Concussion

See also Acquired Brain Injury

Description

‘Concussion’ is used to describe a minor head injury that is not usually life-threatening. It is a common sporting injury, particularly in body contact sports (e.g. football, boxing), and recreational activities where falls are common, such as horse riding, cycling, skiing and diving.

It is generally caused by a direct blow to the head (e.g. after being struck on the head by an object; or striking the head in a fall), but it can also occur after a sudden change in direction, causing the brain to strike against the skull (e.g. swerving on the sporting field; or ‘whiplash’ injury in a car accident). 

Concussion can lead to some or all of the following symptoms: a short period of unconsciousness (30 minutes or less), confusion, dizziness, amnesia (generally lasting less than 24 hours), persistent, low-grade headaches.  A period of amnesia, or not recalling what has happened, is essential to the diagnosis of concussion.

Treatment

Anyone suspected of having concussion should be assessed by a doctor, who should be informed if the patient is taking any medications, such as blood-thinning agents. The doctor may order a CT scan, may order the patient be kept under observation in hospital, or may allow the patient to return home in the care of a responsible person.

Usually the patient will require no more than rest and analgesics to relieve pain. However surgery may be required in some cases where there is severe bruising or swelling in the brain.

Care should be taken to avoid further injury before recovery is complete, as a second even mild concussion can have much more severe effects. Athletes, in particular, should be monitored by a doctor when resuming their sporting activities.

Prognosis

Most people recover completely, with no lasting problems. Sometimes symptoms such as headaches, dizziness, etc. will linger for some weeks. Recovery may take longer for those who have had a previous head injury, the elderly, and those with substance abuse problems. A small number of people may develop “persistent post-concussive syndrome”, where there are a number of symptoms which last for more than three months.

Further Information and Support

Information

# National Centre for Injury Prevention and Control
www.cdc.gov/ncipc/tbi/default.htm

# Pashby Sports Safety Fund Concussion site (Canadian site)
http://www.concussionsafety.com

# Brain Injury Resource Center – information on concussion & persistent post-concussional syndrome
http://www.headinjury.com/sports.htm
http://www.headinjury.com/faqpcs.htm

Date created: 11 June 2003
Reviewed by Associate Professor Nicholas Dorsch, Department of Surgery, Westmead Hospital, Australia