringing sound in the ears 10
- Fatigues, dizziness, and clumsiness 11
- Double or blurred vision 12
- Slurred speech 13
- Nausea and vomiting 14
- Balance problem 15
- Sensitivity to light and noise 16
- Loss of memory 17 and consciousness
- Behavioral and personality changes
- Difficulty in concentrating or focusing 18
- Sleeping disorders 19 and mood swings
- Stress, depression, and anxiety
- Trouble in walking and thinking
Read More About Major Depressive Disorder ( Depression ) Here
One must seek medical help if any of these above-mentioned symptoms have not reduced or relieved within 1 or 2 days. These signs and symptoms may appear immediately or not develop for hours, days, even weeks following the injury. There are certain symptoms that you can observe or witness in a loved one who is injured, such as –
- Temporary loss of consciousness in certain instances
- Loss of coordination and balance issues
- Delayed response to your questions
- Difficulty in walking
- Bleeding or draining of clear fluid from their ears or nose
- Dazed appearance
- Abnormal eye movement
- Vomiting and inability to wake up
Impact Of Concussion In Children
Mild brain injury is very common among young children as their heads are disproportionately big compared to the rest of their bodies. After entering adolescence, they gain more weight and height making them more likely to be injured in minor accidents. It is extremely difficult to detect the symptoms in children as they may not be able to express what they are feeling.
Though the symptoms may vary and not be as noticeable at first, a recent 2020 research paper 20 suggests that behavioral changes are one of the most common symptoms of concussion among children. One can observe those changes by monitoring the injured child for the first 24 hours.
It is extremely difficult to detect the symptoms in children as they may not be able to express what they are feeling. According to a 2010 study 21 , the most common post-concussive symptoms in children include:
- Drainage from mouth, ear, and nose
- Repeated vomiting and upset stomach
- Drowsiness and unsteady walking
- Crankiness and dazed appearance
- Crying continuously
- Fatigue and mental fogginess
- Sensitivity to light and noise
- Changes in feeding and sleeping habits
- Irritability and loss of interest
Types Of Concussions
The types of concussions are graded according to their severity. According to a 2013 research paper 22 , the three grades include:
1. Grade I
The grade I type can be characterized by certain mild symptoms that last less than 30 minutes. It involves no loss of consciousness and extremely temporary memory loss or sometimes no memory loss.
2. Grade II
The grade II type involves some moderate symptoms including loss of consciousness that can last for less than five minutes and memory loss that can last for 30 minutes to one day.
3. Grade III
It involves certain severe symptoms such as loss of consciousness for more than five minutes and memory loss for more than 24 hours.
Causes Of Concussions
The human brain contains numerous soft tissues that are cushioned by spinal fluid and enclosed within the skull. When one has a violent blow, strike, or hit to their head, the sudden movement can jolt their brain. Research 23 reveals that it can cause damage to the blood vessels, internal bruising, development of blood clots, and injury to the nerves. This condition results in the brain not performing natural body functions along with some other crucial signs and symptoms. This sudden acceleration or deceleration can occur during a variety of circumstances including:
Falls are one of the leading causes of traumatic brain injury in young children and older people that can cause serious and long-term consequences. A 2015 research paper 24 suggests that head injury from falls in younger children can be associated with certain concussive symptoms.
2. Automobile accidents
A 2018 study 25 explains that automobile accidents and traumatic brain injuries are closely interlinked with each other. During an automobile accident, every jolt, blow, hit that creates a sudden jerk or movement can result in a concussion.
3. Violent assault
According to a 2019 study 26 , assault is the third most common cause of traumatic brain injury. The study shows that assaulted concussion patients suffer from worse self-reported symptoms than other patients.
4. Contact sports
Traumatic brain injuries can happen in any contact sport like boxing and football or recreational activity due to lack of safety or accidents. Playing sports increases the risk of falls and collisions with objects or other players. Studies 27 have shown that various factors including age, sex, the sport played, the level of the sport, and the types of equipment used are associated with a greater risk of sport-related concussion.
