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Concussion

Concussion – A Knock to the Head

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Concussion - Helpful Diagnosis It should be football that would provide an opportunity to talk about minor head injuries and concussion, but instead I get to turn to baseball and the Yankee – Red Sox series. Eric Hinske ran over Juan Posada at the plate and while he held onto the ball, Posada headed to the hospital after the game to be evaluated for headaches. It's a cryptic message isn't it – "heading to the hospital for further evaluation."

Patients are brought to the hospital after being hit in the head, and the question asked is whether a concussion occurred. Then there is the other question, under the surface, whose words are too frightful to ask: "Is there bleeding in the brain?" This is quickly followed by: "We thought he should be checked because we were afraid for him to go to sleep." So, the decision remains: who needs a CT scan to make sure there is no bleeding, and who gets to go home and sleep well in their own bed?

Concussion Overview

The term concussion describes an injury to the brain resulting from an impact to the head. By definition, a concussion is not a life-threatening injury, but it can cause both short-term and long-term problems. A concussion results from a closed-head type of injury and does not include injuries in which there is bleeding under the skull or into the brain. Another type of brain injury must be present if bleeding is visible on a CT scan (CAT scan) of the brain.

A mild concussion may involve no loss of consciousness (feeling "dazed") or a very brief loss of consciousness (being "knocked out").
A severe concussion may involve prolonged loss of consciousness with a delayed return to normal.

Concussion Causes

A concussion can be caused by any significant blunt force trauma to the head such as a fall, a car accident, or being struck on the head with an object.