Concussion

What Is A Concussion?

A concussion, sometimes called a Mild Traumatic Brain Injury (mTBI), occurs when the head hits an object or an object hits the head.

The brain is protected by the skull and by a shock-absorbing liquid that fills and surrounds the brain and spinal cord. Sometimes, a more severe impact can cause the brain to move around inside the skull, which can cause a small amount of bruising of the brain.The brain is also made up of billions of long thin nerve fibers, and these fibers can be stretched or broken if the movement or blow to the head is severe enough. The microscopic and chemical changes that occur in response to this bruising or stretching are responsible for many of the symptoms that occur after a concussion.

What Symptoms Can I Expect?

The common symptoms that occur after a mild brain injury are called ‘Post Concussion Syndrome’ (PCS). Studies have shown that 8 out of 10 people with a concussion will show some of these symptoms during the first 3 months after their accidents. These symptoms are part of the normal recovery process. They are not signs of a serious brain injury. Few people will experience all of the symptoms, but even one or two can be unpleasant.

Common symptoms of post-concussion syndrome include:

  • Difficulty with concentration
  • Irritability
  • Fatigue
  • Low Mood
  • Mild problems with memory
  • Headaches
  • Anxiety
  • Trouble thinking
  • Dizziness
  • Blurred or double vision
  • Sensitivity to noise and light
  • Difficulty with falling or staying asleep

Signs and Symptoms of Concussion in Athletes

Athletes who experience one or more of the signs and symptoms listed below after a bump, blow, or jolt to the head or body may have a concussion.

Signs Observed by Coaching Staff Symptoms Reported by Athlete
Appears dazed or stunned Headache or “pressure” in head
Is confused about assignment or position Nausea or vomiting
Forgets an instruction Balance problems or dizziness
Is unsure of game, score, or opponent Double or blurry vision
Moves clumsily Sensitivity to light
Answers questions slowly Sensitivity to noise
Loses consciousness (even briefly) Feeling sluggish, hazy, foggy, or groggy
Shows mood, behavior, or personality changes Concentration or memory problems
Can’t recall events prior to hit or fall Confusion
Can’t recall events after hit or fall Just not “feeling right” or is “feeling down”

Concussion Symptoms May be Delayed

Symptoms of a concussion may not appear right away and may not be noticed for days or even months after the injury. Some symptoms of a concussion may be missed initially by the person with the concussion, family members or a doctor. People may look fine even though they are acting or feeling differently. It is important to contact a physician if you recognize concussion signs and symptoms. 

Some people who have had a concussion find it more difficult to deal with school and work demands after the injury, making the signs of concussion more apparent. Sometimes, people are not aware of or will not admit they are having problems. Others may not understand why they are having difficulties, which can make them frustrated.

Concussion in Sports: 4-step Action Plan

If you suspect that an athlete has a concussion, implement your 4-step action plan:

  1. Remove the athlete from play. Look for signs and symptoms of a concussion if your athlete has experienced a bump or blow to the head or body. When in doubt, keep the athlete out of play.

  2. Ensure that the athlete is evaluated by a health care professional experienced in evaluating for concussion. Do not try to judge the severity of the injury yourself. Health care professionals have a number of methods that they can use to assess the severity of concussions. As a coach, recording the following information can help health care professionals in assessing the athlete after the injury:

    • Cause of the injury and force of the hit or blow to the head or body
    • Any loss of consciousness (passed out/knocked out) and if so, for how long
    • Any memory loss immediately following the injury
    • Any seizures immediately following the injury
    • Number of previous concussions (if any)
  3. Inform the athlete’s parents or guardians about the possible concussion and give them the fact sheet on concussion. Make sure they know that the athlete should be seen by a health care professional experienced in evaluating for concussion.

  4. IMPORTANT: Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says he or she is symptom-free and it is okay to return to play. A repeat concussion that occurs before the brain recovers from the first—usually within a short period of time (hours, days, or weeks)—can slow recovery or increase the likelihood of having long-term problems. In rare cases, repeat concussions can result in edema (brain swelling), permanent brain damage, and even death.
CHI Health Sports Medicine