5. History of prior concussion
A 2013 research paper 28 suggests that a history of prior concussion plays the role of a risk factor for subsequent concussion. It also explains the role of family history and genetics in developing certain symptoms of a traumatic brain injury.
Risk Factors Of Concussions
There are certain activities and situations that can increase the risk of a concussion. The activities and situations include:
- Age 29
- Sex 30
- Falls, accidents & injuries
- Previous concussions
- Genetics 31
- Contact sports
- Being hit or struck with a moving object
- Horseback riding 32
- Military service 33
- Assault or physical abuse
- Post-traumatic stress disorder (PTSD) 34
- Depression and anxiety 35
- Explosions 36
Read More About Anxiety Here
Diagnosis Of Concussion
A concussion can happen during different activities. The witness should immediately perform the role of a sideline evaluator. Such evaluation includes several basic tests such as:
- Short-term memory recall test
- Long-term memory recall test
- Attentiveness test
- Consciousness test
The injured one should be taken to a health care center immediately after primary first-aid. A health specialist can decide the severity of the injury and treat him/her according to their medical history. A 2017 research paper 37 explains that a doctor may perform some important medical examination as many people with a concussion do not experience any symptoms until hours or days after the injury. The medical examination involves various tests, including:
1. Neurological examination
A doctor may do a neurological examination, ask about the symptoms, and ask how the injury happened. According to studies 38 , the neurological examination includes evaluating certain significant factors of the patient such as:
- Strength and sensation
2. Cognitive test
A cognitive test is designed to evaluate the patient’s thinking abilities. A 2009 study 39 suggests that the cognitive test evaluates certain factors including:
- Ability to recall basic information
3. Imaging test
Research 40 has found that the patients who experience severe or grade III symptoms like severe headache, repeated vomiting, seizures, loss of consciousness are recommended to go through a brain imaging test. Image testing can detect whether the injury caused bleeding or swelling in the skull. It includes:
- Computed tomography scan (CT scan)
- Magnetic resonance imaging (MRI)
A healthcare professional may advise the injured person to be hospitalized for observation. In certain minor instances, the doctor may advise the patient to be observed at home and someone should check him/her for at least 24 hours.
Treatment Of Concussion
Most mild brain injuries require no medical treatment but some beneficial home remedies. But one needs to check on their symptoms if they’re getting worse or not. A healthcare professional may prescribe you some pain relief medications along with some important guidelines. It’s extremely important to give proper time to allow your brain to heal after an injury. The guidelines involve certain restrictions that include:
1. Physical and mental rest
According to a 2017 study, taking proper rest is the best treatment for recovering from a traumatic brain injury. One can recover quickly if their body is getting enough rest and a sound sleep every night. This study shows that another important part of the recovery process is taking a break from physical activity. Resuming such activities soon after an injury may worsen the symptoms or increase people’s chance of having a second concussion.
2. Avoid substance use
The injured patient should avoid consuming alcohol or any other substance during the recovery process. Though a 2016 research paper 41 claims that alcohol consumption does not prevent healing from any traumatic brain injury, it is safe to avoid any substance use until all symptoms have completely disappeared as it may have side effects.
3. Avoid mental concentrating activities
It is important to allow your brain to rest. One needs to avoid the activities that require mental concentration like watching TV, playing video games, texting, using computers, and the like.
A doctor or a healthcare professional may prescribe you some aspirin-free medicines to relieve your headache and injury pain. You may be recommended some antidepressants or anti-anxiety medications to treat your depression and anxiety, if you’re experiencing any.
How To Prevent A Concussion
No guaranteed prevention is available for concussion prevention, but some safety tips can help you to prevent or reduce your risk of a head injury. Here are some helpful strategies to get started –
- Wear protective headgear like helmets during contact sports or other recreational activities. Check your sports equipment carefully before playing.
- Wear appropriate clothing for sports.
- Wera seatbelts and obey an average speed limit to prevent any type of motor vehicle accidents. Avoid drinking and driving.
- Wear helmets while riding a motorcycle, bicycle, or horse.
- Avoid any kind of physical fight. Try to sort out conflicts by having a conversation.
