What is a concussion?

A concussion is a temporary loss of brain function due to trauma. It may or may not be caused by a blow to the head. A concussion can occur with a jolt or blow to the head causing a "dazed" feeling. You do not have to lose consciousness in order to experience a concussion. A concussion can also be diagnosed as a mild traumatic brain injury  (MTBI).

A concussion/ MTBI causes changes in the  chemistry of the brain. The brain normally maintains a delicate balance between the chemicals that control our behaviors and reactions.  

The brain is surrounded in the skull by fluid. This protects the chemical balance from being altered by trauma to the brain. With a jolt or blow to the head, the brain is bounced around and may make contact with the hard skull. This "bouncing around" can cause an alteration in the chemicals or neurotransmitters (chemicals that are used to relay messages to other cells). These chemical changes cause the symptoms after a concussion.

One of the reasons concussions are so dangerous is a condition called Second Impact Syndrome. If a person sustains a second concussion before completely recovering from the first, the results can be deadly.

How do concussions happen?

Concussions can happen to anyone. Studies have shown the most common ways a person recieves a blow or jolt to the head include:

What happens when someone has a concussion?

As mentioned above, there are chemical changes that occur with a jolt or blow to the head. Immediate signs and symptoms of chemical changes may include:

• Confusion
• Amnesia – especially to details before and/or after the event
• Headache
• Nausea/vomiting
• Poor balance
• Unequal pupil size
• Slurred speech
• Sensitivity to light and noise
• Loss of consciousness

These symptoms may occur at the time of injury and for a short time afterward and may only last an hour or two. Symptoms may also last 5 to 10 days and new ones may appear in this time frame.

What should a person with symptoms of concussion do?

If a person experiences a jolt or blow to the head that causes a "dazed" feeling, he or she should stop whatever they are doing and recognize they have injured their brain. 

Too many times, those with concussion symptoms try to "shake it off" or push on through the symptoms. This may cause further damage to the brain and can also lengthen recovery time. Rest and monitoring is needed. Most injuries do not require extensive medical treatment. The symptoms will lessen and go away. 

Yet, monitoring is needed in case symptoms should worsen and require a doctor's attention. A person with worsening symptoms should be evaluated immediately by a doctor or be taken to an emergency room. 
If in doubt, check it out!

How is a concussion treated?

The symptoms of a concussion usually subside and disappear within 5 to 10 days. During that time, resting the body and the brain should move the recovery process along. The chemical changes that have occurred with a concussion last longer than the symptoms, so returning to exertion and contact sports should be started in steps once the symptoms have gone away. Doctors may treat some of the symptoms such as a headache, yet there is no medicine that can help the chemicals of the brain return to balance. Time and rest are key. 

It is extremely important for persons with concussion symptoms not to return to exertion activities or sports. If the brain has another jolt or blow before it has  healed or fully recovered from the first concussion, a person may experience second impact syndrome (SIS). SIS is a rapid, fatal brain swelling that may occur if a person suffers another head impact - even a minor one - before the physical and cognitive symptoms of a previous concussion have fully cleared.

When should a person seek follow up treatment if the symptoms will not go away or "things just aren’t right"?

It is important that your family doctor be aware of your concussion. If symptoms persist beyond 10 to 14 days, a person may be experiencing post concussive syndrome (PCS) and should seek treatment from a family doctor or a specialized concussion clinic. While there are no medicines that can help the brain chemicals balance, there are treatments for other symptoms such as dizziness, depression, headaches, fatigue, reduced memory and others.

What is involved in the treatment of  post concussive syndrome (PCS)?

Post concussive patients will usually have either a CT or MRI scan performed. These tests will ensure that there are no obvious deformities.

If symptoms persist past 2 to 4 weeks, in-depth cognitive testing is done to help with a recovery plan. A physician will gather information from the testing, his interview and exam for symptoms, and create a plan for a patient to return to daily activities. When a patient is symptom free, a step by step exertion plan will be discussed and monitored for those returning to sports and/or highly physical activities. 

The goal to help the patient return to the same activity level and brain chemical balance as they had before the concussion.  This is not always the case. If a patient does not show improvement with treatment and monitoring, ways to compensate for these changes lasting symptoms are supported through the health care team.

Learn more

Go to the CDC web site to find out about concussion in youth sports. The site offers information for athletes, parents and coaches.