Project Description

Concussion Fast Facts

A concussion is a type of traumatic brain injury (TBI) in which the brain is injured by an impact or a sudden change in movement.

Each year in the United States, sports- and recreation-related activities are the cause of between 1.7 and 3 million concussions. About 300,000 concussions annually are attributable to football-related injuries.

Half of all concussions are not reported, and they go untreated. Most concussions, if treated quickly and correctly, do not cause long-term harm.

It’s been a common misconception that a concussion causes a loss of consciousness, but in fact, most people do not blackout when the concussion occurs.

What is a Concussion?

A concussion is a type of brain injury that results in immediate, temporary loss of some brain functions. It is usually caused by an impact or a blow to the head, but it can also happen when there is a sudden change of motion that causes the brain to move inside the skull. The impact or motion damages brain tissue, and the damage results in symptoms that can begin immediately or may take up to a day to appear.

It’s been a common misconception that a concussion causes a loss of consciousness, but in fact, most people do not blackout when the concussion occurs. Concussions often have a negative effect on memory, balance, coordination, reflexes, judgment, and speech, and the person may have trouble remembering what happened in the time immediately surrounding the injury. These symptoms often present themselves immediately after the injury, but they may take some time to manifest, making quick evaluation and treatment important even when a head injury seems to be minor.

A large majority of concussions do not cause lasting damage to the brain, but multiple concussions can cause cumulative damage that leads to long-term problems. A second concussion that occurs soon after a preceding concussion can be especially dangerous.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

What Causes A Concussion?

Common causes of concussion include sports injuries, blows to the head, falls, and car accidents. The impact or violent shaking of the head that these events produce causes the brain to move, twist, or rotate inside the skull, and the brain may even move so much that it strikes the inside of the skull. This movement can cause bruising of brain tissue, but the damage that usually causes concussion symptoms is a more subtle result of chemical changes in the brain at the cellular level.

Doctors and scientists do not entirely understand the biochemical changes that produce concussion symptoms. The fact that the symptoms are usually temporary leads scientists to believe that the chemical changes make brain cells behave incorrectly for a time without actually killing the cells.

The chemical changes are sometimes called a “neurometabolic cascade.” The process of this “cascade” is complex, but scientists think the injury causes the brain’s nerve cells (neurons) to enter a state in which they can’t communicate effectively with other neurons, leading to the symptoms of a concussion.

Given time and rest, the neurons will usually emerge from this dysfunctional state and begin to work correctly again. However, when the neurons are in an abnormal state, they are especially vulnerable to stress, and they may die or be permanently damaged if injured again before they’ve had a chance to recover. That’s why another head injury that’s incurred soon after a concussion can be so dangerous.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Are Concussions Hereditary?

Obviously, since concussions are caused by injuries and external physical events, the likelihood of suffering a concussion isn’t linked to family history. There is a possibility, however, that the brain’s vulnerability to the effects of a concussion and its ability to recover could be, in some way, linked to genetics.

Several scientific studies have looked at the role of a gene called the apolipoprotein E gene in the brain’s response to traumatic brain injuries. This gene helps to produce a protein that seems to be involved in the maintenance and repair of neurons, and it may play a role in a brain’s ability to recover from an injury. Although the genetic mechanism involved is not yet completely understood, it is possible that this or another gene (or genes) may make brain injuries more or less severe in certain individuals.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is A Concussion Detected?

Concussions often go undiagnosed because the injuries that cause them may seem minor, and the immediate symptoms might not seem severe. However, early detection of a concussion is crucial in order to prevent further injury and possible long-term damage. It’s important to be alert for both immediate symptoms and those symptoms that might emerge sometime after the initial injury.

Common immediate symptoms of a concussion include:

  • Headache or a feeling of pressure in the head
  • Confusion or mental fogginess
  • Dizziness or problems with balance
  • Ringing in the ears and/or “Seeing Stars”
  • Loss of memory of the events surrounding the injury
  • Brief loss of consciousness (although this doesn’t happen with most concussions)
  • Slurred speech
  • Nausea or vomiting
  • Light sensitivity or vision disturbances
  • Fatigue

Symptoms of a concussion that can show up hours or days after the initial injury include:

  • Increased difficulty concentrating
  • More pronounced memory loss
  • Disruption in other senses, including hearing, taste, and smell
  • Difficulty sleeping
  • Personality shifts or increased irritability

In small children who aren’t able to express themselves verbally, warning signs of a concussion can include:

  • Changes in eating or sleeping behavior
  • Walking or balance difficulties
  • Irritability or unusual crying
  • Apparent fatigue or loss of interest in playing

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is A Concussion Diagnosed?

Doctors will take several steps in attempting to diagnose a concussion. The diagnostic steps will begin with tests to see if concussion symptoms are present, and if these tests are positive or the symptoms are serious, further testing may be recommended.

  • Neurological exam. A doctor will perform an in-office exam that tests the patient’s neurological function. This exam will include tests of reflexes, balance, strength, coordination, vision, and hearing. The exam may also include tests of memory, concentration, and cognition.
  • Imaging tests. In cases where symptoms such as headache or vomiting are severe, or when symptoms seem to be getting worse, a doctor may want to perform imaging tests to rule out a more severe brain injury that has caused bleeding or swelling in the brain.
  • Hospitalization and observation. A doctor may recommend hospitalization or in-home observation, often for 24 hours, to be sure that symptoms are not changing or getting worse.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is A Concussion Treated?

There is currently no treatment that will reverse the biochemical effects of a concussion in the brain. In most cases, the effects resolve on their own, given enough time and protection from further damage. Because of that, the treatment prescribed for concussion is almost always rest and protection from further injury. A doctor will usually suggest that the patient stays away from activities, such as physical or mental exertion, that could make symptoms worse.

