Heads Up On Concussion Symptoms
Medically reviewed by Carmen Fookes, BPharm. Last updated on Jan 28, 2021.
What is a Concussion?
Concussion is the term used when a person suffers a blow to the head or upper body that results in short-term confusion, disorientation, forgetfulness, and sometimes, brief loss of consciousness. This can happen while playing a sport, as a consequence of falling, during a physical altercation or as a result of a motor vehicle accident.
Concussion is also referred to medically as a mild traumatic brain injury. The term "Mild" is only used because concussions are not usually life-threatening. Even so, the effects of some concussions can be serious and have long-lasting consequences. A concussion should never be taken lightly.
How Common is Concussion?
True concussion statistics are hard to come by, mainly because many people who get a concussion do not seek medical attention. An estimated 1.6 to 3.8 million sports-related concussions happen each year. Emergency department statistics show over 170,000 occur in children and young adults under the age of 19.
It is important that concussion prevention and management is not overlooked or downplayed in children and teens. This age group is more likely to get a concussion and take longer to recover than adults.
What Are the Signs?
Generally speaking, if somebody has hit their head or upper body and is now confused and unaware of the time, date, or place, then they are showing signs of a concussion.
Other common symptoms include feeling dizzy, or looking dazed or stunned; repeating questions; or sensitivity to light or noise. Symptoms may occur immediately or occur after a delay of several hours. You don't have to always lose consciousness for a head injury to be called a concussion.
Unfortunately, there is no single test that can reliably diagnose a concussion; however, one small study showed that children with a concussion averaged 35 percent less brain response to sound immediately following the injury. The processing of sound is something that cannot be faked or misreported.
In 2018, a blood test, called Banyan BTI (Brain Trauma Indicator), was approved by the FDA to aid in the diagnosis of concussion. This test measures levels of two protein biomarkers -- ubiquitin carboxy-terminal hydrolase-L1 and glial fibrillary acidic protein -- that are released from the brain into blood within 12 hours of head injury.
What If I Suspect a Concussion in Someone?
Everybody should know basic concussion-related first aid. Check out the Heads Up resources for concussion from The Centers for Disease Control and Prevention (CDC) for athletes, parents, coaches, school staff and doctors. ALL concussions should be treated as serious and the concussion ABCs followed:
- Assess the situation
- Be alert for signs and symptoms
- Contact a health professional.
Injured athletes should be assessed by a coach or first aider with training in the sideline assessment of concussion. They should not be allowed to return to play and should also be seen by a doctor that day.
All athletes, not just those playing football, are encouraged to watch the NFLPA Brain Health & Concussion Education Video. This excellent resource talks about the pressure on athletes to return to play too soon after a concussion. As an athlete you should know what symptoms suggest concussion and when you should remove yourself from play. Be insistent. This is your long-term health that is at stake.
Which Symptoms Warrant a Trip to the Emergency Room?
Take anybody whose head injury was caused by a high-impact event or who experiences the following symptoms (either immediately following, or within 24 hours of the injury occurring) to the Emergency Room, or call an ambulance:
- A headache along with nausea and/or vomiting
- Confusion or disorientation
- Loss of consciousness
- Suspected neck or spine injury (only qualified personnel should move the person)
- Suspected skull fracture (symptoms include obvious bruising anywhere on the head, blood or fluid draining from nose)
- Worsening symptoms.
What Is The Treatment For Concussion?
Once a person with a concussion has been checked out by a doctor or discharged from the ED, the best thing to speed their recovery is REST. This means lying down, in a semi-darkened room, with somebody keeping an eye on them for at least the next 24 hours. NO reading, watching TV, computer games, or physical activity. Also, they should not drive, work with machinery, or work at heights until symptom-free.
Once a health care professional has deemed them well enough, then a gradual return to activities is recommended. The most important thing to remember is that everybody is different and some people take a lot longer to recover from a concussion than others. One study found people who were more likely to complain of general body aches and pains caused by mental distress before the event that led to concussion took longer to recover than those who didn't.
