What is a concussion? What should I do?

What is a concussion?

It is a disturbance in brain cells due to an acceleration or deceleration of the brain within the skull. The disturbance in brain cells causes the brain to discharge uncontrollably resulting in one or more of the following signs or symptoms:

  • Loss of consciousness (Not necessarily – over 90% of concussions DO NOT result in a loss of consciousness)
  • Headache
  • Pressure in the head
  • Neck pain
  • Nausea or vomiting
  • Dizziness
  • Blurred vision
  • Balance problems
  • Sensitivity to light
  • Sensitivity to noise
  • Feeling slowed down
  • Feeling of “fogginess”
  • Not feeling right or feeling off
  • Difficulty concentrating
  • Difficulty remembering
  • Fatigue or low energy
  • Confusion
  • Drowsiness
  • Trouble falling asleep
  • More emotional
  • Irritability
  • Sadness
  • Nervous or anxious

This massive discharging of brain cells usually lasts only a short period of time which is why sometimes the person feels better after a few minutes to an hour following injury. Don’t be fooled by this improvement because the second phase of a concussion is called “Spreading Depression.”

What is “Spreading Depression?”

The initial brain cell discharge in a concussion creates an imbalance within the brain cells. In order to restore the balance, the cells frantically use up their energy stores to reset things. Energy stores will continue to decline over the next 3-7 days. This explains why a concussed person is often tired, cranky, and emotional. This is also why the first phase of dealing with a concussion is always rest; we want to conserve energy.

The Bad News…

The second phase of a concussion is actually the most dangerous. When someone is in this low energy state, another blow, even one of much lower magnitude, can cause another concussion. Since the energy levels of the brain are already severely depleted, another concussion can cause extreme energy depletion. This may cause permanent death of the involved brain cells, potentially causing permanent disability, or in some instances, death of the individual.

The Good News…

Research shows that if the brain has fully recovered from an energy standpoint and the person receives another concussion, there is no evidence of an additive effect. This means that it may not be the NUMBER of concussions an individual suffers; but rather, the way each injury is managed that is the major determining factor for long-term problems due to concussions.

The Major Problem with Concussions….

is that symptoms do not coincide with the energy levels in the brain. Most people feel better long before their brain has recovered to the point that they are actually safe to return to their sport. Unfortunately, there is no scan, MRI, or X-ray that can detect a concussion. This is where the benefits of baseline testing come in as the most important step towards proper concussion management.

Here’s a brief summary…

What Should You Do if You or Someone You Care About Has A Concussion?

  • The first 24-48 hours after a concussion are the most critical. Closely monitor the person for at least 3 hours following injury for deterioration in their condition that could indicate bleeding or serious swelling within the brain.
  • Do not allow the injured person to sleep during this initial 3 hours.
  • Wake up the person every 2 hours throughout the first night to ensure they can be awoken and are aware of where they are.

These are signs of potentially serious or life-threatening conditions that require immediate medical attention at the nearest emergency department:

  • Severe or worsening headache
  • Very drowsy or can’t be woken up
  • Vomiting
  • Drug or alcohol intoxication at time of injury
  • Deficits in short-term memory (can’t remember things that just happened, repeating the same questions over and over)
  • Seizure
  • Decreasing level of consciousness or awareness (can’t recognize people or places)
  • Fluid or blood coming from ears, nose, mouth, or eyes
  • Bruising behind ears, black eyes, very tender points on face
  • Inability to remember events 30 minutes before and leading up to the injury or 30 minutes after the injury
  • Unsteady on their feet
  • Slurring of speech
  • Weakness or numbness in the arms or legs
  • Dangerous mechanism of injury such as being struck by a motor vehicle, being ejected from a motor vehicle, or a fall from more than 3 feet or 5 stairs

Other DO’s AND DONT’s for the first 24-48 hours:

  • DON’T give any medication! This may mask the signs of a worsening condition and may increase the risk of bleeding in the brain.
  • Rest is important for recovery, however DON’T allow the athlete to go to sleep for at least 3 hours after injury – this is to monitor for signs of a worsening condition. The injured person will likely be tired and want to sleep but converse with them to make sure they are speaking coherently, not slurring their words and not repeating the same questions over and over.
  • DO periodically stand them up and have them close their eyes with their feet together to check for signs of balance problems. If they are getting worse, take them to the emergency department for evaluation.
  • For the first night following the injury, DO wake the injured athlete every 2 hours to check for responsiveness.  Make sure that they are easily awoken and that they know where they are.
  • DO make an appointment for a full evaluation within 2-days of the injury. It is preferable that the appointment be made for the very next day.

*Disclaimer:  This information is designed to provide education and awareness. This information does not take the place of a proper medical evaluation. Complete Concussion Management™ & STRIDE Physio & Performance do not take any responsibility of injury or death if you choose not to report to a medical professional.

**Information courtesy of Complete Concussion Management Inc.