It is estimated that as many as 3.8 million concussions occur annually in the U.S., as a result of sports and recreation-related activities. Other common causes include work-related injuries, car and bicycle accidents, falls, and fighting. However, patients of mine often do not realize that they have the condition, or to return too quickly to normal life without taking the necessary care. Let’s take a deeper look into what a concussion is and what to do if you find yourself with the condition.
Concussion typically occurs as a result of an impact to the brain, most commonly by a direct blow or bump to the head but also in the setting of an acceleration deceleration injury, as the brain is a soft tissue in a hard box (the skull). For example, in a classic whiplash car accident, the brain and skull move forward together and then when the skull stops (even without being directly hit by a steering wheel), the brain continues to move and smashes into the skull. This impact can jolt and bruise the brain. The most traumatic and serious of these injuries can cause bleeding and bruising in the brain. Most commonly however, the cells in the brain are affected with swelling and edema, and the normal pathways and communication between them are interrupted.
Symptoms of concussion include headaches, dizziness, nausea, memory loss, confusion, speech changes, mood changes, feelings of imbalance, sensitivity to light, and disruption to sleep. It’s also important to remember that a person doesn’t need to lose consciousness to get a concussion, this is usually only in severe cases.
If a person with concussion experiences a dramatic increase in symptoms such as a worsening headache, sleepiness, or numbness, they should go to the Emergency Room to get themselves checked out. Even if the symptoms aren’t this severe, it’s still a good idea to consult with a doctor to determine how serious the concussion is and whether they will need treatment.
It’s also crucial to prevent the likelihood of a second impact, as this could cause more serious symptoms such as brain swelling, brain damage, long-term disabilities, or even death. So, sufferers of concussion should not return to normal activities if they still have symptoms, and should seek advice from a medical professional before returning to work or sports with confidence. The American Academy of Neurology (AAN) produced this evidence-based guideline on sports concussion: risk reduction and recovery post-concussion.
The AAN has also created this quick checklist for athletes that think they may have a concussion. It outlines what to check if an athlete has had a head injury during a game (check that their airways aren’t blocked, make sure they’re breathing normally, and check their heartbeat). If it appears the athlete has a concussion, they should be monitored for the next few hours, they should be seen by a health care provider that’s trained in diagnosing and managing concussion, and they should absolutely not return to play until evaluated and cleared.
Unfortunately, it’s not uncommon for people that are predisposed to migraines to suffer from a string of attacks after experiencing concussion. In terms of treatment, this is mostly the same as the normal abortive and preventive treatment that migraine patients receive. However, for most people that suffer post-traumatic headache after a concussion, this does not become a chronic condition and the symptoms will diminish within a few months.