What Are Concussions?

Concussions are common sports injuries, especially in football, rugby, boxing, and other contact sports.



It is a mild traumatic injury to the brain usually caused by a blow to the head or from an acceleration or deceleration force. 

How It Happens

A direct blow is a common way it happens. This involves either something hitting the head, or often with sports, the head hitting the ground.

Your brain normally floats inside your skull, surrounded by cerebrospinal fluid (CSF). The CSF acts as a cushion to protect your brain tissue, as well as allowing it to remain centered within the skull.

A direct blow to your head can cause a sudden shift of your brain and the CSF, and depending on the severity of the blow, cause your brain to bump into the inside of your skull. Deceleration or acceleration forces can also cause this shift in the brain, resulting in a concussion.

Football is the sport in which they occur most frequently. It is usually due to rapid deceleration of your head, as your helmet helps to protect you from direct blows.


Do you remember the last time you saw a quarterback get sacked with a really hard hit? Think about how he was tackled.

His head whipped around as he went down to the ground. When this happened, his brain shifted, and may have led to a head injury.

Symptoms

Concussions are considered mild brain injuries. However, it is still not something to be taken lightly. What actually happens to your brain is a loss of normal mental function. This can mean confusion, trouble remembering how the injury happened, an inability to concentrate, headaches, fatigue, trouble sleeping, and ringing in the ears.

Concussions do not usually involve actual damage to the structure of the brain. Despite this, symptoms can last for just a few minutes, or may persist for days or weeks.

Grades of Severity

There are numerous classification systems for concussions used by the medical profession. Most are rated on a scale of 1-3 or 1-5, and are based on loss of consciousness, and how long symptoms last. In my clinic, we use a grading scale of 1-3.

Grade I - Symptoms of confusion, headache, dizziness, etc that completely resolve within 15 minutes, at both rest and exertion. There is no loss of consciousness

Grade II - Symptoms of confusion, headache, dizziness, etc that persist for greater than 15 minutes with no loss of consciousness

Grade III - Any loss of consciousness

Treatment

They can be a very serious injury if not treated appropriately. Mild trauma to your brain can predispose you to further injury in the future. It is imperative that any head injury be evaluated by a medical professional. Evaluation involves specific cognitive tests to determine the extent of the injury.

Along with the initial evaluation, periodic follow ups should be performed to make sure that the symptoms are not getting worse. Worsening of symptoms may indicate that there is a more serious injury, such as  intercranial bleeding, or structural damage to the brain. Follow up examinations should be given every 24 hours for the first few days.


Aside from rest, there is little you can for minor concussions. Grades I and II usually require you to stop activity until symptoms are no longer present. Grade III injuries should be evaluated in the hospital, and often warrant and MRI or CT scan to rule out any structural damage.

It is also a good idea to not take any type of pain releiver after a head injury for the first 24-48 hours, as this could mask your symptoms of a more serious injury.

Returning to Play

You should only go back to activities once your symptoms have completely resolved. For grade I's, this may mean being able to return to play the next day, or in a few days. Remember, grade I symptoms resolve within 15 minutes.

For grade II's, you need to be without symptoms for at least 7 days before returning to activities. So, if you have a concussion on Friday night, and your headache and symptoms clear on Wednesday, then you may be able to return to activity the following Wednesday.

Grade III's can take much longer to improve. Symptoms often last for several days to a week, and you should be without symptoms for 1 month before returning to activities.

Multiple Concussions

After one, it is much easier to suffer another. Your brain is not completely back to normal, and often it takes much less force to cause injury than it did the first time. This is the reason that returning to play requires a complete resolution of symptoms.

While they are usually not life threatening, mis-treated concussions have the potential to be. Not only that, but post concussion syndrome can often be a major problem, affecting many aspects of your life outside of sports.

Summary

The most important thing to remember is that they must be dealt with very seriously. You only get one brain, and you have to take care of it. Make sure that you see a doctor if you have a head injury, and follow their recommendations regarding treatment and when you go back to sports. It isn't just your athletic career you are dealing with, it is your life.

Do you have a question about the information on this page? If so, ask me and get an answer.

Or if you have experience with this topic, share your story...

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