Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
A concussion is a mild traumatic brain injury (TBI) that can occur after an impact on the head. Concussions can also happen during a whiplash-type injury that causes the head and brain to shake quickly back and forth.
Not every bump to the head will cause a TBI, but concussions can cause noticeable symptoms that shouldn’t be ignored. These include headaches, an altered mental state, and even loss of consciousness.
Concussions are usually not life-threatening, but they can cause serious symptoms that require medical attention. Treatment may include rest, taking a break from specific activities, and pain medication.
Head injuries – whether caused by a fall at home or in a car accident – can affect anyone. If you participate in impact sports such as football or boxing, you have an increased risk of getting a concussion.
CAUSES
Concussions are caused by some type of impact injury to the head. Our brains float in a jelly-like fluid inside our skulls. This fluid is called cerebrospinal fluid (CSF). A head injury can cause our brain and its surrounding membrane (meninges) to hit the sides of our skull. This kind of impact can damage the brain’s tissues, and even cause our CSF to leak.
Causes of a concussion include:
* Falling
* Getting hit in the head (especially when playing sports)
* Being in a car accident
* Being injured in a blast or explosion
In a severe head injury, part of our skull can fracture. Skull fractures can cause jagged edges of bone to poke at our brain and cause harm. Some traumatic brain injuries involve more than an impact of the brain against our own skull. TBI and concussion can also occur if a foreign object enters the skull, such as a bullet or shrapnel.
CONCUSSION SYMPTOMS
Symptoms of a concussion vary, depending on both the severity of the injury and the person injured. It’s not true that a loss of consciousness always occurs with a concussion. Some people do experience a loss of consciousness, but others don’t.
Concussions can be painful, but most are not life-threatening. Consult a doctor after a possible head injury, as medical treatment may be necessary.
Here’s a breakdown of different symptom categories for concussions:
* Physical symptoms (somatic): Persons can experience sensitivity to light, dizziness, fatigue, headache, nausea and vomiting, and trouble seeing.
* Emotional: Feeling particularly anxious, irritable, moody, or sad
* Thinking and remembering (cognitive): Having difficulty paying attention, problems with short- or long-term memory, feeling groggy
* Sleep: Irregular sleeping patterns (too much or too little), trouble falling asleep.
According to the Centers for Disease Control and Prevention (CDC), symptoms persons may experience during a concussion include:
* Headache
* Nausea or vomiting
* Confusion or feeling disoriented.
* Drowsiness or feeling sluggish.
* Dizziness
* Double vision or blurred vision
* Sensitivity to light or noise
* Balance problems
SYMPTOMS OF CONCUSSION IN A LOVED ONE
Sometimes other people can observe signs of a concussion more clearly than the concussed person. Signs of a concussion observed by others include:
* Memory problems
* Dazed look
* Sudden mood, behaviour or personality changes
* Losing consciousness
* Slow reflexes and responses
These symptoms may begin immediately, or they can be delayed for hours or days following the injury. It’s important to consistently check on someone, if they may have a concussion, to monitor any symptom changes.
RECOVERY SYMPTOMS FOR CONCUSSION
During the recovery period after a concussion, you may still experience uncomfortable symptoms.
These include:
* Irritability
* Sensitivity to light or noise
* Difficulty concentrating
* Mild headaches
CONCUSSION SYMPTOMS IN BABIES
Concussion symptoms can vary when it comes to babies. These may not be as noticeable at first. Babies don’t exhibit slurred speech, walking difficulties and other hallmark symptoms that can be seen in concussed children and adults. Some common signs of a concussion in babies include:
* A visible bump or bruise on the baby’s head
* Crying when you move the baby’s head or neck.
* Vomiting
* Irritability
* Drowsiness
* Seizure
* Dilated pupils
In rare cases, concussions can cause permanent brain damage in infants. While most babies recover from concussions, it’s important to have them checked out by a doctor. Seek immediate medical help if the baby is unconscious.
CONCUSSION SYMPTOMS IN CHILDREN
As children get older, they may show clearer behavioural signs of concussion, and be able to express their symptoms themselves.
According to a 2020 study, common symptoms reported in children aged 5-11 with concussions were:
* Trouble sleeping
* Vision problems (including eye pain, and double vision)
* Headache
* Dizziness
* Other signs to look for in younger children include:
* Excessive crying
* Staring into space
* Behavioural changes
* Trouble concentrating
Because children’s brains are still developing, they are uniquely at risk of TBI, especially if they play sports.
It’s important that children are promptly evaluated after a potential TBI, and provided necessary accommodations at school during their recovery. Kids recovering from a concussion may need time away from sports teams and classes. They may also require extra breaks during the day, or assignment extensions.
EMERGENCY SYMPTOMS: WHEN TO SEE A DOCTOR
See a doctor if it is suspected that you have a concussion. While most concussions resolve on their own, it’s important to evaluate the severity of the injury.
Concussions may be accompanied by injuries to the spine. If a person has a neck or back injury, avoid moving them, and call an ambulance for help. If the person absolutely must be moved, do so very carefully. Keep the person’s neck and back as stationary as possible. This will avoid causing further damage to the spine.
According to the American Association of Neurological Surgeons (AANS), seek immediate medical assistance if someone with a concussion has:
* Slurred speech
* Trouble waking up, or you can’t wake them.
* Seizures
* Consistent vomiting
* A history of multiple concussions
In general, someone with a concussion should absolutely see a doctor if their symptoms aren’t getting better after a few days, or are getting worse.
