Human brain injury (© Crystal light - stock.adobe.com)
Concussions have been all over the news since NFL quarterback Tua Tagovailoa sustained the third known concussion of his career. The most common causes of concussions among adults are falls and motor vehicle accidents. Whatever the cause, here’s what you need to know about concussions.
A concussion is a mild traumatic brain injury (TBI). It occurs with a violent blow to the head, neck, or upper body or sudden acceleration or deceleration, such as a car crash or collision in sports. When someone suffers a concussion, the brain moves around, banging against the inner walls of the skull. These movements briefly affect brain function. Occasionally, a mild TBI causes bleeding in or around the brain. This can also lead to drowsiness, confusion, and even death in certain instances.
Activities that can lead to falls are risk factors for concussions, as are contact sports, especially if the individual is not using appropriate protective gear or lacks supervision. Automobile and bicycle accidents carry extra risk for concussion. Military service and physical abuse are also risk factors. Additionally, having a previous concussion increases the risk of suffering future concussions.
Have you suffered a concussion? Know the symptoms
The symptoms of a concussion may not begin immediately. They can last for days, weeks, or longer. Headaches and persistent ringing in the ears are common. Nausea and vomiting, fatigue or drowsiness, and confusion or brain fog are also common. Someone suffering a concussion may be dizzy or have amnesia of the event that injured them.
If you think someone you’re looking at has suffered a concussion, they may display a temporary loss of consciousness, slurred speech, or a delayed response to questions. The injured person may also have a dazed appearance.
Symptoms that may be delayed include impaired memory and concentration, changes in personality — irritability or moodiness — altered senses of taste and smell, and sensitivity to light and sound.
If someone has these symptoms following a head injury, especially if they’re younger than 12 months, get them emergency care as soon as possible:
- Loss of consciousness for 30 seconds or more
- Repeated vomiting
- Headache getting worse
- Blood or fluid from the ears or nose
- Vision or eye changes (e.g., unequal pupils)
- Ringing in the ears that does not subside
- Weakness in the arms or legs
- Confusion or disorientation (e.g., the person may not recognize people or places)
- Slurred speech or other changes in speech
- Obvious changes in mental function
- Changes in physical coordination, such as stumbling or clumsiness
- Seizures or convulsions
- Dizziness that doesn’t go away or that goes away and comes back
- Symptoms that worsen over time
- Large bumps or bruises on the head, especially bruising around the eyes
How do doctors diagnose a concussion?
To diagnose a concussion, a healthcare professional evaluates your symptoms and reviews your medical history. You may need tests that help diagnose a concussion. These may include a neurological exam, cognitive (thinking) testing, and imaging tests.
The neurological exam includes detailed questions about your injury. This evaluation includes checking your vision, hearing, balance, coordination, reflexes, sensation, and strength. Cognitive testing consists of evaluating memory, concentration, and ability to recall information.
Imaging may be done for patients with symptoms such as bad headaches, seizures, repeated vomiting, or symptoms that are worsening. These scans evaluate bleeding or swelling in the skull.
A CT scan right after the injury is a standard test for adults. For children with a suspected concussion, CT scans are used only if specific criteria are met, such as the type of injury or signs of a skull fracture. The goal is to limit radiation exposure in young children. MRI may be used to identify changes in your brain or to diagnose complications that may occur after a concussion.
What happens if doctors discover a concussion?
After a diagnosis of a concussion, an adult or a child may need to be hospitalized overnight for observation. Sometimes a healthcare professional will allow observation at home. Someone should always stay with the patient for the first 24 hours to quickly detect and report worsening symptoms.
There is no single treatment or recovery protocol for concussions because each has its own unique characteristics. However, there are general treatment measures.
The first few days
Physical and mental rest helps the brain start to recover. Rest doesn’t have to be strict. There’s no need for bedrest or a darkened room. During the first 48 hours, limit activities that require a lot of concentration, such as playing video games, watching TV, doing schoolwork, reading, or using a computer. Don’t do physical activities that increase or provoke symptoms, such as general physical exertion or sports. After a period of relative rest, gradually increase daily activities if you can tolerate them without triggering symptoms.
Later in the week
Light exercise and physical activity as tolerated starting a couple of days after injury have been shown to speed recovery. These activities could include riding a stationary bike or light jogging. Don’t engage in any activities that have an elevated risk of another head impact until you are fully recovered. As your symptoms improve, you may gradually add more activities that involve thinking, such as schoolwork or work assignments.
Don’t resume contact sports until you are symptom-free and cleared by your healthcare professional.
Pain relievers may be needed for headaches in the days or weeks after a concussion. Tylenol is generally safe to use. Don’t take other pain relievers, such as ibuprofen and aspirin, as they may increase the risk of bleeding.
How can you avoid a concussion?
These tips may help you prevent or minimize the risk of a concussion:
- Wear protective gear during sports and other recreational activities.
- Use your seat belt. Car crashes are a leading cause of concussions.
- Make your home safe. Keep your floors free of anything that might cause you to trip and fall. Falls around the home are a leading cause of head injuries.
- Exercise regularly. Exercise strengthens your leg muscles and improves your balance.
If at any time you wonder if you should see a doctor after a head injury, the answer is yes. Even if it seems excessive, it’s better to use extreme caution in these high-stakes situations.
Wow, you’d better step up your knowledge. There are recent tests approved by the FDA to test for concussion and TBI. The word has to get out, especially to the medical community.