The treatment can also include shortened work or school days, breaks from assignments and mentally complex tasks, and avoidance of technology with screens, such as TV, computers, and phones.

To treat headaches, a doctor will usually suggest over-the-counter pain relievers containing anti-inflammatories such as acetaminophen, because concussion-related headaches often don’t respond well to stronger prescription painkillers. Pain relievers containing ibuprofen or aspirin may increase the risk of bleeding and are generally not recommended in the case of head injuries.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Does A Concussion Progress?

The significant danger of concussions is the severe, lasting, and sometimes fatal damage that can be done by repeated concussions or a head injury suffered when the patient is still recovering from a prior concussion. When these recurrent injuries happen, the results can be deadly.

Post-concussion syndrome (PCS) occurs in about 15% of people who suffer concussions. Symptoms of this syndrome can continue for weeks or months after the initial injury, and a diagnosis is usually made when symptoms last longer than three months after the injury.
Symptoms include:

  • Headache
  • Dizziness
  • Light or noise sensitivity
  • Sleep disruption
  • Ringing ears
  • Anxiety or depression
  • Mood swings
  • Aggression
  • Memory problems
  • Concentration problems
  • Cognition problems

Patients suffering from PCS should avoid sports or activities that bring an increased danger of further injury.

Second-impact syndrome (SIS) is a severe, often fatal condition that occurs when someone suffering from a concussion is subjected to a second brain injury. SIS results in brain swelling that can very quickly cause long-term brain damage or death. The cause of SIS is not fully understood, but it’s thought that during recovery from concussion, brain cells have a limited ability to control blood flow into brain tissue, causing them to be vulnerable to blood flow-related swelling.

SIS can happen when an injury is suffered even weeks after the initial concussion, and even a minor impact on the head during the vulnerable period can result in SIS.

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease caused by repeated head injuries.[1] Symptoms may include behavioral problems, mood problems, and problems with thinking.[1] Symptoms typically do not begin until years after the injuries.[2] CTE often gets worse over time and can result in dementia.[2] It is unclear if the risk of suicide is altered.[1]

(1) Asken, BM; Sullan, MJ; DeKosky, ST; Jaffee, MS; Bauer, RM (1 October 2017). “Research Gaps and Controversies in Chronic Traumatic Encephalopathy: A Review”. JAMA Neurology74 (10): 1255–1262. doi:10.1001/jamaneurol.2017.2396PMID 28975240. (2) Stein, TD; Alvarez, VE; McKee, AC (2014). “Chronic traumatic encephalopathy: a spectrum of neuropathological changes following repetitive brain trauma in athletes and military personnel”Alzheimer’s Research & Therapy6 (1): 4. doi:10.1186/alzrt234PMC3979082PMID24423082.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Are Concussions Prevented?

The key to the prevention of concussions is the avoidance of situations that put you at risk of a head injury.

  • Always wear properly-fitted protective headgear that has been officially certified by the American Society for Testing and Materials (ASTM) when participating in any sport or recreational activity that carries a risk of head injury.
  • Do not let young children play sports unsupervised.
  • Follow all safety rules and procedures while participating in sports or recreational activities.
  • Always wear a seat belt and proper restraints in cars and motor vehicles.
  • Always follow your doctor’s recommendations and treatment plan after suffering a head injury, and don’t resume your regular activities until you’ve been cleared by your professional healthcare provider to do so.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Concussion Caregiver Tips

Caregivers can help concussion sufferers by making sure the recovery process goes smoothly and by supporting the doctor’s treatment plan to lessen the severity of symptoms and prevent further injury.

  • Make sure the sufferer is able to get plenty of rest. Provide a quiet, stress-free place to rest, and avoid situations that cause lots of noise or activity in the home during recovery.
  • Parents of children who’ve had a concussion should enforce a recovery-friendly sleep schedule.
  • Communicate with the doctor or healthcare provider to be sure you understand what to look for in terms of symptoms and improvement while you’re caring for the sufferer.
  • Communicate with other people in the sufferer’s life–family members, work colleagues, teachers, coaches, etc.–to be sure that everyone knows the recovery plan and accommodations that need to be made to speed the sufferer’s recovery.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Concussion Brain Science

Scientists are trying to understand the biochemical changes that take place in the brain as a result of a concussion. A more thorough understanding of the process will make it easier to find treatments that can aid in recovery from concussions and decrease the risk of long-term damage from future injuries.

Areas of current research include:

  • Risk of future neurological decline. Some studies have found that even a single concussion can lead to an increased risk of developing dementia or Parkinson’s disease later in life. The link between concussions and these degenerative conditions is not clear; some theories suggest the cause could be concussion-related inflammation, abnormal protein buildup, or simply an increase in the brain’s general vulnerability after a concussion. Research is ongoing.
  • Search for cures. While researchers seek to better understand exactly what happens in the brain after a concussion, other scientists are looking for new therapies that can bolster the brain’s ability to recover from the injury. Researchers in Canada have conducted studies of a non-invasive therapy using low-frequency magnetic fields on rodents that have suffered a concussion. The study results suggest that the therapy can help to speed recovery and may even protect the brain from further degeneration in the future. Human trials of the therapy are planned in the future.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Concussion Research

Scientists are working on several research projects to expand on what is known about Concussions. The research will improve knowledge about the factors that increase the risk for Concussions as well as the causes, and best treatments and cures, and will aid people living with Concussions and their caregivers.

We are currently gathering the information required to support projects such as Aerobic Exercise for Concussion, The Effects of Head Trauma on Collegiate Athletes, and Development of a Neurocognitive Screening Test.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

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