There are more than one million cases of concussions or mild traumatic brain injuries which are diagnosed each year in the United States. This number does not include the number of athletes and individuals who suffer from a mild concussion and are never evaluated by the physician.
A concussion can result when the head hits an object or a moving object strikes the head. This definition includes injuries from car accidents, falls, sporting activities and physical assaults. The movement of the brain inside the skull, in any direction, is what causes the injury.
Unfortunately, the term concussion is often used loosely to define both mild and moderate traumatic brain injuries. In a moderate traumatic brain injury the individual may lose consciousness for up to 30 minutes and present with posttraumatic amnesia, as well add significant cognitive deficits immediately following the injury. However, in a concussion, or mild traumatic brain injury, the individual does not usually lose consciousness or have an altered level of consciousness that is significantly noticeable.
The brain is made out of soft tissue that is cushioned by spinal fluid and encased in a hard protective skull. When an individual either hits his head or it is hit in the head the brain can slosh around inside the skull and even bang up against the bone itself. This bruising, tearing and injury to the nerves is what causes the brain injury.
Mild traumatic brain injuries are fairly common and occur at a greater rate in individuals who play high contact sports such as football, boxing and hockey, even with protective gear. As signs of a concussion are not always well recognized and because of this, teams and coaches may put themselves at greater risk for another injury by continuing to play in the game.
Symptoms of a mild concussion can include \”seeing stars\” and feeling dazed, dizzy or lightheaded. Individuals may report a mild memory loss of things that happened right before or right after the injury but, this is not always the case. Other symptoms can include nausea or vomiting, headaches, blurred vision, slurred speech, difficulty concentrating or thinking and difficulty with ordination or balance. Individuals who have suffered from a mild concussion will also report feeling anxious or out of sorts for no apparent reason or feeling overly fatigued.
Even within the grade of mild traumatic brain injury (concussion), there are three other grades of concussion. Someone who suffers from a grade 1 will not have any loss of consciousness and the symptoms will and within 15 minutes. With a grade two concussion there is no loss of consciousness but the symptoms last longer than 15 minutes and an individual who suffers from a grade 3 concussion will lose consciousness, even if it is only for a few seconds.
It is important to understand and know the different grades of concussion because it gives an indication to physicians and coaches how soon a player can safely return to any sporting activity. With a grade 1 concussion doctors believe the player can safely resume play once the symptoms of stopped. An athlete who suffers from a grade two concussion should not continue playing the game nor should they return to any type of sporting activity for at least a week. And, athletes who suffer from a grade 3 concussion must see their physician as soon as possible in order to ensure they have not suffered from an epidural hematoma which can result in greater injury.
If the physician believes there may be a concussion they will perform a thorough history and physical examination of the neurological system. They may order a CAT scan or MRI to rule out any bleeding or other serious injury involving the brain.
Unfortunately, athletes who return to sporting activities before their brain has fully healed place themselves at greater risk for developing another traumatic brain injury. The second time the injury is often worse than the first. This is because the brain tissue has not had an adequate time to heal and is at greater risk for bleeding or nerve damage.
For instance, think of a sprained ankle in an athlete who plays tennis. If the athlete returns to play tennis before the ankle has thoroughly healed and an appropriate amount of strengthening and rehabilitation is taken place, they are more likely to roll their ankle again during play. Because the ankle is already weakened it is at greater risk for further damage that may not allow the athlete to play tennis again.
While the signs and symptoms of a concussion may be easily overlooked it is important for parents, coaches and individuals to recognize these signs and take appropriate action in order to reduce the risk for further damage.
RESOURCES
MayoClinic: Concussion
KidsHealth.org: Concussion
Center for Disease Control and Prevention: Concussion