A concussion is a brain injury induced by biomechanical forces that can be caused by a direct blow to the head, face, neck or elsewhere on the body. This impact can result in a biochemical and functional imbalance within the body representing a temporary energy deficit within the brain. Individuals who sustain a concussion often experience headaches, fatigue, dizzy or like they are in a fog. As well, they may also experience neck pain, sleep changes, mood changes, and difficulty concentrating or remembering. It is important to note 90% of concussions do not result in a loss of consciousness.
The current recommended approach for concussions is “recognize, remove, re-evaluate, rest (24-48 hours of absolute rest), and rehabilitation”
Following a suspected concussion a player should be immediately removed from play and evaluated by a licensed health care provider on site to determine if immediate medical care is necessary. A player should then be re-evaluated by a licensed health care provider in a timely manner. For non-athletes who sustain a concussion, one should stop all activities and seek evaluation by a knowledgeable and trained licensed health care provider within a timely manner.
Red Flag Symptom of a Concussion
Red flag symptoms are meant to alert you to more serious injury and to seek urgent medical care to ensure more serious injuries are not present. If red flags are present, immediate medical care should be sought.
Here are a list of danger sings or red flags according to the Centre For Disease Control, Atlanta, USA.
Danger Signs in Adults:
In rare cases, a person with a concussion may form a dangerous blood clot that crowds the brain against the skull. Contact your health care professional or emergency department right away if you experience these danger signs after a bump, blow, or jolt to your head or body:
- Headache that gets worse and does not go away.
- Weakness, numbness or decreased coordination.
- Repeated vomiting or nausea.
- Slurred speech.
The people checking on you should take you to an emergency department right away if you:
- Look very drowsy or cannot wake up.
- Have one pupil (the black part in the middle of the eye) larger than the other.
- Have convulsions or seizures.
- Cannot recognize people or places.
- Are getting more and more confused, restless, or agitated.
- Have unusual behavior.
- Lose consciousness.
Danger Signs in Children:
Take your child to the emergency department right away if they received a bump, blow, or jolt to the head or body, and:
- Have any of the danger signs for adults listed above.
- Will not stop crying and are inconsolable.
- Will not nurse or eat
How Long is Concussion Recovery
The vast majority of individuals will clinically recover within the first month of injury with younger athletes generally taking longer to recover. However some injuries may persist beyond this point representing the very multi-dimensional and individualistic nature of this particular injury. Each concussion is different and may take more or less time to recover.
It is important to have your injury properly assessed by a knowledgeable and trained licensed health care provider.
What are the Steps to Concussion Recovery
A brief period (24-48 hours) of absolute rest is recommended. For students a 4 stage approach to return-to-school strategy should be employed followed by a 5 stage return-to-play approach for athletes.
For adults, a brief period of absolute rest should be followed by light daily activities at home. Return-to-work should closely resemble the 4 stage return-to-learn approach.
For persistent concussion complaints a variety of treatment options are available including; education, diet, symptom-limited aerobic exercise program, cervical and vestibular rehabilitation. All of which can be effectively assessed and employed by a knowledgeable and trained licensed health care provider.
A multi-modal baseline test, assessing a variety of cognitive, physical, balance, and coulomotor domains, can help aid a clinicians ability to assess if an athlete is clinically ready to return-to-play.
McCrory P, Meeuwisse W, Dvořák J, Aubry M, Bailes J, Broglio S, Cantu RC, Cassidy D, Echemendia RJ, Castellani RJ, Davis GA, Ellenbogen R, Emery C, Engebretsen L, Feddermann-Demont N, Giza CC, Guskiewicz KM, Herring S, Iverson GL, Johnston KM, Kissick J, Kutcher J, Leddy JJ, Maddocks D, Makdissi M, Manley GT, McCrea M, Meehan WP, Nagahiro S, Patricios J, Putukian M, Schneider KJ, Sills A, Tator CH, Turner M, Vos PE. Consensus statement on concussion in sport-the 5(th) international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017 Jun;51(11):838-847.
Centre for Disease Control and Prevention. (2017). Traumatic Brain Injury & Concussion. Retrieved from https://www.cdc.gov/traumaticbraininjury/symptoms.html