Understanding Concussion
The Impact of Even Minor Head Injuries
A small bang to the head can have a big impact…
Concussion 101
If you've had a concussion, or think you have a concussion, take it seriously and see your doctor.
It is important to be vigilant for the following signs within the initial 24 hours of a concussion, as they warrant immediate medical attention:
• Worsening headache.
• Severe drowsiness or inability to be awakened.
• Inability to recognize people or places.
• Loss of consciousness or experiencing a blackout.
• Persistent vomiting (more than three times).
• Unusual behaviour or confusion.
• Onset of seizures.
• Weakness in arms or legs, or difficulty with balance.
• Slurred speech.
Most people can expect their symptoms to diminish after 2-3 weeks. If symptoms continue beyond 14 days, it is important to consult with a healthcare professional trained in concussion management.
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It is generally safe for a person with a concussion to go to sleep. As long as they are awake, able to hold a conversation, and not experiencing any additional concerning symptoms like dilated pupils or difficulties with walking, allowing them to fall asleep is acceptable. However, it is recommended to wake the concussed individual every 2 or 3 hours during the first 12 hours. Simple questions, such as asking for their name, can be asked to check for any noticeable changes in their appearance or behavior. If the person cannot be awakened normally, seeking medical assistance is necessary. It's important to note that our brain undergoes recovery during sleep, making adequate rest even more crucial in the concussion recovery process.
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Do not drink alcohol or take sleeping pills for at least 48 hours.
Alcohol can impair cognitive function and judgment, which may exacerbate the existing symptoms and delay the healing process. It is essential to prioritise rest and allow the brain to recover fully without the interference of alcohol, as it can interfere with the brain's healing mechanisms and potentially increase the risk of complications. -
Do not drive for at least 24 hours. You can drive again when you stop feeling giddy and you feel well enough; if you have any concerns, talk to your doctor.
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It's safe to take paracetamol for the headache. Don’t take medication containing aspirin or disprin for the next 4 days. This type of medicine can make you bleed more from cuts and bruises.
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You must stand down from sport for at least 3 weeks AND you should not return to sport or training until you are symptom free AND have medical clearance. That way you’ll return 100% ready for play.
Why?
Repeated concussions have a cumulative effect, so if you keep having concussions you may end up with a more serious injury and a permanent disability.
Second Impact Syndrome – acute brain swelling and bleeding that occurs when a second concussion is sustained before the first one has healed properly. This can be difficult to treat, and can be fatal.
What is a Concussion?
A concussion, also known as a mild traumatic brain injury, occurs when there is a direct impact to the head, face, neck, or any other part of the body that exerts force on the head or by violent shaking. It is a very common injury in New Zealand, with approximately 24,000 cases every year. Concussions are a complex and potentially dangerous injury, with significant implications for the brain. When a sudden jolt occurs, the brain, made of soft fatty tissue, can shift and collide with the skull's hard interior. This impact can result in a range of symptoms and damage to the delicate structure of the brain. It's important to note that immediate medical attention may not be necessary, but it is crucial to be aware that signs and symptoms can manifest hours or even days later. Additionally, it is not necessary to lose consciousness in order to sustain a concussion.
The symptoms experienced are a result of nerve damage, which may not be identifiable through scans or x-rays. These symptoms serve as your body's way of indicating that something is amiss. Fortunately, in most cases, the damage is not permanent. However, like any injury, the body requires time to heal and repair the damage.
Concussions can also lead to emotional, behavioral, and cognitive challenges that can disrupt one's daily life. Fortunately, most of these problems typically resolve within three months. However, in some cases, these symptoms may persist beyond this period, a condition known as Post-Concussion Syndrome.
If you’ve had a concussion, or think you have a concussion, take it seriously and see your doctor.
Fatigue, also known as extreme tiredness, is one of the most common symptoms of brain injury. Often fatigue is connected with thinking tasks, a tired mind rather than a tired body. For the brain to heal it needs lots of rest!
Symptoms of Concussion
Concussions can manifest in various ways, including blackout, headache, blurry vision, balance problems, mood and behavioral changes, memory and thinking issues, and sleep disturbances. It is important to note that every brain is unique, explaining the wide variation in people's experiences with concussions. Fortunately, the majority of concussions fully heal, and symptoms subside within days or weeks. Adequate rest and a gradual return to activity allow the brain to heal itself.
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A person may complain of:
Appears dazed
Confused
Poor balance and lack of coordination
Answers questions slowly
Runs in the wrong direction
Forgets events that occurred before and after the impact
Loses consciousness – but it is important to remember that a person can sustain a concussion without losing consciousness
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A person may complain of:
Headache
Nausea and vomiting
Double or blurred vision
Confusion
Fatigue
Poor concentration
Memory problems
Sleep difficulties
Irritability
Sensitivity to noise and light
Ringing in ears
Effects of Concussion
Following a concussion, individuals may experience changes in cognitive functioning, including difficulties with attention, memory, and information processing. They may struggle to concentrate or find it challenging to remember new information or organize their thoughts effectively. These cognitive impairments can significantly impact their ability to perform everyday tasks, maintain productivity, and engage in social interactions.
Effects of Concussion on Thinking, Behavior, and Personality Changes:
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Difficulties with attention, memory, and information processing.
Challenges in concentration, remembering new information, and organising thoughts effectively.
Impaired cognitive functioning impacting daily tasks, productivity, and social interactions.
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Impulsivity, rushing into things before thinking.
Disinhibition is a lack of self-control.
Difficulty in initiating tasks or getting started on things.
Irritability, feeling frustrated and having a short fuse.
Lack of insight and self-awareness, inability to judge one's strengths/weaknesses and understand how actions affect others.
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Social withdrawal or isolation, especially for previously outgoing individuals.
Lack of motivation or interest in activities once enjoyed.
Strained relationships with family, friends, and colleagues due to personality changes.
It's important to remember that the effects of a concussion can vary among individuals, with different severities and durations of symptoms. Seeking medical attention and appropriate rehabilitation services following a concussion is crucial for facilitating recovery and effectively managing these cognitive, behavioural, and personality changes.
Treatment for Concussion
Concussion treatment typically involves a multifaceted approach aimed at managing symptoms, promoting recovery, and preventing further complications. Upon diagnosis, the immediate focus is often on physical and cognitive rest to allow the brain to heal. This may involve a period of reduced activity, including avoiding activities that worsen symptoms, such as physical exertion, strenuous mental tasks, and screen time. Gradual return to normal activities is recommended under the guidance of a healthcare professional.
In addition to rest, healthcare providers may prescribe symptomatic treatment to alleviate specific symptoms such as headaches or nausea. This can include over-the-counter pain relievers, anti-nausea medications, or other targeted therapies. Cognitive rehabilitation, which may involve working with a neuropsychologist or occupational therapist, can help address cognitive impairments and improve thinking skills.
It is crucial for individuals with a concussion to closely follow the recommended treatment plan, attend all medical appointments, and communicate any changes in symptoms to their healthcare provider. They should also prioritise self-care, including getting adequate sleep, maintaining a healthy diet, and managing stress levels.
Each concussion is unique, and the duration of treatment can vary. It's important to note that returning to activities too soon or without proper guidance can increase the risk of re-injury or prolonged symptoms. Therefore, a gradual and individualised approach to recovery is essential.
Overall, a comprehensive treatment plan for concussion involves a combination of rest, symptom management, cognitive rehabilitation, and gradual return to activities, all tailored to the individual's specific needs and guided by healthcare professionals.