Concussion

Overview

What is a concussion?

A concussion is a type of traumatic brain injury (TBI) that is caused by a blow to the head. It is also possible to get a concussion from a blow to the neck or body that causes sudden head movement. This type of brain injury can happen in recreational activities and in sports. In sports, concussions don’t happen only during competition. They can also happen during drills or practices. A blow to the head, neck, or body from a fall or a car accident can also cause a concussion.

Symptoms

What are some signs of a concussion?

In most cases, a person who has a concussion will not lose consciousness. A concussion can cause a variety of symptoms, including:

Symptoms may be noticed right after the injury, or they may not be noticed until hours or days later.

  • Headache or feeling of pressure in the head
  • Problems remembering or concentrating
  • Dazed appearance
  • Confusion
  • Noticeable balance problems
  • Slow response to questions
  • Nausea
  • Dizziness
  • Blurry vision
  • Sensitivity to light or noise
  • Changes in mood or behavior (for example, irritability)
  • Sleep changes (for example, having trouble falling asleep or sleeping more than usual)

Causes & Risk Factors

Who is at risk for concussion and other sports- and recreation-related traumatic brain injuries?

Recently, more attention has been focused on concussions and other traumatic brain injuries (TBIs) that happen in sports and recreational activities. It is estimated that between 1.6 million and 3.8 million sports- and recreation-related TBIs happen each year in the United States. Many of these are not reported or treated by a doctor or at an emergency room. There’s no guaranteed way to prevent concussions, so anyone who participates in sports or recreational activities is at risk.

Parents should be aware of the risk of concussion and other sports- and recreation-related TBIs in children. More than half of the emergency room visits for these injuries are for children 5 to 18 years of age. Males 10 to 19 years of age have the most emergency room visits for sports- and recreation-related TBIs. Bicycling, football, basketball, soccer, and baseball are associated with the greatest number of emergency room visits for TBIs in children and teens. But concussions can happen in many other sports and recreational activities.

Diagnosis & Tests

How is a concussion diagnosed?

Be sure to contact a doctor if you or a loved one has any concussion symptoms after a blow to the head, neck, or body. The doctor will want information from people who were there when the injury happened. He or she will want to know about the injured person’s symptoms. He or she may test the person’s strength, senses, balance, reflexes, and memory. In more serious cases, the doctor may want to do specific medical tests (for example, a computed tomography [CT] scan) to look for more severe problems from the injury.

It is especially critical to call 911 or go to the emergency room right away if you cannot wake the injured person or if:

  • Any concussion symptoms (for example, headache or confusion) are severe or are getting worse over time
  • The injured person is having seizures
  • The injured person cannot recognize people or places
  • One pupil (the black center of the eye) is bigger than the other
  • The injured person keeps vomiting

Prevention

How can concussions in sports and recreational activities be prevented?

There’s no guaranteed way to prevent concussions. However, you can decrease your risk by learning proper techniques for your sport or activity, and using the right protective equipment. If you play a sport, following the rules can also reduce your risk of getting injured.

Many sports organizations offer programs to help young athletes learn proper techniques so they can avoid injuries. For example, USA Football—which is the National Football League’s (NFL’s) youth development arm—introduced a program called Heads Up Football®. It teaches players to keep their heads up and to lead with their shoulders when tackling.

When you play a sport, a coach or trainer can tell you what protective equipment you need. For example, a helmet can help reduce the risk of a brain injury. However, it will not completely prevent a concussion. There are no “concussion-proof” helmets.

Your protective equipment should fit properly. It should also be kept in good condition. Use this equipment every time you participate in the activity or sport, even during drills and practices.

Are there any lasting effects of a concussion?

Most people get better after a concussion and do not have any permanent brain damage. However, in some cases, memory problems can last for months after the injury. Some people may have a condition called post-concussion syndrome (PCS). People who have PCS have concussion symptoms that last for months, or even years, after the injury. If you do not get proper treatment after a concussion, you are at greater risk for PCS.

Treatment

How is a concussion treated?

If you have a concussion, your brain needs time to heal. It’s important to get rest from both physical and mental activities. Your doctor will let you know when you can gradually return to your normal daily activities. Most people who have a concussion get better within a week or two. Young children and teens may take longer to get better.

While you are recovering from a concussion, you should:

Don’t drive a car, ride a bike, or operate heavy equipment until your doctor says it is safe. While you are recovering from a concussion, you may feel frustrated, sad, or upset. Talk to your doctor, friends, and family members to get support and encouragement.

  • Limit the time you spend on activities that require concentration (for example, texting, watching television, playing video games, using a computer or smartphone, or reading)
  • Drink plenty of fluids
  • Eat healthy foods
  • Get enough sleep
  • Ask your doctor before you take any medicine.
  • Avoid alcohol

When can I return to play?

If you have any concussion symptoms after a blow to the head, neck, or body, you should not return to play on the day of the injury. If your concussion involves memory loss or loss of consciousness, you may not be able to return to play for several weeks. After a severe concussion, you may not be able to return to play for as long as a month. If this wasn’t your first concussion, your return to play may take even longer.

A doctor who is experienced in evaluating concussions should let you know when it is safe to return to play. The recovery time will be different for each person. You should not return to play until your concussion symptoms are completely gone.

If an activity makes your symptoms worse, you should stop doing it. If your concussion symptoms continue to get worse, contact your doctor.

Complications

What are the risks of returning to play too soon?

If you return to play before completely recovering from a concussion, a second blow to the head—even a minor one—can be dangerous. You are at risk of a rare condition called second impact syndrome. This is a rapid brain swelling that is usually fatal. Never return to a sport or recreational activity after a concussion until you have been cleared by a doctor.

Questions to Ask Your Doctor

  • Could I have a concussion without knowing it?
  • When can I safely return to my sport or recreational activity?
  • Should I call you if my symptoms get worse, or should I go to the emergency room?
  • How can concussions be prevented?
  • How can I let coaches and school officials know about the risks of concussions?

Other Organizations

Bibliography

Citations