Concussions and head injuries
A concussion is a traumatic brain injury (“TBI”) usually caused by a blow to the head. It can also be caused by violent shaking of the head or body, such as during a car accident. In most cases concussion doesn’t involve a loss of consciousness, but all concussions are serious. Recognizing concussion and responding properly can help prevent additional injury or even death.
Older adults, younger people are more at risk
Concussions are more common in older adults and young people. These increase your risk:
- Car or bike accidents, especially if there is a blow to the head.
- Failing to use proper sports equipment.
- Having a history of concussions.
- Playing a contact sport like football, hockey, or cheerleading.
When to seek medical care
If you or someone you know experienced a head injury and develops the following symptoms, call 911:
- A headache that gets progressively worse.
- A loss of consciousness exceeding 30 seconds.
- Numbness in the face, arms, or legs.
- Obvious declines in mental function or behavior.
- Repeated vomiting.
- Vision disturbances or unequal pupil size.
Concussion symptoms in children
Young children are also at risk for traumatic brain injuries. This is because their heads are often disproportionately large compared to their bodies. It may be harder to recognize a concussion in a young child, especially if they are not able to verbalize their symptoms. Therefore, it is important to monitor a child’s behavior for changes. Symptoms in children may include:
- Crankiness or irritability.
- Dazed appearance.
- Excessive crying.
- Loss of balance or difficulty walking.
- Loss of interest in favorite toys.
If you suspect your child of having a concussion, you should monitor them in the first 24 hours. It is best to see your pediatrician 1-2 days after the suspected concussion occurred. However, if your child’s symptoms get worse, seek immediate medical attention.
Concussion Assessment Program (CAP)
In the Colorado Springs area, UCHealth Concussion Assessment Program clinics work closely with your primary care team to bring expert comprehensive concussion assessment, treatment and management.
The CAP individualizes your recovery through adaptive care, ranging from recommendations for accommodations to transition back to normal school and work activities.
You should follow up with your doctor if you experienced a head injury. Your doctor will evaluate your symptoms, get your medical history, and ask questions about the events surrounding the injury. If you lost consciousness following a head strike, let your doctor know.
Your doctor may also perform some simple neurological and cognitive tests to assess your hearing, eyesight, balance, coordination, memory, and concentration. These tests assess your brain function and can help determine the severity of your concussion.
Brain imaging is not recommended for most concussions. However, brain imaging may be required when a severe brain injury is suspected to rule out bleeding or brain swelling. These imaging tests include:
CT (computed tomography) scan. A CT scan is a detailed, cross-sectional image of your brain. Your doctor will examine these images to see if there is bleeding or swelling.
MRI (magnetic resonance imaging) scans. An MRI uses strong magnets and radio waves to create a detailed image of the brain. Your doctor can examine these images for abnormalities or complications.
Sports and concussions
Concussions can occur in many different settings and almost any sport, including cheerleading. Athletes in contact sports such as football, hockey, rugby, soccer, lacrosse, basketball, baseball, and softball have a 10% to 20% chance of experiencing sports related concussion each playing season. In high school football alone, players across the United States experience as many as 250,000 concussions each year.
Given these risks, coaches, parents, athletic trainers, and players need to be aware of concussion symptoms; the sooner a concussion is detected, the better the outcomes for the player.
If a player hits their head or is suspected of having a concussion, take them off the field immediately. Athletes should not return to play or engage in vigorous activity while concussion symptoms remain. Doing so could put them at greater risk for getting a second concussion or experiencing concussion complications.
Rest is best.
Rest – both physical and mental – is the most effective treatment for a concussion. Even for a mild concussion, you should not return to physical activity or intensive cognitive activities (like studying) for a few days. Instead, engage in relative rest, which involves activities that don’t require mental concentration. This is the best way to let your brain heal.
You can use medications to lessen headaches. Ask your doctor about what pain relievers are best for you. You should avoid aspirin or ibuprofen (Advil, Motrin), as these can increase your risk for bleeding.
After a few days, you can start gradually increasing your level of physical and mental activity. Take it slow and take breaks if you begin to experience symptoms like a headache. You should not engage in activities that put you at risk for head injury until your symptoms have fully resolved.
In the case of serious concussions, your doctor may prescribe additional treatments, like speech, vision, or cognitive therapy.
The best way to treat a concussion, of course, is to avoid it in the first place. You should take the following steps to protect yourself and your children against head injury:
- Drive safely. You should never drive under the influence. You should also always use your seat belt. For young children, be sure to use an appropriate booster seat.
- Ride safely. Whether on a motorcycle or a bicycle, you should always wear a helmet.
- Wear protective equipment. Wearing properly-fitted, well-maintained equipment while playing sports can help protect you from injuries.
- Make your home safe. If you have small children, install window guards and block off staircases. You can also prevent falls by keeping your floors clear of clutter.
- Educate yourself and others. Knowing how to spot a concussion is the first step to getting treatment. Inform yourself and others about the concussion risks, prevention, and symptoms to spread awareness. Parents and coaches should inform themselves and engage in good sportsmanship to protect their athletes.
American Academy of Family Physicians. Current Concepts in Concussion: Evaluation and Management (https://www.aafp.org/pubs/afp/issues/2012/0115/p123.html)
Pubmed: National Library of Medicine. Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines (https://pubmed.ncbi.nlm.nih.gov/31654620/)