Todd Reynolds MD
Concussion Discussion: Joggin' Your Noggin
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Oct 1, 2008 - 9:03:08 AM

Concussions are a common traumatic injury.  It is estimated that about two to four million concussions occur annually in the U.S.  Many of these occur with contact sports: football, soccer, basketball, and rugby. 

A concussion is defined as a temporary disruption in brain function that results from a direct impact to the head.  In its broadest sense, the term “concussion” is usually used to describe any blow to the head, ranging from mild or severe.  It is not life-threatening and does not include injuries that involve bleeding inside the skull or within the brain.  

The severity of a concussion is based on the symptoms the victim exhibits and whether or not they lost consciousness and for how long.  A mild concussion may result from getting hit on the head, a collision, or a fall.  The injured party may be “knocked out” for just a few seconds, or there may be no loss of consciousness.  In contrast, a severe concussion involves a prolonged loss of consciousness (greater than 30 seconds to minutes) and a delayed return to normal.

Symptoms that may be experienced depend on the severity of the injury.  Mild symptoms include “seeing stars” and being dazed or slightly confused.  Headache, blurred vision, mild dizziness, slight nausea, and minimal temporary amnesia (not remembering events just before or after the injury) are common.

Symptoms that indicate a more severe injury include extended loss of consciousness, persistent confusion, nausea with repeated vomiting, extreme drowsiness, weakness or inability to walk, severe headache, persistent blurred vision, slurred speech, and losing consciousness again after a few minutes.

In small children, the degree of injury is more difficult to determine.  They may not be able to communicate specific symptoms and may simply exhibit irritability.  Often, they are more emotionally upset than physically injured.  It is usually best to allow the child a few minutes to calm down before deciding on the course of action.  

About 10% of individuals who have suffered a concussion will experience a constellation of symptoms called the “postconcussive syndrome.”  These symptoms include a persistent headache, dizziness, nausea, minor visual changes, and difficulty concentrating.  The symptoms gradually improve and will eventually go away with time.  It can last a few weeks.  
With mild concussions, the treatment follows the general rules of first aid.  Ice can be applied to the area of impact on the head.  Pain relief can be provided through over-the-counter medications such as acetaminophen or ibuprofen.  

The individual should be watched for any changes and symptoms above that might indicate a more severe injury.  Victims, particularly children, who appear normal initially, do not need to be kept awake after the injury.  However, they should be easily aroused from sleep.  In cases of severe blows to the head and prolonged loss of consciousness, it is usually best to seek immediate medical attention.  

People who have suffered a concussion are more susceptible to concussions in the future.  And the effects can be cumulative.  This is why it is important to take care in protecting the head when engaging in at-risk activities such as contact sports and the like.  

Players should be encouraged to tell their coach if they’ve been injured and not “play through” the symptoms.  Games should be strictly officiated and safe playing techniques should be taught and practiced by all players at all levels.  Insist that safety comes first.

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.



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