Concussion

What is a Concussion?

A concussion is a traumatic injury to the brain that results in a temporary loss of it’s normal function. Concussions are the result of a sudden and direct blow or jolt to the head or neck, and in some cases violent shaking of the head and upper body. The brain is made to move inside the skull, and severe concussion can cause damage to nerves and blood vessels. Loss of consciousness can occur in severe concussion, but this is less common. Depending on how violently the brain was shaken, concussions and their related symptoms can pass within a matter of days or weeks; in more serious cases, these can last for months and may require emergency intervention. Symptoms may include losing balance, feeling confused, a disturbance in your vision and nausea/vomiting; more severe symptoms such as loss of consciousness, bleeding from the ears or noses, and seizures should not be ignored and immediate medical attention should be sought. 

What are the typical symptoms of a Concussion?

The severity of the injury will reflect in the symptoms experienced. In most cases, a single concussion should not cause any permanent damage and mild concussion symptoms are temporary. These may appear suddenly, though in some cases can onset shortly after injury, referred to as a delayed concussion. Symptoms can include any of the following:

• Memory loss. Amnesia, or loss of memory, is a common symptom of concussion, and can cause an individual to forget the details of how or when the injury occurred. 
• Confusion. Due to the temporary loss of normal brain function, feeling dazed, confused or stunned is a common sign of a concussion. 
• Headache. As the injury has occurred to the brain, headaches can present themselves after suffering with a concussion. 
• Ringing in the ears. Tinnitus can be experienced in concussion and is usually temporary, and is one of the more common concussion symptoms. 
• Dizziness. A difficulty with balance is another one of the more common signs of concussion due to the disturbance in the brain and inner ear. 
• Nausea/vomiting. Feeling sick can be the result of dizziness experienced following a mild concussion; vomiting may follow, depending on the severity of the injury. 
• Fatigue and drowsiness. Sleep problems in general, such as insomnia, may follow a concussion, as well as feeling very tired and sluggish.
• Disturbed vision. This can include blurred vision, double vision, difficulty focusing, light sensitivity and problems reading. 
• Behaving out of character. Personality changes may present in an individual following concussion; irritability is most commonly reported, as well as mood swings, impulsitivity, anxiety and depression.

What causes a Concussion?

A concussion is the result of an injury to the head that causes the brain to move around and strike into the inner walls of the skull; it may even twist side to side depending on the severity of the injury. The brain is usually protected from doing this day to day by a substance inside the skull called cerebrospinal fluid, and a significant force is required to disturb it. Accidents and injuries are the causes of concussions, with some of the exact causes listed below:

• Violent blow to the head. This can include the head being hit with an object, hitting your head on something with great force, or something hitting the chest or neck. A blow to the head causes the brain to suddenly jolt in the skull, which may result in a concussion. Falling, sports injuries, motor vehicle and bicycle accidents are common causes.
• Sudden acceleration/deceleration. Being propelled at a high speed, or being stopped suddenly from a high speed, can cause the brain to slide back and forth. Car crashes and whiplash are often the common causes of this type of concussion.
• Violent shaking. Either to the upper body or the head itself, violent shaking may lead to a concussion. 
• Blast injury. Though less common, a blast injury (caused by shockwaves from a nearby explosion) can send ripples through the brain without anything physically contacting it in a typical trauma; this can cause a concussion to occur.  

How to help prevent a Concussion

As concussions are caused by injury, there are certain risk factors that increase the risk of them occurring. Below are some preventative measures that can be taken to reduce any likelihood of receiving a brain injury:

• Wearing helmets or protective headgear. Protecting the head when playing high-contact sports, or when riding a motorcycle or bicycle, can absorb the shock of any direct impact and reduce the risk of experiencing concussion. In some sports, even wearing a gumshield or mouthguard has been known to reduce concussions by absorbing the shock of an impact.
• Remove trip hazards from the home. Falling and hitting the head can lead to a concussion; by taking steps to improve safety in the home, such as securing rugs, electric cables, and tidying away objects from the floor will remove the risk of a trip or fall.
• Safe driving. Never drive under the influence of drugs or alcohol, or prescription medication that can cause cognitive impairment. Always wearing a seatbelt whilst driving or being driven in a motor vehicle will reduce the risk of a concussion in the event of a crash or collision. 

How is a Concussion typically diagnosed?

It is recommended to seek medical attention if suffering a suspected concussion, even with only mild symptoms. A doctor will physically assess you, checking for trauma and tenderness signs on the head or neck, and ask about the injury that caused it and any symptoms you are experiencing. On occasion, a doctor may also ask some simple questions to assess memory and concentration, such as your name, your address, and who the current prime minister is. Concussion diagnosis can usually be achieved from an assessment of your symptoms alone, however further tests may be carried out to rule our more significant effects of a head injury such as a bleed to the brain.

• Coordination and reflex tests. These are simple tests that may be performed to assess how well you can balance and respond to external stimuli.
• CT scan/MRI scan. Where a more severe concussion is suspected, a doctor may request some imaging to assess whether more serious damage has been caused. While CT scans expose you to a very small amount of radiation, CT and MRI scans are completely harmless.

How is a Concussion treated?

Depending on the severity of the injury, concussion treatment begins at home. A doctor will recommend what steps you should take to recover and reduce the long-term effects of concussion. These will likely include:

• Rest. Staying seated or laying down, avoiding stressful situations and strenuous exercise, are the first essential steps to treatment. You may also be signed off work, school or college and be told to refrain from driving or riding a bike until you have fully recovered.
• Observation. A doctor may recommend someone be with you for the first two or three days following a concussion to check on symptoms such as behavioural changes and ability to concentrate.
• Avoid alcohol. You will be told to avoid drinking any alcohol for a period of time until you start feeling back to your usual self.
• Painkillers. Where headaches present, paracetamol or ibuprofen may be recommended; aspirin is to be avoided to decrease any risk of a bleed to the brain. 

How can Doctify help with a Concussion?

At Doctify, we are proud to work with leading specialists in all fields of medicine. Our service could put you in touch with some of the country’s leading consultants based on real patient reviews. To find the right doctor for you, visit www.doctify.com/uk.