What Should You Do If You Think You Have Had a Concussion?

BrainLine

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• The medical definition of  "concussion" needs be quantitative and non-static. It also needs to have clinical utility. See more of Dr. Ghajar's videos here. Dr. Jamshid Ghajar: Complex Project to Define Concussion
• Concussions have been around since the beginning of time, but our knowledge and treatment of them are and need to be vastly different. It all starts with the need for one, sound definition. See more of Dr. Ghajar's videos here. Dr. Jamshid Ghajar: Multiple Definitions of Concussion
• Educate everyone involved about concussion — from the player and his parents to the coach and the teammates. Importance of Concussion Education
• Learn the basic signs and symptoms of a brain injury from loss of consciousness to changes in behavior. Basic Signs and Symptoms of TBI
• The first of a four-part podcast series for healthcare professionals who are NOT specialists in brain injury. The Basics of TBI
• Oftentimes a child sustains a TBI but her CT or MRI scan shows nothing. If symptoms persist, seek out a specialist.
  
  Transcript of this video. What to Do If Your Child's Symptoms Are Not Abating
• Diffuse axonal injury affects nerve fibers, which can lead to a  disruption in nerve communication — affecting a person's physical and cognitive abilities. Understanding Diffuse Axonal Injury

What exactly is a concussion?

Although there is actually no single, accepted definition of concussion, it is commonly described as a blow or jolt to the head that disrupts the function of the brain.

Also called a mild traumatic brain injury, a concussion can result from a car crash, a sports injury, or from a seemingly innocuous fall. Concussions can also occur when the head and upper body are shaken violently. Recovery times can vary greatly.

So, how do you know if you should seek medical attention or wait and see?

The best answer: when in doubt, get prompt medical attention. Lots of people may have a headache or dizziness for a day or so and then recovery fully, but a very small group of people who sustain a concussion — five percent — can develop bleeding or a blood clot that can be life threatening if not promptly diagnosed.

Brain injuries are extremely common, but diagnosis can be complicated. Today, there is no single, objective measure that can determine if someone has had a concussion. To make a diagnosis, professionals look at many variables that might indicate trauma,  ranging from changes in balance to memory lapses and dizziness.

It’s critical to seek immediate medical attention in a hospital or emergency department if any of these symptoms are present:

• Loss of consciousness, even if only briefly
• Any period of amnesia, or loss of memory for the event
• Feeling dazed or confused
• Headache
• Vomiting
• Seizure
• In addition, for children under 2 years of age, any scalp swelling or abnormality in the way they usually behave.

And if possible, see a medical professional who has knowledge of and experience with brain injury.

Tests

Depending on your symptoms, your age, and the severity of the injury, the emergency department physicians may order some tests. Here are some of the most common:

• Neurological test– A basic neurological exam in the ER assesses motor and sensory skills, the functioning of one or more cranial nerves, hearing and speech, vision, coordination and balance, mental status, and changes in mood or behavior, among other abilities. 
• CT scan– A CT is a special computerized x-ray that provides images of the brain and is sometimes used to look for suspected bleeding or swelling.
• MRI scan– A Magnetic Resonance Imaging test provides detailed pictures of the brain using magnetic energy instead of radiation.

Even though someone has had a concussion, the MRI and CT scans are often negative. That does not mean that there is no injury; it just means that the damage is not visible on the scans.

Rest

Simple though it sounds, rest is the best treatment we have today for a concussion.

If you think of the brain as an engine, it runs out of gas faster after an injury. Rest is the only way to fill up the tank again. So, the best way to recover is to rest.

Rest is important because the brain continues to heal even after all the symptoms are gone. At least initially, rest means not reading, not listening to music, not watching TV. It means no texting, no email, no cell phone. Rest means physical rest AND cognitive rest.

That said, if symptoms persist — headaches, nausea, dizziness, balance problems, confusion — after you have gotten medical care, call your healthcare provider again. Be persistent and find a healthcare provider who specializes in treating traumatic brain injury.

Prognosis

Most people who sustain a concussion or mild TBI are back to normal often in a week or two and almost always within a few months. But others can have long-term problems either from the concussion or from injury to surrounding soft tissues.

The sooner someone is diagnosed, the better the chances for a good recovery because rest is so important

One word of caution: Because a concussion affects the brain, the injured person may lack the clear judgment to make an informed decision regarding whether or not to go to the hospital. Family and friends can be instrumental in urging him or her to seek medical attention. Remember, when in doubt, check it out!