Understanding Concussions:
Symptoms and Recovery
Concussions are a form of traumatic brain injury. Specifically, they are known as a subset of a mild traumatic brain injury and have become more of a focus with prevention, education, and screening in the medical community. They have been identified as a major health concern due to high rates of occurrence and potential for long-term effects.
According to the CDC, there are an estimated 1.6 to 3.8 million mild traumatic brain injuries that occur annually. Concussions are not only sports-related as well, but can occur with motor vehicle accidents, falls, and military injuries for example.
Concussions can present with a loss of consciousness OR without a loss of consciousness and as a result can go unrecognized due to variation in symptoms and presentation. Overall prevention is key and parents, players, and coaches should be able to recognize signs and symptoms, especially in the first 48 hours.
SIGNS AND SYMPTOMS
Symptoms of concussions can include dizziness, nausea, impaired memory, poor concentration, noise and light sensitivity, confusion, blurred and double vision, and “not feeling right.”
Signs that can be observed include memory loss, unsure where they are, behavior/personality changes, clumsy, slow, and unclear responses, and loss of consciousness.
RED FLAGS
Red flags or emergency indicators that we watch for include spinal fractures, cervical myelopathy, upper cervical spine ligamentous instability, and vertebral artery insufficiency.
- Battle Sign: Bruising behind the ear and at the mastoid process.
- Raccoon eyes: Darkening and bruising around eyes.
- Increasing number of symptoms
WHAT TO DO IF YOU SUSPECT A CONCUSSION
If there is a suspected concussion, the individual needs to be monitored for the first 48 hours for worsening of symptoms. NSAIDs should be avoided, and physical activity should be limited. Sleep is essential, and avoiding screen time is recommended as well.
While there can be a lot of concern with concussions, most individuals have their symptoms resolved 7-14 days post-injury. The concern comes into play further when as many as 5% to 58% have persistent symptoms that linger and affect daily function.
Recovery can vary quite greatly, be complex, and be influenced by multiple factors. It has been found that typically females, youth, and individuals with a history of migraines and ADHD may experience longer recovery. Also, individuals can be more susceptible to a longer recovery if there are injury-related factors such as loss of consciousness, amnesia, and delayed removal from sport. Overall, a clear characterization of risks that may cause poor recovery remains unclear and needs further study and research.
For individuals with ongoing and lingering symptoms, a physical therapist with expertise in this area can help guide a safe return to normal function and a specialized treatment plan based on the limitations of the individual, as well as work with your physician for optimal recovery.
TREATMENT
Some treatments may include self-management and education, specific exercises building up to sport and work-specific tasks, eye and vision tasks, and balance and coordination training.
Concussions can be confusing and intimidating at first glance, but we can help guide you or your loved one back to their everyday activities and rediscover adventure!
