Article > Head & Neck > Concussion

Concussion

The word "concussion" has been around for quite some time, and it is referred to in the world of contact sports often. So what exactly is defined by "concussion"? If you don't know for sure, you're not alone. Much confusion exists as to the details, precautions and treatment of concussions. In many cases, concussions may either go unnoticed or be deemed insignificant. This may have serious repercussions to the health of the individual, especially if he / she returns to activity too soon and puts him / her-self at risk for further injury.

A concussion is the impairment of neural function that one may suffer, following trauma. The symptoms may include any of the following:

• a change in the level of consciousness (not necessarily unconscious)
• disorientation and confusion
• headache
• nausea and / or vomiting
• altered sense of balance
• altered coordination
• vision difficulties
• speech difficulties

The traumatic event is not always a direct blow to the head. In fact, many times it is simply a sudden movement or change in acceleration of the head through space. For example, a football player may be hit suddenly on one shoulder, which causes a rapid twisting motion of his body and head. Although the head was not hit directly, a concussion may result.

With severe trauma, bleeding, damage to structures within the brain and even death may result. However, in many cases the symptoms of a concussion are not quite as extreme, yet still may be dangerous. As long as symptoms persist, the individual is more prone to suffering another concussion if he / she does not rest properly. Resting properly means to avoid all activity that makes the symptoms worse. The two unfortunate aspects of concussions are that the duration of increased vulnerability is not known, and the extent of the damage often won't appear on a CT scan.

Following a concussion, an individual may be suffering from just a few or possibly all of the aforementioned symptoms. This becomes difficult when grading the severity of a concussion, because many different grading scales exist. The main principal here is to report all symptoms presented as accurately as possible.

PREVENTION

We should never underestimate the importance of prevention, since the effects of a concussion can be serious and long-lasting. One of the more obvious preventative techniques is the use of proper protective equipment, such as helmets and pads. Depending on the sport or activity, specific quality and safety rating systems may be in place, and should be adhered to at all times. The age and general condition of the equipment must also be taken into consideration. The rules & regulations of a particular sport are created, in part, to promote safety, as well as define the sport. Teaching and performing techniques for safe play can further reduce the risk. Lastly, due to the cumulative effects of concussions, return to activity should only take place once symptoms have ceased.

TREATMENT

If a person is thought to have sustained a concussion, (meaning that they present with any of the symptoms) they should sit-out the current activity, and be seen by a physician. They should also be monitored for worsening symptoms, which may indicate monitoring throughout the night depending on the severity. A gradual return to activity should then be monitored by a physician.

When returning to activity, the general guideline is that all activity must be completely assymptomatic (ie: no symptoms present). The progressive levels of activity allowed are roughly as follows:

• rest, no activity
• light exercise
• sport-specific exercise
• full activity, without body contact
• full activity, full body contact

The main principal being to only participate at the level where no symptoms appear. Great care must be taken when dealing with concussions, because the consequences can be long term and sometimes even fatal.