- Keep your home safe and well-lighted. Make sure that the floors have no slippery liquid on them that may increase your risk of falling.
- Use home safety measures including blocking off stairways and installing window guards to reduce the risk of head injuries to your children.
- Try to exercise regularly to strengthen your muscles and practice balancing tasks.
- Educate others about concussions and their consequences to help spread awareness.
- If you experience any kind of traumatic brain injury and prolonged severe symptoms, seek medical help immediately.
A concussion is a type of mild traumatic brain injury that people may experience during falls, contact sports, automobile accidents, or any recreational activities. They may have certain mild to severe symptoms that can last for a few minutes to a few weeks. Most people fully recover from such brain injury. However, one should consult with a healthcare professional if their symptoms get worse over time.
Concussion At A Glance
- Concussion refers to a type of mild traumatic brain injury caused by a bolt, bump, jolt, or hit to the head.
- People may experience such brain injuries while playing a contact sport, during a fall, physical conflict, a car accident, or any other daily activity.
- A traumatic brain injury can cause several physical and psychological symptoms such as loss of consciousness, headache, memory loss, behavioral and personality changes.
- A brain injury can be diagnosed by performing some neurological, cognitive, and imaging examinations.
- Concussion patients should be under observation for at least 24 hours after the injury.
- People with mild brain injury need no medical treatment except some basic home remedies as well as pain relief medications.
- Ferry B, DeCastro A. Concussion. [Updated 2021 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537017/
- Hon, K. L., Leung, A., & Torres, A. R. (2019). Concussion: A Global Perspective. Seminars in pediatric neurology, 30, 117–127. https://doi.org/10.1016/j.spen.2019.03.017
- Eisenberg, M. A., Meehan, W. P., 3rd, & Mannix, R. (2014). Duration and course of post-concussive symptoms. Pediatrics, 133(6), 999–1006. https://doi.org/10.1542/peds.2014-0158
- Veliz, P., McCabe, S. E., Eckner, J. T., & Schulenberg, J. E. (2017). Prevalence of concussion among US adolescents and correlated factors. JAMA, 318(12), 1180. https://doi.org/10.1001/jama.2017.9087
- McKeithan, L., Hibshman, N., Yengo-Kahn, A. M., Solomon, G. S., & Zuckerman, S. L. (2019). Sport-Related Concussion: Evaluation, Treatment, and Future Directions. Medical sciences (Basel, Switzerland), 7(3), 44. https://doi.org/10.3390/medsci7030044
- Giza, C. C., & Hovda, D. A. (2001). The Neurometabolic Cascade of Concussion. Journal of athletic training, 36(3), 228–235.
- Quinn, D. K., Mayer, A. R., Master, C. L., & Fann, J. R. (2018). Prolonged Postconcussive Symptoms. The American journal of psychiatry, 175(2), 103–111. https://doi.org/10.1176/appi.ajp.2017.17020235
- Permenter CM, Fernández-de Thomas RJ, Sherman Al. Postconcussive Syndrome. [Updated 2021 Mar 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534786/
- Lucas S. (2011). Headache management in concussion and mild traumatic brain injury. PM & R : the journal of injury, function, and rehabilitation, 3(10 Suppl 2), S406–S412. https://doi.org/10.1016/j.pmrj.2011.07.016
- Vernon, J. A., & Press, L. S. (1994). Characteristics of tinnitus induced by head injury. Archives of otolaryngology–head & neck surgery, 120(5), 547–551. https://doi.org/10.1001/archotol.1994.01880290057010
