By David A. Baker, Psy.D., Pediatric Neuropsychologist, Concussion Program at Children’s Hospital Colorado.
You would be hard-pressed in these times to go about your day without hearing at least one news story or casual conversation on the topic of concussion. In just a few decades, concussions have gone from relative obscurity to a significant topic of discussion in our culture.
Despite this ‘buzz’ around concussions, there can be confusion and misconceptions about what actually defines a concussion. I hope to bring some clarity to this popular but often misunderstood topic.
A concussion is a mild brain injury and is diagnosed based on two criteria: First, there must be a substantial jolt or blow to the head, face, neck or body that causes rapid movement of the head and subsequently the brain. Not every head injury results in a concussion. In fact, many times people will hit their heads and not have a concussion. Second, there will typically be immediate signs and symptoms suggestive of brain dysfunction. Signs and symptoms of a concussion vary from person to person but often include:
- loss of consciousness
- brief memory loss or amnesia
- disorientation and confusion
- blurred vision
- nausea and/or vomiting
- balance difficulties
In some cases, a concussion can be a serious matter so it is important to look for signs of a more serious injury which requires immediate medical attention, including:
- Prolonged loss of consciousness (i.e., >30 seconds)
- Lasting amnesia and/or confusion after the injury
- Repeated vomiting
- Excessive sleepiness
- Loss of sensation or abnormal movements.
Regardless of severity, anyone who thinks he have may sustained a concussion should be seen by a medical provider as soon as possible, within hours or a day at most after the injury.
Common Concussion Myths
- If a person did not lose consciousness, he or she did not have a concussion.
This is a myth. A person can sustain a concussion without losing consciousness. In fact, a majority of concussions do not involve a loss of consciousness.
- There are medical tests such as CT scan or blood tests that can tell if a person had a concussion.
This is a myth. While this is an active area of research, there are no tests that can definitively tell us if a person had a concussion. Brain imaging such as MRI and CT scans can not detect a concussion and neither can blood tests. Diagnosis of concussion is based on the injury characteristics and the onset of signs and symptoms shortly after the injury.
- A person should not return to school or work until all symptoms have resolved.
This is a myth. As long as an appropriate healthcare provider is involved in the person’s care, that person can return to school or work even with symptoms. Keeping a person out of their normal routines for lengthy periods of time (e.g., weeks) often causes unintended academic, social, and emotional stress, which can prolong or worsen symptoms.
- Helmets, head bands, or mouth guards cannot prevent concussions.
This is true. There have been no well-controlled independent studies that prove helmets, mouth guards, or soccer head bands effectively prevent concussions. However, helmets are important to prevent more serious injuries such as skull fractures and mouth guards help prevent dental injuries.
How Long Will Concussion Symptoms Last?
Another common misconception is that concussions can cause lasting, permanent impairments. In fact, research has found that in the vast majority of cases, the effects from a single concussion are temporary, and symptoms typically resolve within days to weeks.
What to Do After a Concussion?
Often in the few days following a concussion, physical and mental rest may help reduce concussion symptoms. However, as symptoms improve after a few days of rest, it is wise to start slowly getting back to normal routines.
What if Symptoms Do Last Longer than a Few Weeks?
If symptoms last for many weeks then it is advisable to seek specialty concussion care with a professional who has expertise in concussions. There could be other issues complicating a person’s recovery such as neck strain or whiplash, stress, and/or depression. See www.childrenscolorado.org/concussion for more information about comprehensive concussion care for children and teens.