Davin Quinn, MD Davin Quinn, MD

Heading Off Brain Trauma

Knowing the Warning Signs and Seeking Treatment for Concussion

Much national attention has focused recently on head injuries, but many people might not really know what a concussion is, how to recognize if we or our loved ones have had a concussion, or what to do after a concussion.

“A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth,” according to the Centers for Disease Control and Prevention. It can lead to disruption of normal brain function, such as losing consciousness, or feeling dazed.

Concussions are considered to be a form of mild traumatic brain injury. An estimated 2.8 million Americans are seen in the hospital for a traumatic brain injury every year, with the vast majority of those being mild cases, but this is likely a low estimate, as many cases are believed to go unreported.

Concussions can occur at any age, but they are more common in early childhood and older adulthood, and are usually caused by falls. Motor vehicle accidents are a more common cause in those aged 15-44 years, while sports- and recreation-associated concussions are typically seen from early childhood to young adulthood.

Males are more often seen for concussion than females throughout their lifespan, and are more likely to experience more than one concussion, but females may have higher rates of concussion in sports played by both of the sexes.

If you suspect you or a loved one have suffered a concussion, it is important to recognize the common physical signs and symptoms after an injury in order to receive appropriate diagnosis and treatment.

Early signs of concussion following a head injury include nausea, vomiting, headache, dizziness, difficulty focusing, fatigue, sensitivity to light and noise, blurry vision or ringing in the ears, mood swings and insomnia.

Go to the emergency room if you or your loved one has experienced loss of consciousness, seizure, weakness, numbness or discoordination, difficulty speaking, changes in vision or hearing, neck tenderness or limited movement of the neck, excessive drowsiness, memory loss – including memory of the concussion event – and worsening headache that won’t go away.

Some individuals might not show signs of a concussion until they engage in a mentally or physically demanding task. You needn’t visit the emergency room if you have not experienced one of these symptoms, but if you are unsure, it is always safer to seek medical attention.

It is important to rest for the first 48 hours until symptoms resolve. This also prevents the likelihood of Second Impact Syndrome – the occurrence of a second concussion before the initial injury has healed. Having a second concussion during the vulnerable window prolongs recovery and increases the risk for worse outcomes.

Most concussions resolve within a week, but recovery also depends on the individual’s age, the severity of the injury, the quality of rest, medical history and the symptoms following the concussion.

Following the first 48 hours, one may gradually return to normal activity, while avoiding those activities that increase the risk of a second injury or worsening of symptoms.

Resuming light, non-contact physical activity soon after the initial rest period may help speed recovery (there is also evidence that too much rest can actually delay recovery). It may take time to resume normal activity and that modifications in the workplace and/or school may be necessary during the recovery period.

Although symptoms typically resolve fairly quickly, it is not uncommon for symptoms to last longer. In fact, recent studies have shown that up to 25% of people with a concussion will have symptoms for up to three months.

For those whose symptoms last more than three months, it may be necessary to consult a specialist. Risk factors for developing prolonged post-concussive symptoms include prior concussion, recreational substance use, female sex, level of education, attentional, learning or developmental disorder, depression or anxiety and migraines.

Treatment should focus on reducing risk factors, identifying causes of symptoms and engaging in specific therapies, such as physical therapy for visual and balance symptoms.

The main thing to remember is that concussions are common and often occur in everyday life – and they are treatable. Meanwhile, ongoing research studies at UNM and the Raymond G. Murphy Veterans Affairs Medical Center are evaluating experimental treatments for prolonged post-concussive symptoms.

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