Concussion
Brain injury - concussion; Traumatic brain injury - concussion; Closed head injury - concussion
A concussion may occur when the head hits an object, or a moving object strikes the head. A concussion is a minor or less severe type of brain injury, which may also be called a traumatic brain injury.
A concussion can affect how the brain works for a awhile. It may lead to headaches, changes in alertness, or loss of consciousness .
Loss of consciousness
Unconsciousness is when a person is unable to respond to people and activities. Doctors often call this a coma or being in a comatose state. Other c...
Causes
A concussion can result from a fall, sports activities, or car accidents. A big movement of the brain (called jarring) in any direction can cause a person to lose alertness (become unconscious). How long the person stays unconscious may be a sign of how bad the concussion is.
Concussions do not always lead to loss of consciousness. Most people never pass out. They may describe seeing all white, all black, or stars. A person can also have a concussion and not realize it.
Symptoms
Symptoms of a milder concussion can include:
- Acting somewhat confused, feeling unable to concentrate, or not thinking clearly
- Being drowsy, hard to wake up, or similar changes
- Headache
-
Loss of consciousness
for a fairly short period of time
Loss of consciousness
Decreased alertness is a state of reduced awareness. A coma is a state of decreased alertness from which a person cannot be awakened. A long-term co...
-
Memory loss (
amnesia
) of events before the injury or right after
Amnesia
Memory loss (amnesia) is unusual forgetfulness. You may not be able to remember new events, recall one or more memories of the past, or both. The me...
- Nausea and vomiting
- Seeing flashing lights
- Feeling like you have "lost time"
- Sleep abnormalities
The following are emergency symptoms of a more severe head injury or concussion. Seek medical care right away if there are:
- Changes in alertness and consciousness
- Confusion that does not go away
- Seizures
- Muscle weakness on one or both sides
- Pupils of the eyes that are not equal in size
- Unusual eye movements
- Repeated vomiting
- Walking or balance problems
- Unconsciousness for a longer period of time or that continues (coma)
Head injuries that cause a concussion often occur with injury to the neck and spine. Take special care when moving people who have had a head injury .
Head injury
A head injury is any trauma to the scalp, skull, or brain. The injury may be only a minor bump on the skull or a serious brain injury. Head injury c...
Exams and Tests
The health care provider will perform a physical exam. The person's nervous system will be checked. There may be changes in the person's pupil size, thinking ability, coordination, and reflexes.
Tests that may be done:
-
EEG
(brain wave test) may be needed if seizures continue
EEG
An electroencephalogram is a test to measure the electrical activity of the brain.
-
Head CT
scan
Head CT
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
-
MRI of the brain
MRI of the brain
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
Treatment
For a mild head injury, no treatment may be needed. But be aware that the symptoms of a head injury can show up later.
Your providers will explain what to expect, how to manage any headaches, how to treat your other symptoms, when to return to sports, school, work, and other activities, and signs or symptoms to worry about.
-
Children will need to be
watched and make activity changes
.
Watched and make activity changes
Mild brain injury in children - discharge; Brain injury in children - discharge; Mild traumatic brain injury in children - discharge; Closed head inj...
-
Adults also need close observation and activity changes
.
Adults also need close observation and ...
Brain injury - concussion - discharge; Traumatic brain injury - concussion - discharge; Closed head injury - concussion - discharge
Both adults and children must follow the provider’s instructions about when it will be possible to return to sports.
You will likely need to stay in the hospital if:
- Emergency or more severe symptoms of head injury are present
- There is a skull fracture
- There is any bleeding under your skull or in the brain
Outlook (Prognosis)
Healing or recovering from a concussion takes time. It may take days to weeks, or even months. During that time you may:
- Be withdrawn, easily upset, or confused
- Have a hard time with tasks that require memory or concentration
- Have mild headaches
- Be less tolerant of noise
- Be very tired
- Feel dizzy
- Have blurry vision at times
These problems will probably recover slowly. You may want to get help from family or friends for making important decisions.
In a small number of people, symptoms of the concussion do not go away. The risk for these long-term changes in the brain is higher after more than 1 concussion.
Seizures may occur after more severe head injuries. You or your child may need to take anti-seizure medicines for a period of time.
More severe traumatic brain injuries may result in many brain and nervous system problems.
When to Contact a Medical Professional
Call the provider if:
-
A
head injury
causes changes in alertness.
Head injury
A head injury is any trauma to the scalp, skull, or brain. The injury may be only a minor bump on the skull or a serious brain injury. Head injury c...
- A person has other worrisome symptoms.
- Symptoms do not go away or are not improving after 2 or 3 weeks.
Call right away if the following symptoms occur:
- Increased sleepiness or difficulty waking up
- Stiff neck
- Changes in behavior or unusual behavior
- Changes in speech (slurred, difficult to understand, does not make sense)
- Confusion or problems thinking straight
- Double vision or blurred vision
- Fever
- Fluid or blood leaking from the nose or ears
- Headache that is getting worse, lasts a long time, or does not get better with over-the-counter pain relievers
- Problems walking or talking
- Seizures (jerking of the arms or legs without control)
- Vomiting more than 3 times
If symptoms do not go away or are not improving a lot after 2 or 3 weeks, talk to your provider.
Prevention
Not all head injuries can be prevented. Increase safety for you and your child by following these steps:
- Always use safety equipment during activities that could cause a head injury. These include seat belts, bicycle or motorcycle helmets, and hard hats.
-
Learn and follow
bicycle safety recommendations
.
Bicycle safety recommendations
Many cities and states have bike lanes and laws that protect bicycle riders. But riders are still at risk of being hit by cars. Therefore, you need...
Do not drink and drive. Do not allow yourself to be driven by someone who may have been drinking alcohol or is otherwise impaired.
References
Heegaard WG, Biros MH, Head injury. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 41.
Kerr HA. Closed head injury. Clin Sports Med . 2013;32:273-287. PMID: 23522509 www.ncbi.nlm.nih.gov/pubmed/ 23522509 .
Krach LE. Severe traumatic brain injury. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 710.
Liebig CW, Congeni JA. Sports-related traumatic brain injury (Concussion). In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 688.
Rossetti HC, Barth JT, Borshek DK, Freeman JR. Concussion and brain injury. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 125.
-
Brain - illustration
The major areas of the brain have one or more specific functions.
Brain
illustration
-
Concussion - illustration
A concussion may result when the head strikes against an object or is struck by an object. Concussions may produce unconsciousness or bleeding in or around the brain.
Concussion
illustration
-
Brain - illustration
The major areas of the brain have one or more specific functions.
Brain
illustration
-
Concussion - illustration
A concussion may result when the head strikes against an object or is struck by an object. Concussions may produce unconsciousness or bleeding in or around the brain.
Concussion
illustration
Review Date: 11/4/2015
Reviewed By: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.