- Fife, T. D., & Kalra, D. (2015). Persistent vertigo and dizziness after mild traumatic brain injury. Annals of the New York Academy of Sciences, 1343, 97–105. https://doi.org/10.1111/nyas.12678
- Gunasekaran, P., Hodge, C., Rose, K., & Fraser, C. L. (2019). Persistent visual disturbances after concussion. Australian journal of general practice, 48(8), 531–536. https://doi.org/10.31128/AJGP-03-19-4876
- Hiploylee, C., Dufort, P. A., Davis, H. S., Wennberg, R. A., Tartaglia, M. C., Mikulis, D., Hazrati, L. N., & Tator, C. H. (2017). Longitudinal Study of Postconcussion Syndrome: Not Everyone Recovers. Journal of neurotrauma, 34(8), 1511–1523. https://doi.org/10.1089/neu.2016.4677
- Ledic, D., Sosa, I., Linic, I. S., Cvijanovic, O., Kovacevic, M., Desnica, A., & Banicek, I. (2012). Vomiting as a reliable sign of concussion. Medical hypotheses, 78(1), 23–25. https://doi.org/10.1016/j.mehy.2011.09.032
- Valovich McLeod, T. C., & Hale, T. D. (2015). Vestibular and balance issues following sport-related concussion. Brain injury, 29(2), 175–184. https://doi.org/10.3109/02699052.2014.965206
- Waddell, P. A., & Gronwall, D. M. (1984). Sensitivity to light and sound following minor head injury. Acta neurologica Scandinavica, 69(5), 270–276. https://doi.org/10.1111/j.1600-0404.1984.tb07812.x
- Hudac, C. M., Cortesa, C. S., Ledwidge, P. S., & Molfese, D. L. (2018). History of concussion impacts electrophysiological correlates of working memory. International journal of psychophysiology : official journal of the International Organization of Psychophysiology, 132(Pt A), 135–144. https://doi.org/10.1016/j.ijpsycho.2017.09.020
- Committee on Sports-Related Concussions in Youth; Board on Children, Youth, and Families; Institute of Medicine; National Research Council; Graham R, Rivara FP, Ford MA, et al., editors. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington (DC): National Academies Press (US); 2014 Feb 4. 4, Treatment and Management of Prolonged Symptoms and Post-Concussion Syndrome. Available from: https://www.ncbi.nlm.nih.gov/books/NBK185342/
- Viola-Saltzman, M., & Watson, N. F. (2012). Traumatic brain injury and sleep disorders. Neurologic clinics, 30(4), 1299–1312. https://doi.org/10.1016/j.ncl.2012.08.008
- Gagner, C., Dégeilh, F., Bernier, A., & Beauchamp, M. H. (2020). Persistent Changes in Child Behavior After Early Mild Traumatic Brain Injury. Journal of pediatric psychology, 45(1), 50–60. https://doi.org/10.1093/jpepsy/jsz071
- Taylor, H. G., Dietrich, A., Nuss, K., Wright, M., Rusin, J., Bangert, B., Minich, N., & Yeates, K. O. (2010). Post-concussive symptoms in children with mild traumatic brain injury. Neuropsychology, 24(2), 148–159. https://doi.org/10.1037/a0018112
- McCrea, H. J., Perrine, K., Niogi, S., & Härtl, R. (2013). Concussion in sports. Sports health, 5(2), 160–164. https://doi.org/10.1177/1941738112462203
- Mckee, A. C., & Daneshvar, D. H. (2015). The neuropathology of traumatic brain injury. Handbook of clinical neurology, 127, 45–66. https://doi.org/10.1016/B978-0-444-52892-6.00004-0
- Burrows, P., Trefan, L., Houston, R., Hughes, J., Pearson, G., Edwards, R. J., Hyde, P., Maconochie, I., Parslow, R. C., & Kemp, A. M. (2015). Head injury from falls in children younger than 6 years of age. Archives of disease in childhood, 100(11), 1032–1037. https://doi.org/10.1136/archdischild-2014-307119
- Viano, D. C., Parenteau, C. S., Xu, L., & Faul, M. (2017). Head injuries (TBI) to adults and children in motor vehicle crashes. Traffic injury prevention, 18(6), 616–622. https://doi.org/10.1080/15389588.2017.1285023
