Concussion: The Invisible Injury

Concussions, also known as mild traumatic brain injuries, are typically caused by a blow or jolt to the head, which can result in temporary loss of brain function. There are many circumstances in which a person may get a concussion, from being in a vehicular accident and participating in contact sports to falling and bumping one’s head.

Recently, concussions in athletes at the college and professional levels have received increased attention. This may be due to research results showing the cognitive effects of the injury up to 30 years later. These effects are sometimes difficult to observe because concussions are almost invisible. They cannot be seen on CTs or MRI scans, and an individual does not need to lose consciousness to have suffered one.
 

Understanding How Concussions Occur

The brain is cushioned inside the skull by protective membranes and fluid. During impact, the organ pushes through the protection and strikes the inside of the skull. It then rebounds and hits the other side of the head, causing bruising and swelling.

Different parts of the brain may move at different speeds. This can produce forces strong enough to stretch or tear the delicate nerve tissue. Impaired nerve cell function can be the result of an altered balance of chemicals and ions. Depending on the force of the impact and the severity of damage caused to the nerve fibers, some cells will recover while others will lose their ability to communicate with other cells.
 

Recognizing Concussion Symptoms

Symptoms may take hours or days to manifest following a concussion.  Headaches, dizziness, fatigue, and inability to concentrate are among the most common aftereffects. However, other symptoms may go unnoticed:

• Sensitivity to sounds or light

• Moodiness or irritability

• Disturbed sleep

• Depression

• Dizziness

• Confusion

• Problems with balance/equilibrium
   

The term “mild traumatic brain injury” can be misleading. There are different levels of concussion severity. Some extreme symptoms can signal medical attention is needed immediately, including:

• Pupils that are dilated or of different sizes

• Consistent memory loss

• Loss of smell or taste

• Ringing in the ears
   

Diagnosing a Concussion

A medical professional can evaluate the symptoms, conduct a variety of tests and review medical history. Any of these tests may be performed:

• A cognitive test evaluates the ability to recall information and concentrate. Memory tests may also be recommended.

• A neurological examination evaluates vision, hearing, strength, coordination, balance, and reflexes.

• An imaging test may be necessary if symptoms are extreme or persistent. While these tests may not show the actual injury, complications resulting from the concussion, such as swelling or bleeding in the skull, can be identified.
   

Recovering From a Concussion

This is considered a functional rather than a pathological injury. It affects how the brain works, but its deleterious effects are usually temporary. A concussion can typically resolve itself in one to six weeks, but the patient does need to assist in the healing process.

Physical and mental rest is required to recover. Sports or vigorous activity should be avoided. Video games, schoolwork, reading, and computer use are considered mentally taxing. They should be limited to prevent triggering new symptoms or worsening existing symptoms. Once all symptoms have resolved, a doctor can discuss the timeframe for resuming physical activities such as jogging or playing sports.