What Are Signs of a Concussion?

Reviewed on 1/11/2022

Immediate signs and symptoms of a concussion (appear minutes to hours after injury) may include confusion, headache, dizziness, memory loss, nausea or vomiting, balance problems, tiredness, crankiness, irritability, or unusual behavior.
Immediate signs and symptoms of a concussion (appear minutes to hours after injury) may include confusion, headache, dizziness, memory loss, nausea or vomiting, balance problems, tiredness, crankiness, irritability, or unusual behavior.

A concussion is a traumatic brain injury caused by impact to the head or body that causes the head and brain to move around quickly. 

Signs and symptoms of a concussion that can occur minutes to hours after injury may include:

Signs and symptoms of a concussion that can occur hours to days after injury may include:

  • Trouble sleeping
  • Inattention
  • Mood or behavior changes
  • Memory problems 
  • Problems walking or talking
  • Vision changes
  • Sensitivity to noise or light

If you get a concussion, someone should stay with you for at least 24 hours to monitor you for new or worsening symptoms. 

A person with you should call a doctor right away if they notice dangerous signs and symptoms of a concussion such as:

  • Drowsiness or inability to wake up
  • One pupil larger than the other
  • Severe or worsening headache that does not go away
  • Weakness or numbness in part of the body
  • Slurred speech
  • Decreased coordination
  • Convulsions or seizures
  • Vomiting more than 3 times
  • Difficulty walking or talking
  • Changes in vision 
  • Loss of bladder or bowel control
  • Unusual behavior, increased confusion, restlessness, or agitation
  • Loss of consciousness, even a briefly

What Causes a Concussion?

Concussions are caused by bumps, blows, jolts, or other impact to the head, or by hits to the body. 

Common causes of concussions include:

  • Motor vehicle accidents
  • Sports injuries or hits
  • Bicycling accidents
  • Falls
  • Beatings or other kinds of physical abuse

How Is a Concussion Diagnosed?

A concussion is diagnosed with a patient history, neurological assessment, and metal status testing. 

The patient history includes asking the patient to describe the incident in as much detail as possible to assess any memory loss.  

A neurologic examination includes assessment of:

  • Cranial nerves III through VII (extraocular movements, pupillary reactivity, face sensation, and movement) 
  • Limb strength 
  • Coordination 
  • Gait

Mental status testing may include assessment of: 

Other tools used to evaluate a concussion include: 

  • Standardized Assessment of Concussion (SAC) 
    • A standardized tool for the sideline evaluation of athletes who suffer a head injury
    • Includes measures of orientation, immediate memory, concentration, delayed recall, neurologic screening, and exertional maneuvers 
  • Post-Concussion Symptom Scale and Graded Symptom Checklist
    • Requires the patient to rate severity of symptoms on a 7-point scale (0 = none; 6 = severe) for 15 to 30 symptoms associated with concussion (e.g., headache, dizziness, irritability, difficulty concentrating)
  • Sport Concussion Assessment Tool (SCAT5) which includes 
    • A review of subjective symptoms
    • The Glasgow Coma Scale (GCS)
    • SAC cognitive assessment
    • Evaluation of balance and coordination
  • Westmead post-traumatic amnesia scale (WPTAS) 
    • Takes less than one minute in an emergency department setting 
    • Involves a series of simple questions such as the patient’s name, name of the place, why they are there, month and year, town, age, date of birth, time of day, and pictures for recall
    • Any incorrect response to any question on the WPTAS is considered a sign of cognitive impairment after head injury

Imaging tests used to diagnose the extent of a concussion include: 

SLIDESHOW

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What Is the Treatment for a Concussion?

A mild concussion may not need treatment. Most concussions get better on their own over time. 

A mild concussion may last only hours to 7 to 10 days. More severe concussions may last weeks to months. Symptoms that persist are called “post-concussion syndrome.”

Home treatment for a mild concussion includes:

  • Rest your body and brain
    • Get plenty of sleep
    • Avoid too much physical activity 
    • Avoid activities that need concentration or a lot of attention 
  • Avoid alcohol while symptoms are still present
  • Over-the-counter (OTC) pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)

Post-concussion syndrome, also called persistent post-concussion symptoms, refers to symptoms of a concussion (traumatic brain injury) that last longer than the normal expected time frame for recovery.

Treatment for post-concussion syndrome may involve a combination of modalities. The goal of treatment is to relieve symptoms of post-concussion syndrome. 

Treatments endorsed by the 5th International Consensus on Concussion include: 

  • Individualized aerobic exercise program (also called graduated exercise therapy, or graded exercise therapy) for patients whose symptoms are associated with autonomic nervous system dysfunction (such as problems with blood pressure and breathing)
  • Physical therapy program in patients with neck (cervical spine) or vestibular dysfunction
  • Cognitive behavioral therapy (CBT) to learn to cope with chronic mood or behavioral issues

Additional treatments for post-concussion syndrome may include:

  • Vision therapy
  • Vestibular therapy 
  • Medications used to treat symptoms such as:
  • Light therapy (photobiomodulation) 
  • CBD/medical marijuana
  • Craniosacral therapy
  • Massage therapy
  • Hormone therapy 

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Reviewed on 1/11/2022
References
Image Source: iStock Images

https://www.uptodate.com/contents/concussion-in-adults-the-basics?search=concussion&source=search_result&selectedTitle=1~81&usage_type=default&display_rank=1

https://www.cdc.gov/headsup/basics/concussion_whatis.html

https://www.uptodate.com/contents/head-injury-in-children-and-adolescents-the-basics?search=concussion&source=search_result&selectedTitle=5~81&usage_type=default&display_rank=5

https://www.uwsp.edu/stuhealth/Documents/Other/Head%20Injury%20-%20Concussion.pdf

https://www.cdc.gov/concussion/headsup/clinicians/resource_center/complications_of_concussion.html

https://www.concussionalliance.org/treatments