Written by Rose Kivi | Published on August 7, 2012
Medically Reviewed by George Krucik, MD on August 7, 2012

What Is a Concussion?

A concussion is a mild traumatic brain injury. It can occur after an impact to your head or after a whiplash-type injury that causes your head and brain to shake quickly back and forth. Concussions are usually not life threatening, but they can cause serious symptoms that require medical treatment.

Anyone can become injured during a fall, car accident, or any other daily activity. If you participate in impact sports—such as football or boxing—you have an increased risk of getting a concussion.

The University of Michigan Health System estimates that approximately 3.8 million people in the United States get concussions from sports injuries every year (UMHS).

Recognizing the Signs and Symptoms of a Concussion

It’s not true that a loss of consciousness always occurs with a concussion. Some people do experience a loss of consciousness, but others do not. Symptoms of a concussion vary depending on the severity of the injury and the person.

The symptoms may begin immediately, or they may not develop for hours, days, weeks, or even months following the injury. The signs of a concussion may include:

  • brief loss of consciousness after the injury
  • memory problems
  • confusion
  • drowsiness or feeling sluggish
  • dizziness
  • double vision or blurred vision
  • headache
  • nausea or vomiting
  • sensitivity to light or noise
  • balance problems
  • slowed reaction to stimuli

During the recovery period after a concussion, you may experience the following symptoms:

  • irritability
  • sensitivity to light or noise
  • difficulty concentrating
  • mild headaches

You Asked, We Answered

  • I've always heard that you should keep someone awake for 24 hours if they've suffered a significant head injury, but is that true? Why is it so important?- Anonymous
  • The traditional teaching is that it is important to awaken someone periodically after a traumatic brain injury (e.g., if they have suffered loss of consciousness or a severe concussion) in order to be certain that they are not deteriorating. Being unable to arouse someone would be indicative of an extreme situation. But the act of sleeping itself would not be harmful. In the hospital, if someone has suffered a sufficiently bad injury, it is likely that they would have had a CT scan or MRI to directly identify an area of bleeding, fractured skull, or other injury. In the wilderness, away from testing, it is reasonable to awaken someone every few hours to be certain that they are not getting worse. There is no absolute interval for or duration of such evaluation, but remember that at some point, people need to sleep because they are tired, and rest is important for recovery.

    - Paul Auerbach, MD, MS, FACEP, FAWM

Emergency Symptoms: When to See a Doctor

If you suspect that you or someone else has a concussion, you should see a doctor. If a concussion occurs during a sports practice or game, tell the athletic coach or go to a doctor. Call 911 if the symptoms are severe.

Concussions may be accompanied by injuries to the spine. If you suspect that the person has a neck or back injury, avoid moving them and then call an ambulance for help. If you must move the person, do so very carefully. You should try to move the person’s neck and back as little as possible. This will avoid causing further damage to the spine.

If you, or someone you know, experience any of the following severe symptoms after an injury, you should seek immediate emergency medical treatment:

  • inability to wake up (also called a coma)
  • seizures
  • draining of blood or clear fluid from the ears or nose
  • unequal pupil size (one pupil is larger than the other)
  • eyes moving abnormally
  • lasting confusion
  • slurred speech
  • repeated vomiting
  • weak muscles
  • problems walking

How Is a Concussion Diagnosed?

When you see a doctor, he or she might ask you questions about your injury and its symptoms. The doctor might then perform a physical examination to determine if you have symptoms of a concussion.

If you are experiencing serious symptoms, your doctor may request an MRI or CT scan of your brain to see if you have any serious injuries. If you are having seizures, your doctor may also perform an EEG test, which monitors your brain waves.

How Is a Concussion Treated?

Treatment for a concussion depends on the severity of your symptoms. Surgery or other medical procedures may be required if you have bleeding in the brain, swelling of the brain, or a serious injury to the brain. However, most concussions do not require surgery or any major medical treatment.

During the first 24 hours after the injury, your doctor may suggest that you have someone wake you up every two to three hours. This ensures that you have not gone into a coma and also allows someone to check whether you are experiencing signs of severe confusion or abnormal behavior.

If you experience headaches, your doctor may tell you to take over-the-counter pain relievers such as ibuprofen (Advil) or acetaminophen (Tylenol). Your doctor may also tell you to get plenty of rest, avoid sports and other strenuous activities, and avoid driving a vehicle or riding a bike for 24 hours or a few months, depending on the severity of your injury. Alcohol might slow your recovery, so discuss with your doctor whether you should stop drinking alcoholic beverages and for how long.

A Warning Regarding the Long-Term Effects of Multiple Concussions

Do not participate in sports or strenuous activities after a concussion without your doctor’s permission. You are more at risk for a second concussion while you are recovering.

Getting a second concussion before you are fully healed from a first concussion can cause a condition known as second impact syndrome (SIS). Second impact syndrome can increase the chances of severe brain swelling, which may be fatal.

Remember, it is important to take time to rest after any concussion. This allows the brain to heal. If your doctor has given you permission to begin sports again, do so gradually. Don’t start up as active as you were before the concussion.

How to Prevent Concussions

You can reduce your risk of getting a concussion by wearing the correct helmet and other athletic safety gear during sports activities. Always make sure your helmet and other gear fits properly and is worn appropriately.

Ask your coach or another sports professional about safe playing techniques, and make sure to follow his or her advice.

Long-Term Outlook After a Concussion

Most people completely recover from their concussions, but it may take months for the symptoms to disappear. In rare instances, you may experience permanent physical, emotional, neurological, or intellectual changes. Repeat concussions should be avoided, since they can increase your chances of getting permanent brain damage and may even result in death.

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