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Concussion

What is a concussion?

A concussion is a mild traumatic brain injury (TBI). 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. A concussion results in an altered mental state that may include becoming unconscious.

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. Concussions are usually not life-threatening, but they can cause serious symptoms that require medical treatment.

A concussion is different from a contusion. A concussion specifically affects your brain, but contusions are bruises. Contusions can occur on your head, but they aren’t typically serious and tend to resolve within several days.

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Symptoms

Recognizing the signs and symptoms of a concussion

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.

It’s important to understand the symptoms you could go through yourself when you’re having a concussion, as well as the signs of someone else having a concussion.

Symptoms you may experience

The signs of a concussion may include:

  • 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

The symptoms may begin immediately, or they may not develop for hours, days, weeks, or even months following your injury.

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

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

Signs of concussion in a loved one

In some cases, a friend or loved one might be having a concussion, and they don’t know it. The following are some of the signs to look out for:

  • irritability
  • balance issues
  • loss of coordination
  • problems walking
  • seizures
  • draining of blood or clear fluid from the ears or nose
  • unequal pupil size
  • abnormal eye movement
  • lasting confusion
  • slurred speech
  • repeated vomiting
  • brief loss of consciousness after the injury
  • an inability to wake up (also called a coma)

If you or someone you know experiences any of these symptoms after an injury, seek immediate emergency medical treatment or call 911.

Concussion symptoms in babies

Concussion symptoms can vary in babies. These may not be as noticeable at first, since babies don’t exhibit slurred speech, walking difficulties, and other hallmark symptoms that can be exhibited by children and adults.

Some common signs of a concussion in babies include:

  • vomiting
  • drainage from their mouth, ears, or nose
  • irritability
  • drowsiness

Rarely, concussions can cause permanent brain damage. While most babies recover from concussions, it’s important to have them checked out by a doctor. Seek immediate medical help if your baby is unconscious.

Emergency symptoms: When to see a doctor

See a doctor if you suspect that you or someone else has a concussion. If a concussion occurs during sports practice or a game, tell the athletic coach and go to a doctor.

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

Diagnosis

How a concussion is diagnosed

If a doctor or emergency room visit is necessary, your doctor will begin with questions about how the injury happened and its symptoms. Your doctor might then perform a physical examination to determine what symptoms you have.

In the case of serious symptoms, your doctor may request an MRI scan or a CT scan of your brain to check for serious injuries. In the case of seizures, your doctor may also perform an electroencephalogram, which monitors brain waves.

Some doctors use a special eye test to look for concussions. This test is sometimes used by certified athletic trainers. It’s conducted to assess if any visual changes are related to a concussion. Your doctor may look for changes in pupil size, eye movements, and light sensitivities.

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Treatment

How a concussion is treated

Treatment for a concussion depends on the severity of your symptoms. You might need surgery or other medical procedures if you have:

  • bleeding in the brain
  • swelling of the brain
  • a serious injury to the brain

However, most concussions don’t require surgery or any major medical treatment.

If the concussion is causing headaches, your doctor may recommend over-the-counter pain relievers such as ibuprofen (Advil) or acetaminophen (Tylenol). Your doctor will also probably ask 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 even a few months, depending on the severity of your injury. Alcohol might slow recovery, so ask your doctor if you should avoid drinking it. If you should avoid alcohol, ask your doctor for how long.

  • 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
  • Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Long-term effects

A warning about the long-term effects of multiple concussions

Anyone who has had a concussion shouldn’t return to sports or strenuous activities without a doctor’s permission. Getting a second concussion before the first concussion is healed can cause a condition known as second impact syndrome, which can increase the chances of severe brain swelling and may be fatal.

Remember, it’s important to take time to rest after any concussion. This allows your brain to heal. Even once your doctor has granted permission to return to sports or exercise, that return should be gradual.

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Complications

Other concussion complications

Other long-term complications include:

  • post-concussion syndrome, which causes you to experience concussion symptoms for weeks (or even months) instead of just a few days
  • post-traumatic headaches, which may last for a few months
  • post-traumatic vertigo, or dizziness that lasts for up to several months
  • brain injuries from multiple TBIs
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Prevention

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 the helmet and other gear fit properly and are worn appropriately. Ask a coach or other sports professional about safe playing techniques, and make sure to follow their advice. The CDC provides an extensive overview of concussion information.

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Outlook

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, people experience emotional, mental, or physical changes that are more lasting. Repeat concussions should be avoided because even though they are rarely fatal, they can increase the chances of getting permanent brain damage.

Find a doctor

Finding a concussions doctor

Looking for doctors with the most experience treating concussions? Use the doctor search tool below, powered by our partner Amino. You can find the most experienced doctors, filtered by your insurance, location, and other preferences. Amino can also help book your appointment for free.

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