A concussion is the sudden impairment of brain function following a head injury such as during a traffic accident, sports injury or fight. It can also develop indirectly follow a sharp fall on the buttocks. A concussion is part of the so-called primary brain injuries, as it develops at the time of injury. Concussions are considered reversible brain injuries that usually do not leave any long-term consequences. However, it is important to monitor an injured person for 48 hours in order to detect possible complications early.
Cause of Concussion
A concussion develops as a result of a force exerted on the head. This can be a blunt blow to the head, bumping the head against an object, or indirectly in the form of a sharp fall on the buttocks. These injuries are usually caused by falls from height, car accidents or sports injuries. The exact mechanism of the development of a concussion is not known. What is known, however, is that it is a functional impairment of the brain. Only in some cases has microscopic structural brain damage due to a concussion been proven with the help of imaging methods.
Symptoms of a Concussion
The main symptom of a concussion is loss of consciousness that usually lasts a few seconds. A minor concussion usually results in loss of consciousness lasting a few seconds to a minute, and a major concussion causes a loss of consciousness lasting up to 30 minutes. If loss of consciousness lasts even longer, there is the possibility of more severe injuries, such as cerebral contusion. Another typical symptom of a concussion is amnesia, or memory loss, where the injured cannot remember the mechanism of the accident or injury. Sometimes amnesia extends to the events before or after the injury, in which case it is called pre-traumatic or post-traumatic amnesia. A special form of post-traumatic condition is when the injured becomes aggressive and restless and demands to be released from the hospital. This condition usually appears in alcoholics. Once a patient regains consciousness, vomiting typically ensues. Other than these most basic symptoms of a concussion, an individual may also experience headaches, nausea, dizziness, increased heart rate when standing up, or a decreased heart rate. Children with a concussion often appear in a trance or sleepy. The child may fall asleep, but this must be distinguished from subsequent loss of consciousness, which would indicate a more severe brain injury.
Complications of a Concussion
A concussion is the reversible functional impairment of the brain, which can, however, become more complicated in 50% of cases, with a host of complications called postconcussive syndrome. It is still not known why these complications arise, but it is thought that the psyche and severe brain injuries play a part. These include subarachnoid or subdural hemorrhaging, or whiplash. Postconcussive syndrome most often follows the acute stage of concussion. However, sometimes this complication appears after the patient has been released from the hospital. Postconcussive syndrome is manifested by headaches, dizziness, difficulty concentrating, fatigue, decreased productivity and sleep disorders. This complication can last a number of weeks, however 15-20% of patients experience these complications for a number of months, or even a year following their injury.
Diagnosing a Concussion
A concussion is diagnosed based on the information provided by the patient or a witness of the event. Neurological tests always come out normal with a concussion. Vomiting is an important symptom that helps diagnose a concussion, as is amnesia. A patient must be monitored in the hospital for 2 days, focusing on his or her level of consciousness, mobility and pupil response. Patients suffering from a head injury are always sent for x-rays of the head and neck and a CT or computer tomography. This is performed especially in order to eliminate the possibility of bleeding into the brain or a skull fracture.
Treating a Concussion
The most basic part of treating a concussion is bed rest for several days. Medications can be given to reduce headaches, vomiting and sometimes even substances influencing the autonomic nervous system which is responsible for a number of clinical symptoms of a concussion. The length of bed rest depends on every individual, but in most cases patients are completely symptom free after 3 weeks.