- Bown, D., Belli, A., Qureshi, K., Davies, D., Toman, E., & Upthegrove, R. (2019). Post-traumatic stress disorder and self-reported outcomes after traumatic brain injury in victims of assault. PloS one, 14(2), e0211684. https://doi.org/10.1371/journal.pone.0211684
- Ianof, J. N., Freire, F. R., Calado, V., Lacerda, J. R., Coelho, F., Veitzman, S., Schmidt, M. T., Machado, S., Velasques, B., Ribeiro, P., Basile, L., Paiva, W. S., Amorim, R., & Anghinah, R. (2014). Sport-related concussions. Dementia & neuropsychologia, 8(1), 14–19. https://doi.org/10.1590/S1980-57642014DN81000003
- Scopaz, K. A., & Hatzenbuehler, J. R. (2013). Risk modifiers for concussion and prolonged recovery. Sports health, 5(6), 537–541. https://doi.org/10.1177/1941738112473059
- Hu, T., Hunt, C., & Ouchterlony, D. (2017). Is Age Associated With the Severity of Post-Mild Traumatic Brain Injury Symptoms?. The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques, 44(4), 384–390. https://doi.org/10.1017/cjn.2016.441
- Mollayeva, T., El-Khechen-Richandi, G., & Colantonio, A. (2018). Sex & gender considerations in concussion research. Concussion (London, England), 3(1), CNC51. https://doi.org/10.2217/cnc-2017-0015
- Guth, T., Ketcham, C. J., & Hall, E. E. (2018). Influence of Concussion History and Genetics on Event-Related Potentials in Athletes: Potential Use in Concussion Management. Sports (Basel, Switzerland), 6(1), 5. https://doi.org/10.3390/sports6010005
- Bixby-Hammett, D., & Brooks, W. H. (1990). Common injuries in horseback riding. A review. Sports medicine (Auckland, N.Z.), 9(1), 36–47. https://doi.org/10.2165/00007256-199009010-00004
- Rigg, J. L., & Mooney, S. R. (2011). Concussions and the military: issues specific to service members. PM & R : the journal of injury, function, and rehabilitation, 3(10 Suppl 2), S380–S386. https://doi.org/10.1016/j.pmrj.2011.08.005
- Bryant R. (2011). Post-traumatic stress disorder vs traumatic brain injury. Dialogues in clinical neuroscience, 13(3), 251–262. https://doi.org/10.31887/DCNS.2011.13.2/rbryant
- Martin, R. J., & Chaney, B. H. (2018). Exploration of the Relationship Between Concussions and Depression Symptoms, Anxiety Symptoms, and Hazardous Drinking Among a Sample of College Students. Journal of dual diagnosis, 1–8. Advance online publication. https://doi.org/10.1080/15504263.2018.1473906
- Bryden, D. W., Tilghman, J. I., & Hinds, S. R., 2nd (2019). Blast-Related Traumatic Brain Injury: Current Concepts and Research Considerations. Journal of experimental neuroscience, 13, 1179069519872213. https://doi.org/10.1177/1179069519872213
- Mann, A., Tator, C. H., & Carson, J. D. (2017). Concussion diagnosis and management: Knowledge and attitudes of family medicine residents. Canadian family physician Medecin de famille canadien, 63(6), 460–466.
- Clark A, M Das J, Mesfin FB. Trauma Neurological Exam. [Updated 2020 Nov 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507915/
- Covassin, T., Elbin, R. J., 3rd, Stiller-Ostrowski, J. L., & Kontos, A. P. (2009). Immediate post-concussion assessment and cognitive testing (ImPACT) practices of sports medicine professionals. Journal of athletic training, 44(6), 639–644. https://doi.org/10.4085/1062-6050-44.6.639
- Lee, B., & Newberg, A. (2005). Neuroimaging in traumatic brain imaging. NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics, 2(2), 372–383. https://doi.org/10.1602/neurorx.2.2.372
- Silverberg, N. D., Panenka, W., Iverson, G. L., Brubacher, J. R., Shewchuk, J. R., Heran, M. K., Oh, G. C., Honer, W. G., & Lange, R. T. (2016). Alcohol Consumption Does not Impede Recovery from Mild to Moderate Traumatic Brain Injury. Journal of the International Neuropsychological Society : JINS, 22(8), 816–827. https://doi.org/10.1017/S1355617716000692