Concussions

What is a concussion?

Concussion refers to a mild traumatic injury to the brain without an associated structural abnormality such as bleeding. It may occur with or without loss of consciousness.

While concussions can occur from direct impact, many occur without any contact to the head. A sudden abrupt stop, such as a fall to the ground or two players running directly into one another without hitting heads, can cause a concussion.

Signs/symptoms

Only one of the following needs to be present for a concussion to be suspected. It is also possible to have any combination of these symptoms.

• Confusion/disorientation

• Dizziness

• Headache

• Blurred vision

• Unsteadiness

• Nausea

• Feeling “in a fog”

• Vomiting

• May or may not involve loss of consciousness (loss consciousness is not typical)

If an athlete only has a headache, is it a concussion?

A headache can be a symptom of a concussion until determined otherwise by a medical provider trained in evaluating concussions. If the headache started after any sudden event such as a blow to the head or face, or after an abrupt stop without striking the head, such as a hard fall, then yes, a simple headache is a sign of a concussion. In fact, it is often the only sign of a concussion.

What should be done if a concussion is suspected?

• Seek medical advice from an individual who is trained in assessing and diagnosing concussions

• Do not have the person take ibuprofen related products or aspirin

• Carefully watch the injured person for worsening symptoms

• If symptoms continue to worsen, transport the athlete to the local emergency room for further evaluation

Concussion classification/grading

In the past, health professionals used a variety of classification/grading systems to define concussion. These have been determined to be obsolete. It is now known that the severity of a concussion can only be determined after the symptoms have resolved. The severity of the concussion is related to the intensity and duration of the symptoms.

What to watch for after a head injury

Normal signs in the first two days include:

• Fatigue and desire for extra sleep (can be awakened normally)

• Headache (mild, not worsening)

• Problems with thinking, concentration and attention span (may persist for extended periods)

Signs that suggest the need for immediate medical attention include:

• Marked change in personality, often with confusion and irritability

• Worsening headache, especially if associated with nausea or vomiting

• Numbness, tingling or weakness in the arms or legs, changes in breathing pattern or seizure

• Eye and vision changes (double vision, different-sized pupils, blurred vision that is persistent or begins well after the incident)

Preventing Head Injuries

• Understand concussion severity and symptom presentation

• Follow a physician’s “return to play” guidelines

• Equipment should be properly fitted, routinely checked and replaced or refitted when necessary (this includes protective oral devices such as mouth-guards)

• Always follow “safe sports techniques” as they pertain to your sport

• If an athlete has sustained a head injury and has concussion symptoms, he/she should not return to play without being evaluated by a medical professional