A concussion is a brain injury that may result in a bad headache, altered levels of alertness, or unconsciousness.
It temporarily interferes with the way your brain works, and it can affect memory, judgment, reflexes, speech, balance, coordination, and sleep patterns.
See also: Concussion - first aid
There are more than a million cases of concussion each year in the United States.
A concussion may result when the head hits an object or a moving object strikes the head. A concussion can result from a fall, sports activities, and car accidents. Significant movement of the brain (jarring) in any direction can cause unconsciousness. How long a person remains unconscious may indicate the severity of the concussion.
Concussions don't always involve a loss of consciousness. In fact, most people who have concussions never black out. Some people have had a concussion and never even realized it.
Symptoms can range from mild to severe. They can include:
Head injuries that result in concussion often are associated with injury to the neck and spine. Take particular care when moving patients who have had a head injury.
A neurological examination may show abnormalities. The doctor will check your pupil size.
Tests that may be performed include:
A health care provider will do a brain and nervous system (neurological) evaluation to determine the right treatment for an uncomplicated concussion.
If a blow to the head during athletics leads to a bad headache, a feeling of being confused (dazed), or unconsciousness, a trained person must determine when the person can return to playing sports.
If a child or young adult has lost consciousness, that person should not play sports for a period of 3 months. There is an increased rate of brain injury and occasionally death in persons who have had a previous concussion that resulted in unconsciousness.
You may use acetaminophen (Tylenol) for a headache. Do NOT use aspirin, ibuprofen (Motrin or Advil), naproxen, or other similar drugs.
Eat a light diet. Light activity around the home is okay. You do not need to stay in bed. However, avoid exercise, lifting weights, or other heavy activity.
Have an adult stay with you for the first 12 - 24 hours after you are home from an emergency room.
Do not drink alcohol until you have completely recovered. Alcohol may slow down your recovery, increase your risk for another injury, and make it even harder to make decisions.
A concussion with bleeding or brain damage must be treated in a hospital.
Full recovery is expected from an uncomplicated concussion. Dizziness, memory loss, problems thinking, irritability, headaches, sleep disturbances, and other symptoms may occur continue for weeks or even months afterwards.
If someone has received a blow to the head, the person should be watched closely for signs of possible brain damage.
Call your health care provider if anyone has a head injury that causes unconsciousness, or a head injury without unconsciousness that produces worrisome symptoms.
If symptoms do not go away or are not improving after 2 or 3 weeks, talk to your doctor.
Call the doctor if you have:
Call 911 or go the emergency room if emergency signs develop.
Attention to safety, including the use of appropriate athletic gear, such as bike helmets and seat belts, reduces the risk of head injury.
Ropper AH, Gorson KC. Clinical practice: concussion. N Engl J Med. 2007;356:166-172.
Kirsch TD, Lipinski CJ. Head injury. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. Columbus, OH: McGraw-Hill; 2006:chap 255.
Heegaard WC, Biros MH. Head. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 38.