A concussion is one of the most common conditions arising from severe head injury and is not always evident after trauma. The full effects of a concussion may only be noticed days, weeks or month after the incident and if they persist for a long period of time, it is known as post concussion syndrome. A concussion is any trauma to the brain resulting in impairment of normal brain functions, either short or long term. Fainting or a ‘black out’ meaning a loss of consciousness does not always occur in a concussion and for this reason many head trauma patients ignore the possibility of a concussion and do not seek medical investigation or treatment after their injury.
What causes a concussion?
Causes of a Concussion
Picture of whiplash which can cause a concussion
The brain is housed within the cranial cavity of the skull and is cushioned by cerebrospinal fluid (CSF) which surrounds the brain. In a head injury, the sudden snapping movement of the head causes the brain the smash against the bony skull and this impact can cause damage to parts of the brain. Alternatively swelling due to inflammation or bleeding after the impact can gradually increase and compress the brain, thereby affecting the normal brain functions. A concussion often occurs in car accidents due to whiplash even if there is no direct injury to the head. Any trauma to the head due to an assault, fall or accident where there is an impact to the head may lead to a concussion.
What are the signs and symptoms of a concussion?
Signs & Symptoms of a Concussion
The signs and symptoms may vary depending on whether it is a mild or severe concussion. The lack of symptoms after a head injury may not mean that a concussion has not occurred and could appear at a later stage in post concussion syndrome.
- Loss of consciousness may occur as a result of a concussion.
- Confusion is one of the most common symptoms. The patient may not know where they are, what they were doing or how they even sustained the injury.
- Amnesia. The patient may not recall their name, home address, details of their family and friends and other personal information.
- Fatigue. A lack of energy and usual vitality.
- Dizziness and the patient may appear drowsy immediately after the trauma.
- Temporary loss of senses, particularly vision and hearing.
- Later symptoms include headaches, nausea, vomiting, slurred speech, blurred vision, ringing in the ears and seizures.
Post Concussion Signs and Symptoms
These symptoms usually persist for a long period of time after the initial head injury and may only become evident days, weeks or months after the incident.
- Sensitivity of the senses. Noise and light sensitivity are usually reported.
- Insomnia
- Persistent headaches.
- Poor memory and lack of concentration.
- Mood changes. Often irritable, anxious and fearful.
- Changes in bowel movements, appetite, coordination and usual abilities may be noticed.
- Other symptoms of a concussion may also persist over a long period as part of a post concussion syndrome.
How is a concussion treated?
Treatment of a Concussion
Usually no treatment is required for a concussion but the patient should be under close medical supervision. Any signs or symptoms of a concussion that are not easing with time or aggravating further requires immediate medical intervention. The belief that a patient should not be allowed to sleep for 24 hours is based on the fact that signs and symptoms of a progressing concussion may not be detected during sleep but sleep is difficult to prevent in any person who has undergone trauma. The patient should be assessed at regular intervals to identify any signs of confusion, amnesia or drowsiness. Any medication, like analgesics (pain killers) and sleeping tablets should not be administered to any person who has sustained a concussion within 24 to 48 hours after the incident. In post concussion syndrome, analgesics may be useful in managing the headaches, while sleeping tablets may be administered in those suffering with insomnia. There is no definitive treatment for post concussion syndrome but the signs and symptoms should be managed until the syndrome resolves.
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