Between 1.6 and 3.8 million concussions are believed to occur across the United States each year. Thankfully, an increased awareness has prompted an increase in diagnosis of concussive injuries.
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But what exactly is a concussion?
“It’s a short-lived functional brain injury typically caused by a bump or blow to the head,” explains concussion specialist, Richard Figler, MD. “A concussion sets off a chemical process in the brain as it’s trying to heal itself. During that process, and depending on what part of the brain was impacted, it can affect different functions like balance, memory, focus or even cause visual disturbances.”
There’s also usually a neck component when it comes to concussions. When you hit your head, the neck can take on some of that force as well.
If you’ve been diagnosed or suspect that a friend or family member has a concussion, treatment — including physical and mental rest — should start right away. Don’t wait to seek help from a medical professional with expertise in evaluating and managing concussions.
What are the signs, symptoms & warning signs of a concussion?
Signs and symptoms of a concussion can occur immediately, hours or even days after the initial “hit” or fall. Symptoms can change over time, depending on activity level and with other potentially associated injuries, making them difficult to recognize and manage.
“Only about 5 to 10% of people who get concussions will experience loss of consciousness,” says Dr. Figler. “Loss of consciousness does equal a concussion, but not having loss of consciousness does not mean you didn’t have a concussion either.”
Anyone experiencing or demonstrating any of the following sign and symptoms after suffering a direct blow or jarring contact with their head or body may have a concussion and should be evaluated by a healthcare provider.
- A dazed or stunned appearance.
- Personality or behavioral changes.
- Loss of consciousness — even brief.
- Seems “out of it.”
- Forgetting events prior to or after a “hit.”
- Slow response to questions or repeatedly asking questions.
- Balance problems.
- Double, blurry or changed vision.
- Sensitivity to light and/or noise.
- Excessive fatigue or drowsiness.
- Trouble comprehending, concentrating and/or paying attention.
- Irritability, nervousness.
- Feeling increasingly emotional or sad.
- Feeling “just not right” or in a “fog.”
- Changes in sleep patterns.
Because more concerning problems can arise in the first 24 to 48 hours after a head injury, anyone suspected of sustaining a concussion should be monitored for worsening symptoms.
If you have any concerns or notice any of the following warning signs after a head injury, always seek medical attention immediately.
- Repetitive severe nausea or vomiting.
- Pupils that are enlarged or unequal in size.
- Unusual or bizarre behavior.
- Inability to recognize people or places.
- Severe dizziness or feeling lightheaded.
- Progressively worsening headache.
- Double or blurry vision.
- Numbness or weakness in the arms or legs, clumsiness.
- Excessive drowsiness or fainting.
- Slurred speech.
- Difficulty waking from sleep.
How do doctors assess a concussion?
Since there’s such a wide range of symptoms, doctors use an array of tests to evaluate, monitor and diagnose a concussion.
“We’ll test everything from checking their balance, to their reaction time, to some in-depth neurocognitive tests,” says Dr. Figler. “But every evaluation will include a graded symptom checklist and then an exam to make sure that there’s nothing lurking that we don’t outwardly see.”
Other tests can include: eye movement and function testing, a cervical spine exam and a thorough neurological exam to make sure there’s nothing underlying that might warrant further imaging or testing down the road.
5 steps to take after a concussion
Follow these tips to start the healing process after a concussion:
- Identify and avoid triggers. Any activity that produces or increases symptoms is considered a trigger. It’s important for you to know what aggravates your symptoms to help recovery. For example, if bright lights are bothering you more than they have in the past, control that brightness by turning down the light, wear sunglasses or use a brimmed hat such as a baseball cap.
- Get some sleep. Our brain recovers during sleep. Sleep is even more important when recovering from a concussion. Dr. Figler says it’s common to feel more exhausted from daily activities such as school or homework while recovering from a concussion. If needed, take short naps (30 to 60 minutes) when tired. But try not to take so many that they interfere with your ability to sleep later on at night. Minimize any distractions, such as TV or phones, while trying to fall asleep.
- Rest your brain. Over stimulating your brain after a head injury will not allow it to rest and recover. Using your brain to think hard, read, study or try to learn new material may be very difficult and may aggravate your condition. Processing new information can be harder for anyone who is concussed. If you have work or studying to do, spread it out and take frequent breaks. Students should talk to teachers about adjusting assignments while they recover.
- Rest your body. While recovering, avoid doing anything that significantly increases your heart rate unless you’ve been cleared by a physician. Light activity, such as walking or riding a stationary bike, may actually help in your recovery, as long as it doesn’t worsen the symptoms.
- Be smart. Rest and recover. Returning to sports or other activities too soon after a concussion can worsen symptoms and keep you off the court or field longer.
4 things to avoid after a concussion
Steer clear of these things to optimize your recovery:
- Excessive physical activity. An increased heart rate may worsen your symptoms, dragging out your recovery.
- Strenuous mental activities. Reading, computer work, playing video games, texting and watching TV can overstimulate your brain, says Dr. Figler. It’s OK to try these activities, but if symptoms occur, you should stop, rest and recover before returning to them.
- Driving too soon. As a precaution, do not drive for at least 24 hours after a concussive injury. Your reaction time may be slowed down, increasing the risk of accidents and further injury.
- Pain relievers. Use caution taking aspirin or anti-inflammatory medications such as ibuprofen (Motrin®, Advil®) or naproxen (Aleve®). Theoretically, they may increase your risk of bleeding. They can also mask symptoms, leading to worsening symptoms when the medications wear off.