Alternative Names closed head injury, postconcussive syndrome
Definition A concussion is the most common form of head injury. Most concussions are caused by a blow to the head or sudden, uncontrolled, rapid movement of the head. A concussion may cause temporary symptoms but not permanent brain damage.
What are the signs and symptoms of the injury? The American Academy of Neurology recently established guidelines for sorting concussions into Grades 1, 2, and 3. Each grade has different symptoms, and treatment recommendations vary according to the grade.
A person with a Grade 1 concussion does not lose consciousness. Symptoms of a Grade 1 concussion go away in less than 15 minutes, and may include:
A person with a Grade 2 concussion does not lose consciousness, and has symptoms similar to those of a Grade 1 concussion. However, the symptoms last more than 15 minutes.
A person with a Grade 3 concussion does lose consciousness for a few seconds to many hours. When the person awakens, he or she may have many of the symptoms of a Grade 1 concussion, as well as:
loss of awareness
memory loss regarding the events surrounding the injury, also known as amnesia
an altered level of consciousness. The person may be difficult to awaken or may not be acting normally.
What are the causes and risks of the injury? There are many possible causes for a concussion. Some common causes are bicycle accidents, automobile accidents, falls, and work-related injuries. Contact sports, especially football, are another common source of concussions. Some other sports that place a person at risk for concussions include:
boxing
basketball
baseball
ice hockey
skiing
skateboarding
wrestling
almost any other contact sport
Concussions are more common in an individual who has:
an altered mental state due to drugs or disease
difficulty walking because of arthritis, leg injury, or neuromuscular disease
loss of balance or poor co-ordination from ageing or disease
What can be done to prevent the injury? Sports safety guidelines should be followed for children, adolescents, and adults. Helmets and seat belts are especially important in the prevention of head injuries leading to concussions.
How is the injury recognised? A concussion can be diagnosed by a doctor with a standard neurological examination and complete history. An EEG, or electroencephalogram, may be ordered to check for abnormalities in the brain waves.
Tests such as a cranial CT scan, X-ray, and cranial MRI may also be used to determine the amount of damage to the brain. Often, all tests will be normal because the injury is not severe enough to detect.
What are the treatments for the injury? A person with a Grade 1 concussion should be checked at the time of the head injury, and then every 5 minutes until the symptoms go away. If the symptoms disappear in 15 minutes or less, the person can return to normal activity, including sports.
A person with a Grade 2 concussion should be examined by a doctor and should avoid sports for a week.
When a person loses consciousness for any length of time following a concussion, he or she has a Grade 3 concussion. The individual should be immediately transported with a neck brace to a hospital for treatment.
What are the side effects of the treatments? Most people fully recover from concussions without side effects.
What happens after treatment for the injury? A person with a Grade 1 concussion can return to normal activity, including sports, when the symptoms go away. An individual with a Grade 2 concussion should refrain from sports for one week. If the person is still symptom free after one week, he or she may return to sports activities.
A person with a Grade 3 concussion should follow the recommendations of the healthcare professional regarding activity. The person's return to sports will depend on how long he or she was unconscious, and how long it took for the symptoms to go away. An individual with repeated concussions should be carefully evaluated before returning to sports activities.
Any new or worsening symptoms should be reported to the doctor.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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