Concussion
What
is it?
A
concussion is a trauma-induced injury to the brain
occurring after a blow to the head. It can cause
confusion, amnesia and loss of consciousness.
Who
gets it?
Over
1.1 million adults and children in the U.S. suffer
a concussion each year, most of them occurring to
young men between 16 and 25 years of age.
The
risk of concussion from football is extremely
high, especially at the high school level. Studies
show that approximately one in five players suffer
concussion or more serious brain injury during
their brief high-school careers. The rate at the
collegiate level is approximately one in twenty.
What
causes it?
A
concussion occurs when a blow to the head causes
the brain to be jarred against the skull with
sufficient enough force to cause temporary loss of
function in the higher centers of the brain. A
concussion may result from a fall, car accident,
sports injury, or any action that results in a
blow to the head. In motor vehicle accidents, a
concussion can occur without an actual blow to the
head. Instead, concussion occurs because the skull
suddenly decelerates or stops, which causes the
brain to be jarred against the skull.
What
are the symptoms?
Symptoms of a concussion include headache,
dizziness, loss of consciousness, and a lump, cut,
bruise or swelling on the head. Other signs are
numbness, nausea, vomiting, mental confusion, or
memory problems. The patient may feel tired, not
see clearly, have incoherent or incomprehensible
speech, ringing in the ears and have amnesia for
the events just prior to the blow. The symptoms of
a concussion may last several minutes to several
hours, with more severe, longer-lasing symptoms
indicating a more severe brain injury.
How is
it diagnosed?
To
diagnose a concussion, the doctor may play close
attention to the patient’s symptoms and
progression immediately after the accident. The
duration of unconsciousness and degree of
confusion are very important indicators of the
severity of the injury and help guide the
diagnostic process and treatment decisions. The
doctor may perform a neurologic exam of the
pupils, coordination, sensation and brief tests of
orientation, memory and concentrations.
Questionable or more severe cases may require CT
or MRI scans to look for brain injury.
What
it the treatment?
Treatment for a concussion will depend upon the
severity of symptoms. A grade one or two
concussion where the patient remains conscious and
other symptoms disappear within one week can
usually be treated with rest and continued
observation. The patient may return to contact
sports only after all symptoms have completely
resolved. Worsening of symptoms, or continuation
of any symptoms beyond one week may indicate the
need for a CT or MRI scan.
A
patient with a grade three concussion (involving
any loss of consciousness, no matter how brief)
should be examined by a medical professional
either on the scene or in an emergency room. The
doctor may perform a CT or MRI scan along with a
thorough neurological and physical exam if the
patient’s symptoms are severe. The patient may be
hospitalized if any abnormalities are found or if
confusion persists. Following discharge from
professional care, the patient may be closely
monitored for neurological symptoms that may arise
or worsen. Contact sports should be avoided for
one week following unconsciousness of only
seconds, and for two weeks for unconsciousness of
a minute or more.
It is
important that a patient who has sustained a
concussion of any severity avoid the possibility
of another blow to the head until after all
symptoms have cleared to prevent second impact
syndrome. Second impact syndrome occurs when a
person with a concussion, even a very mild one,
suffers a second blow before fully recovering from
the first. The brain swelling and increased
pressure on the brain can potentially be fatal.
A
recent study indicates repeated concussions may be
associated with the later development of clinical
depression. In a study of the nearly 2,500 retired
professional football players, 263 suffered from
depression. Researchers found players who
sustained three or four concussions had twice the
risk of depression, compared with those with no
history of the mild brain injury. Having sustained
at least five concussions nearly tripled the risk
of depression.
Self-care tips
Using
appropriate protective gear, such as helmets when
participating in contact sports such as bicycling,
skiing or horseback riding, may prevent many
concussions. Seat belts and air bags in
automobiles can also prevent concussions.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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