Are Boys More at Risk of Concussion Than Girls?
Yes, boys are more at risk of concussion, mainly because they are more likely to play sports that carry a higher risk of concussion, such as football or rugby. Also, rates of participation in sports are higher in boys than girls. However, in sports such as basketball and soccer that have high numbers of both male and female participants, the risk of concussion is higher in girls.
Since 2007, the number of concussion diagnoses has more than doubled among U.S. kids and teens. Children aged 10 to 14 have experienced a more than tripling of their injury rate.
Unfortunately, guidelines regarding concussion in children are often ignored. Almost one-third of children aged between seven and 14 returned to play on the same day. Children who return to play too early are more likely to suffer a second concussion or take longer to recover. Some experts even suggest children who have had a concussion should undergo a comprehensive eye exam before going back to school as ongoing vision and concentration difficulties can impair their ability to learn.
You can learn more about specific signs and symptoms of a concussion in children by reading this article.
What Sports Have the Greatest Risk?
Overall, concussion risk is greatest in football, rugby, hockey and soccer.
Risk can vary depending on position played (quarterbacks, defensive backs and linebackers have a higher risk than receivers), safety gear worn (half-face shields in hockey are not as protective as full-faced shields) and type of playing surface (artificial turf is a lot less forgiving than dirt).
Statistics report that you are less likely to receive a concussion in sports such as baseball, softball, volleyball and gymnastics.
How Can I Lower My Risk Of Getting a Concussion?
You are less likely to get a concussion if you:
- Use protective equipment during sports with a correct technique
- Use safety equipment such as seat belts, booster seats, and helmets
- Improve safety to prevent falls around your home, garden, or playground Develop and strengthen your neck muscles
- Have not had a concussion before.
You are more likely to get a concussion if you:
- Play certain sports
- Have a body mass index (BMI) of more than 27kg/m2
- Have had a concussion in the last ten days.
When is it Safe to Return to Play?
An athlete should only return to play following a concussion once an experienced licensed healthcare provider (LHCP) has given the all-clear.
An LHCP is not a coach, a parent, or the athlete himself. Athletes should not return to play the same day. Anybody who returns to play too early is six times more likely to sustain another concussion than people who have never had a concussion. For every subsequent concussion an athlete sustains, their recovery is longer and they are more likely to develop complications such as second impact syndrome (brain swelling) or suffer long-lasting effects.
Some school in the U.S. are now requiring Impact Testing as a way of measuring the athletes mental status at baseline before the sports season begins. This enables more efficient comparison should a concussion occur during play in that season. New state laws now also mandate standardized treatment of concussions.
What Are The Long-Term Effects of a Concussion?
Most people with a concussion recover with minimal input from medical personnel.
However, symptoms of headache, dizziness, and drowsiness may last for six months or longer in some people. Teenagers and children take longer to recover than adults and can still experience learning difficulties a year down the track. Schools should be informed and accommodations granted with regards to time off from school, rest breaks during the day, and a break from standardized testing.
Studies are ongoing regarding the long-term consequences of concussion. One study has found a higher risk of suicide later in life in those who have been concussed. Diseases such as Parkinson's Disease or dementia are more common in those who have a history of concussion.
Everybody with ongoing symptoms following a concussion should remain under the care of a doctor.
Finished: Heads Up On Concussion Symptoms
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- What is a Concussion? Updated Feb 12, 2019. Centers for Disease Control and Prevention. https://www.cdc.gov/headsup/basics/concussion_whatis.html
- Concussion. Mayo Clinic. 2021 https://www.mayoclinic.org/diseases-conditions/concussion/symptoms-causes/syc-20355594
- Updated Mild Traumatic Brain Injury Guideline for Adults. Updated January 22, 2016. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/mtbi_guideline.html
- West TA, Marion DW. Current recommendations for the diagnosis and treatment of concussion in sport: a comparison of three new guidelines. J Neurotrauma. 2014;31(2):159-168. doi:10.1089/neu.2013.3031