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.