From the Guidelines
A concussion is a type of mild traumatic brain injury caused by a rapid movement of the head and brain, resulting in a range of symptoms including headache, nausea, impaired balance, and difficulties concentrating.
Key Characteristics of Concussion
- Concussions are typically caused by a blow to the head, face, neck, or body, with linear and rotational acceleration-deceleration forces acting on the brain 1
- Symptoms of concussions can be highly variable, but common signs and symptoms include headache, nausea, impaired balance, difficulties concentrating, confusion, emotional lability, and fatigue 1
- Repeated concussions may lead to long-term difficulties with memory, concentrating, fatigue, headache, and other neurological sequelae 1
Diagnosis and Management
- There is no validated scoring system for concussion identification in the first aid setting, and diagnosis is often based on symptom-based tools and clinical evaluation 1
- Current clinical guidelines recommend removing individuals with concussions from activities posing a risk of reinjury until they have fully recovered, with specific requirements and timing of return to contact determined in consultation with a healthcare professional 1
- Athletes with concussions should be immediately removed from activity and not allowed to return until evaluated by a healthcare professional, and those with severe head injury symptoms should have EMS activated 1
From the Research
Definition of Concussion
- A concussion is a type of mild traumatic brain injury (mTBI) that affects the brain as a result of traumatic biomechanical forces 2, 3.
- It is a complex pathophysiological process that can cause disturbances in brain activity 3.
- The exact mechanism of a concussion is unknown, but it is currently accepted that the acceleration and deceleration of the brain is the insult causing disturbances in activity 2.
Symptoms of Concussion
- The most common symptoms of concussions include dizziness, nausea, vomiting, and headaches 2.
- Concussions can also cause permanent changes such as chronic traumatic encephalopathy (gradual degeneration of brain tissue), which can lead to personality changes and memory deficits 2.
- Other symptoms can include fatigue, academic difficulty, cognitive decline, gut microbiome changes, gait changes, and increased risk of lower extremity injury 2, 4.
Management of Concussion
- Management of concussion includes rapid removal from play, symptomatic treatment, and return to learn/play recommendations 4.
- Treatment options include sub-symptom threshold aerobic exercise, cervical physical therapy, vestibular therapy, vision therapy, cognitive rehabilitation, cognitive behavioral therapy, pharmacological management, or a combination of treatments 5.
- Understanding the key features of diagnosis, postinjury assessment tools, symptomatic treatment, and management of concussion is essential for primary care providers 4.
Long-Term Consequences
- Repeated unrecovered concussions can result in chronic brain injury syndrome, also known as chronic traumatic encephalopathy 3.
- The physiological changes present after a concussion have the potential to develop into long-term complications such as academic difficulty, cognitive decline, and increased risk of lower extremity injury 2.
- It is important to immediately address the symptoms of concussions to expedite treatment and prevent deleterious changes to the brain 2.