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Illnesses & Symptoms

Concussion

Concussions range from mild to severe, but they all temporarily interfere with the way your brain works. They can affect memory, judgment, reflexes, speech, balance, and coordination. See also our page on head injuries for a discussion of other head injuries and for prevention information.

What is a concussion and how is it diagnosed?

Concussions occur from a significant blow to the head, with or without a helmet.

It is not necessary to lose consciousness to have a concussion. Coaches have commonly referred to them as "bell ringers" - but don't mistake the innocent name. These can be a serious brain injury.

A concussion is diagnosed based on symptoms and exam. A CT of the head may be used to rule out a serious bleed into the head, but is not required to diagnose a concussion.

Concussions are common, especially in people who play contact sports. But every concussion, no matter how mild, injures your brain. This injury needs time and rest to heal properly. Most concussions are mild and people usually recover fully.

If players return to their sport before the brain heals (i.e. there are still symptoms of the concussion), they are more likely to permanently injure the brain. To prevent permanent severe damage to the brain, it is important to not return to contact sports until all concussion symptoms have resolved.

Symptoms of a concussion

The signs and symptoms of a concussion can be subtle and may not appear immediately.

After a head injury, monitor your child closely for the next 48 hours.

Symptoms can last for days, weeks, or in rare instances can last several years.

The two most common concussion symptoms are confusion and amnesia. The amnesia, which may or may not be preceded by a loss of consciousness, almost always involves the loss of memory of the impact that caused the concussion.

Immediate signs and symptoms of a concussion may include:

  • Headache
  • Dizziness
  • Ringing in the ears
  • Nausea or vomiting
  • Slurred speech
  • Confusion Amnesia

Some symptoms of concussions don't appear until hours or days later. These include:

  • Mood and cognitive disturbances
  • Sensitivity to light and noise
  • Sleep disturbances
  • Balance problems
  • Difficulty concentrating
  • Fatigue and sleep disturbances
  • Visual problems

Symptoms in infants and toddlers

Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they can't readily communicate how they feel. Nonverbal clues of a concussion may include:
  • Listlessness, tiring easily
  • Irritability, crankiness
  • Change in eating or sleeping patterns
  • Lack of interest in favorite toys
  • Loss of balance, unsteady walking

When to go to the hospital or physician's office

While most concussions get better on their own, some blows to the head can cause more serious injuries. You should seek urgent medical evaluation if you have any of the following symptoms:
  • Prolonged headache or dizziness (go immediately to the ER if the headache is worsening)
  • Vision disturbances
  • Nausea or repeated vomiting
  • Impaired balance (unsteady)
  • Prolonged memory loss
  • Ringing in the ears
  • Loss of smell or taste
  • Numbness or tingling in the arms or legs
  • Slurred speech
Any child who has lost consciousness after a blow to the head should be seen by a doctor. Emergently go to the ER if there are other warning signs of a potentially serious injury, such as persistent vomiting, seizures, worsening headache, or non-repsonsiveness.

If there are concerns of other injury, such as open laceration that needs repair, your child should be seen as soon as possible.

In general, a bruise on the front of the head is less dangerous than one on the side or back of the head.

Treatments

There are no specific treatments for concussion. Brain rest is the key. This might mean no activities, such as reading, listening to music, anything on a screen or phone, school, homework, or sports. If something causes symptoms, do not do it. This might mean complete bed rest initially.

Brain Rest
  • No texting
  • No reading
  • No video games
  • No music
  • No lights
  • No TV
  • No school
  • No homework
  • Be bored! Sleep!
It is very important to avoid activities that increase the risk of another head injury when healing from a concussion to prevent further brain damage.

Headache is treated with pain relievers or migraine medications.

Memory and thinking problems are sometimes treated with rehabilitation and memory devices (such as a calendar).

Depression and anxiety should be addressed by a provider who is experienced in dealing with post-concussion syndrome.

Return to Play

An athlete can return to play ONLY after all symptoms have resolved. Returning too soon risks permanent brain damage. They should never return to play the same day as a concussion. The following step-wise return to play can be followed as long as symptoms do not return at any step. There should be at least 24 hours for each step. If symptoms return, go back to rest and start the process again.
  • Rest until no symptoms (see above list)
  • Light aerobic exercise (such as a stationary bike or ellipitical machine)
  • Sport specific exercise
  • Non-contact training drills / light resistance training
  • Full contact training after medical clearance Return to competition

Video on concussions EVERY parent and child should see:

DocMikeEvans Concussion

If your child is not convinced about staying on the sidelines until ALL symptoms are cleared, read these two stories: Talk to your coach or trainer about sideline concussion screening. They can use the SCAT2 on all players at the beginning of the season for an individualized baseline and then again after injury to assess concussions. (FYI... the instruction sheet for the athlete after an injury mentions using paracetamol for headache. This is known as acetaminophen / Tylenol in the US.)

For more information from the CDC, click here.

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Illnesses & Symptoms