Concussion

Also known as: Mild traumatic brain injury

A concussion is a brain injury that is caused by a sudden blow to the head or to the body. The blow shakes the brain inside the skull, which temporarily prevents the brain from working normally.

The Providence Concussion Management Program teaches patients, physicians and community members how to manage concussions in order to minimize long-term effects. Our physicians specialize in treating sports-related concussions, as well mild traumatic brain injuries caused by accidents or falls. They use the latest treatments and refer patients for rehabilitation services when needed.

Definitions related to concussion

Concussion
A concussion is a mild traumatic brain injury (MTBI) that occurs when the head or body hits an object, when a moving object hits the head or body, or when the head or upper body are severely shaken. There may be no physical signs of injury, and most concussions do not cause loss of consciousness. Concussions do not typically show up on traditional brain scans. They are diagnosed and managed based on a person's symptoms. While MTBI is considered a "mild" injury because it is not life-threatening, symptoms can disrupt daily function and may cause long-term problems.

Post-Concussion Syndrome
Post-concussion Syndrome (PCS) is diagnosed when concussion symptoms last longer than generally expected. Patients who have sports-related concussions typically recover within 7 to 10 days of their injury. The majority of people who have non-sports-related concussion generally take several months to recover. Various sources define PCS differently, and the term can be controversial diagnosis because concussion symptoms may overlap with other diagnoses or medical issues.
(Leddy, JJ, Sandhu, H, Sodhi, V, Baker, JG & Willer, B (2012). Rehabilitation of Concussion and Post-concussion Syndrome, Sports Health, 4(2): 147-154.)

Signs and symptoms of concussion

Signs are what others can observe. Symptoms are what someone feels. Possible signs and symptoms of a concussion include:

  • Headache
  • Changes in vision
  • Changes in balance
  • Dizziness
  • Difficulty concentrating or thinking
  • Difficulty remembering things
  • Increased irritability
  • Increased sensitivity to stimulation, including noise, light or movement
  • Fatigue

Red flags
"Red flags" are signs/symptoms that indicate a more serious condition and warrant immediate medical attention, such as brain swelling or bleeding. Call 911 immediately if you observe:

  • Sudden and severe headache that doesn't get better with rest and/or medication
  • Repeated vomiting (more than 1x)
  • Increased confusion (unsure of date, time, place, etc.)
  • Sudden and/or drastic change in speech, thinking, walking or vision
  • Acute and drastic change in behavior (such as tearfulness, anger, irritability, etc.)
  • Seizures

Treatment/Concussion medical management

Treatment
Treatment for a concussion depends on how severe the symptoms are and how much time has passed between the time of injury and the time of treatment. Patients who have sport-related concussions typically recover within 7 to 10 days of their injury. The majority of people who have non-sports-related concussions recover within several months (Leddy et al., 2012). Medical treatment can range from having a physician monitor the patient's recovery to providing specialized rehabilitation services for the patient

Immediate treatment
It is important to seek medical treatment from a physician immediately after the suspected concussion occurs. In the early stages, a physician will evaluate the patient and monitor the patient's recovery and activities until all concussion symptoms resolve. During this recovery time, it is important that the patient rests physical and mentally (also called cognitive rest). In order to properly rest after a concussion or MTBI, the brain needs "down time" balanced with gentle activity to heal. This means avoiding physical activities that increase the heart rate or could result in another concussion. It also means avoiding mental activities that significantly increase symptoms. Students may need to stay home from school, and avoid texting, playing videogames, physical tasks and reading. Adults may need to take time off of work to allow the brain to heal. Most concussions will get better with rest and time.

Prolonged treatment
In some cases, concussion symptoms do not resolve within an expected timeframe. In these cases, a physician familiar with concussion management and treatment may prescribe medications, refer patients to specialists, such as a neurologist or physiatrist, or to specialized rehabilitation services.

(Leddy, JJ, Sandhu, H, Sodhi, V, Baker, JG & Willer, B (2012). Rehabilitation of Concussion and Post-concussion Syndrome, Sports Health, 4(2): 147-154.)