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What is a Concussion?
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By Engineer Greg Whitman
May 20, 2015

Only recently have we begun to understand what occurs to the brain during a concussion. In the past, people used the analogy that a concussion was a “bruise to the brain.” It is actually a very complex physiologic event. Common sports injuries such as torn ligaments and broken bones are structural injuries that can be seen on x-rays or felt during an examination. A concussion, however, affects how the brain works. It’s a problem of function, not structure. That is why brain CT scans and MRI results are normal with most concussions. A concussion is not an injury that can be seen.

Even what appears to be a mild jolt or blow to the head or body may cause the brain to shift or rotate suddenly within the skull. This sudden movement of the brain causes stretching and tearing of brain cells, damaging the cells and creating chemical changes in the brain. These chemical changes result in physical, emotional, and cognitive symptoms (see the symptom checklist for common signs/symptoms of concussion). Once these changes occur, the brain is vulnerable to further injury and sensitive to any increased stress until it fully recovers. Studies suggest that it usually takes brain cells about three weeks to regain normal function, but it may take even longer.

Whether it happens while playing sports, at work, or just slipping on an icy sidewalk. Head injuries can range from “mild” to “severe”, with a majority of cases being concussions or mild TBI.

A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth.

Health care professionals may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, their effects can be serious.

You can’t see a concussion and some people may not experience and/or report symptoms until hours or days after the injury.The good news is that most cases are treatable and there are several ways to help prevent injury.

Second-Impact Syndrome (SIS)

Second Impact Syndrom occurs when the brain swells rapidly, and catastrophically, after a person suffers a second concussion before symptoms from an earlier one have subsided. This second blow may occur minutes, days or weeks after an initial concussion, and even the mildest concussion can lead to SIS. The condition is often fatal, and almost everyone who is not killed is severely disabled. The cause of SIS is uncertain, but it is thought that the brain’s arterioles lose their ability to regulate their diameter, and therefore lose control over cerebral blood flow, causing massive cerebral edema.

Most cases of SIS have occurred in young people, who are thought to be particularly vulnerable. In order to prevent SIS, guidelines have been established to prohibit athletes from returning to a game prematurely. For example, professionals recommend that athletes not return to play before symptoms of an initial head injury have resolved.

SIGNS/SYMPTOMS

The signs and symptoms of a traumatic brain injury (TBI) can be subtle. But for some people, symptoms can last for days, weeks, or longer. In general, recovery may be slower among older adults, young children, and teens.

Those who have had a concussion in the past are also at risk of having another one and may find that it takes longer to recover if they have another concussion.

OBSERVED SYMPTOMS

Appears Dazed or Confused
Confused about events
Repeats questions
Answers questions slowly
Can’t recall events prior to the injury
Can’t recall events after the injury
Forgets assignment or schedule

PHYSICAL SYMPTOMS

Headache or “pressure” in head
Nausea or vomiting
Dizziness or balance problems
Fatigue or feels tired
Blurred vision or double vision
Sensitive to light or noise
Numbness or tingling

COGNITIVE/EMOTIONAL SYMPTOMS

Difficulty thinking clearly
Difficulty concentrating
Feeling sluggish hazy
Feeling foggy
Irritable or more emotional
Changes in sleep patterns
Sad or nervous (new)

OTHER SIGNS AND SYMPTOMS MAY INCLUDE:

Difficulty remembering, concentrating, or making decisionsInformation_for_Parents
Slowness in thinking, speaking, acting, or reading
Getting lost or easily confused
Loses balance, drops things, trips
Feeling tired all of the time, having no energy or motivation
Urge to vomit or feeling nauseous
Loss of sense of smell or sense of taste
Ringing in the one or both ears

SIGNS AND SYMPTOMS IN INFANTS AND CHILDREN:

Children with a brain injury can have the same symptoms as adults, but it is often harder for them to let others know how they feel.

Call your child’s doctor if you notice any of these symptoms after injury:

Tiredness or listlessness
Irritability or crankiness (will not stop crying or cannot be consoled)
Changes in eating (will not eat or nurse)
Changes in sleep patterns
Changes in the way the child plays
Changes in performance at school
Lack of interest in favorite toys or activities
Loss of new skills, such as toilet training
Loss of balance or unsteady walking
Nausea and Vomiting

Information courtesy of Hits To The Head

Hyperlinks: HitsToTheHead.org
 

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