Concussion is a common and mild form of traumatic brain injury. A concussion happens when the brain is jostled inside the skull due to an outside impact to the head or body, a fall against a hard surface, or a hit to the body that causes the head and brain to move quickly back and forth. This sudden movement of the brain can damage and stretch brain cells, cause chemical changes, and temporarily disrupt normal brain function, especially in the areas of memory and orientation. Traumatic brain injuries, even mild ones like concussions, are considered a brain disorder and can potentially cause lasting or permanent impact, including chronic traumatic encephalopathy (CTE), a fatal brain disease associated with repeated traumatic brain injuries.
The estimated number of people who experience a concussion each year
The number of concussions that go unreported or undetected
The percentage of traumatic brain injuries that are considered mild, like a concussion, in the U.S.
Concussion Risk Factors
The number of people who experience a concussion each year is difficult to pinpoint because many concussions go undetected or unreported. However, mild traumatic brain injury accounts for at least 75 percent of all traumatic brain injuries in the United States, according to the Centers for Disease Control and Prevention (CDC). Some organizations are working to improve how concussion data is gathered to show their true impact, assess prevention measures, and give care providers insight through programs like the CDC National Concussion Surveillance System.
Anyone can experience a concussion. However, young children, teenagers, and people aged 65 and older have a greater risk for these mild traumatic brain injuries. Males are at a higher risk compared with females in most age groups, and people in the military and athletes who play contact sports have a greater risk for repeated concussions. Additionally, individuals with a history of multiple concussions have a greater risk for a longer recovery, more severe symptoms, and long-term problems with memory loss, headache, or issues with balance or concentration.
The most common causes of concussion include car accidents, falls, and sports injuries. High-contact sports such as football, basketball, soccer, ice hockey, lacrosse, field hockey, and wrestling can put athletes at a greater risk. For younger children, accidents like a fall on the playground or off a bicycle can cause a concussion.
While not all concussions can be prevented, following safety guidelines can reduce risk. Steps like wearing a helmet or seatbelt can help protect a person’s head and body and reduce the effects of a violent impact. It’s important to get a prompt diagnosis and medical care because repeated concussions can affect the severity of symptoms. The American Academy of Neurology (AAN) created a Concussion Quick Check app to evaluate if someone has a concussion and needs to see a neurologist.
Symptoms and Signs of Concussion
A concussion can cause loss of consciousness for a few seconds or minutes. Immediate symptoms may include headache, dizziness, nausea, or vomiting, difficulty concentrating, feelings of grogginess, fatigue, or sleepiness, slurred speech, blurred or double vision, and confusion. An individual with a concussion may briefly lose consciousness, provide delayed verbal responses, and have difficulty with balance, controlling their emotions, and accessing their memories from immediately before, during, or after the injury. To help determine whether an individual has a concussion, the AAN created a printable resource that categorizes symptoms as observable or those an individual may be able to express. The short-term effects of a concussion may last for days or weeks after the initial injury occurs; however, most people recover within a week or two.
While concussions are usually not life-threatening, they can be serious. Some people experience persistent, lasting effects in the weeks and months following a concussion. These long-term effects can include memory issues, headaches, and behavioral changes.
To diagnose concussion, a doctor will look for symptoms such as confusion and memory loss following a blow to the head or body that may have jostled the brain. They may also test hearing, vision, balance, and reflexes or conduct neurocognitive tests to assess recall, concentration, and problem-solving. These tests help identify the effects of a concussion, but a patient may have a concussion even if the tests are negative.
A doctor may also use the Glasgow Coma Scale to determine the severity of a traumatic brain injury. This 15-point scale measures a person’s ability to follow directions and move their eyes and limbs. People with more severe symptoms of concussion, such as vomiting, seizures, and severe headaches, may have a computed technology (CT) or magnetic resonance imaging (MRI) scan to look for swelling or bleeding in the brain.
It’s important to get medical care following a head injury. A doctor can help with recovery and monitor for more serious or longer-term effects. If a person is playing sports when the concussion occurs, they should be removed from play, evaluated by a neurologist, and cleared before returning to play.
For children who experience concussion, the American Academy of Pediatrics (AAP) encourages limiting physical activity during the recovery period to low-risk activities, such as brisk walking, and avoiding those that may cause reinjury. The updated AAP guidelines for the treatment of sports-related concussion also allows for the use of electronic devices and supports children returning to school as soon as possible, with a reduced workload if necessary.
Treatment for concussion typically includes rest and monitoring the individual for changes in or worsening of symptoms. Doctors often recommend acetaminophen (Tylenol) for headache due to concussion instead of nonsteroidal anti-inflammatory medication like ibuprofen (Advil) or aspirin, which may increase the risk of a brain bleed. Individuals with more severe concussion or longer-lasting effects may benefit from physical or occupational therapy and psychological or psychiatric support.
As concussion continues to gain more attention in sports and the media, developing protocols for diagnosis and recovery has become a focus. Current research is also investigating the biological and biochemical mechanisms of traumatic brain injury, secondary conditions such as depression, and how concussions affect the brain long term.
A consortium of the National Collegiate Athletic Association, the Department of Defense, the Center for Injury Research and Prevention, the Centers for Disease Control and Prevention, and the National Institutes of Health is gathering data to better understand concussion prevention, diagnosis, treatment, and recovery.
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