Understanding Concussions: Symptoms, Causes, Diagnosis, & Treatment

ProActive Rehab & Sport Injury Centre, Huntsville ON, Head Concussion

Understanding Concussions

The brain is an extremely sensitive organ and is the control centre of our body. When reflecting on common injuries resulting from sport or daily activities, injuries occurring to the brain are often overlooked. Injuries to the brain are extremely common, particularly if you partake in sport, and even more so if you partake in a contact sport. You don’t need to participate in a sport to cause injury to your brain. Non-sport related injuries to the brain can occur during activities such as falls or motor vehicle accidents. Injury to the brain from these or similar causes is termed a concussion. A concussion in the medical world is considered a mild head injury or mild traumatic brain injury (TBI). Due to the injury, the brain cannot function the way it normally does. Your ability to perform your normal activities with the same speed, reaction time, and precision as prior to the injury can be significantly altered.

Fortunately, the symptoms of a concussion in most cases are temporary and resolve over time. With each concussion, however, there is a small chance that permanent brain damage can occur, so proper treatment and sound medical advice regarding management of this injury is crucial.

This guide will help you understand:

  • how the condition develops
  • how health care professionals diagnose the condition
  • what treatment approaches are available
  • what ProActive Rehab’s approach to rehabilitation is

ANATOMY

What is the anatomy of the brain?

The brain is a soft organ that sits in the hard skull for protection. It is cushioned by cerebrospinal fluid that fills in the space between the skull and the brain. The cerebrospinal fluid acts like packing foam that protects your fragile items from both the sides of the hard moving box itself and from the rapid or sudden motions that the box may endure.

The brain is the control centre for all of the body’s activities. Damaging the brain can alter your ability to perform tasks both mentally and physically.

CAUSES

What causes a concussion?

Any force that causes the brain to move rapidly within the skull and bang against the inside of the skull can cause a concussion. In layman’s terms, a concussion can be caused by anything that ‘rattles the brain.’

Typically concussions are thought to be caused by direct blows to the head, such as in boxing or bar fighting, or by hitting your head on the ground during a fall, but indirect forces to the head are also common causes of concussions. For example, a fall onto your buttocks or onto any other part of your body can transmit a force strong enough to your brain to cause a concussion, even if you do not hit your head during the fall. Similarly, a blow to your neck, face or any other area of your body that is severe enough to transmit the force to your head can cause a concussion.

Motor vehicle accidents often similarly cause concussions due to the whiplash motion of your neck which subsequently forces your brain to rapidly hit the inside of your skull. The shaken baby syndrome is another example of this indirect mechanism of brain injury, as are explosions where your body is rapidly thrown back.

SYMPTOMS

What are the symptoms of a concussion?

Signs and symptoms of a concussion can vary extremely between people. It is not always obvious that someone has a concussion, so if the mechanism of injury for a concussion was present, a concussion should always be suspected and thoroughly investigated.

You do not need to lose consciousness to suffer a concussion, and in most cases, there is no loss of consciousness. If you do lose consciousness, however, you have most certainly sustained a concussion. Any loss of consciousness should be taken seriously, and any bouts lasting more than approximately a minute are considered severe.

Signs and symptoms of a concussion can vary extremely between individuals and can last days, weeks, months, or even longer in some cases. Fortunately, however, in the majority of cases, symptoms usually resolve within 7-10 days.

One of the most common symptoms of a concussion is a headache. Confusion is another common sign. This sign can easily be overlooked by the examiner unless the patient is moderate to severely confused, so ruling out a concussion should not be based on the fact that the patient ‘did not appear confused.’

Other signs and symptoms of a concussion that may be present on their own or in combination are concentration difficulties, decreased attention, difficulty with mental tasks, memory problems, difficulties with judgment, a decrease in balance and coordination, a feeling of disorientation, a feeling of being ‘dazed,’ fatigue, blurred vision, light and/or sound sensitivity, difficulty sleeping or sleeping more than usual, being overly emotional, being irritable or sad, neck pain, a feeling of ‘not being right’, and ringing in the ears. Amnesia may be another symptom. Two types of amnesia can occur Retrograde amnesia which is forgetting events that happened before or during the concussion event, or anterograde amnesia, which is when you do not form new memories about events that occurred after the concussion. In severe concussions, a change in personality may even occur. If a patient shows even one sign or symptom listed above this should be indicative of a concussion occurring and a full concussion evaluation should proceed.

Signs and symptoms that are even more severe after an injury to the head, such as recurrent vomiting, a change in pupil size, blood or fluid coming from the ears or nose, seizures, or obvious physical coordination or mental difficulties indicate a severe brain injury and require immediate emergency attention.

In most cases, signs and symptoms appear immediately after the concussion has occurred, however, in some cases, the signs and symptoms can be delayed by a few hours or possibly even days. For this reason, if the mechanism of injury suggests a concussion despite a lack of obvious symptoms being immediately present, the patient needs to be thoroughly examined for latent development of concussion signs or symptoms over a reasonable time frame, and a concussion must be thoroughly ruled out before returning to activity.
Diagnosis

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