Concussions

The brain is composed of soft, delicate structures that lie within the rigid skull. Surrounding the brain is a tough, leathery outer covering called the dura (door-a). Within the brain are (cranial) nerves that are responsible for many activities, such as eye opening, facial movements, speech and hearing. These nerves carry and receive messages that allow the person to think and function normally. There are also centers that control level of consciousness and vital activities, such as breathing. The brain is cushioned by blood and spinal fluid. There is very little extra room within the skull cavity.

An injury to the head causes the brain to bounce against the rigid bone of the skull. This force may cause a tearing or twisting of the structures and blood vessels of the brain, which results in a breakdown of the normal flow of messages within the brain. The damage to the brain generally is found deep within the brain tissue. Because of this damage, the normal function of the brain signals are interrupted.

Doctors use the term concussion to describe an injury to the brain that results from an impact to the head. By definition, a concussion is not a life–threatening injury, but it can cause both short–term and long–term problems. A concussion results from a closed–head type of injury. Concussions do not include injuries where there is bleeding under the skull or into the brain. Another type of brain injury is present if bleeding is visible on a CT scan (CAT scan) of the brain.

• A mild concussion may involve no loss of consciousness (being "dazed") or a very brief loss of consciousness (being "knocked out").
• A severe concussion may involve prolonged loss of consciousness with a delayed return to normal.

A concussion can be caused by any significant blunt force trauma to the head such as a fall, a car accident, or being struck on the head with an object.

Concussion categories

Grade 1
The mild concussion occurs when the person does not lose consciousness (pass out) but may seem dazed.

Grade 2
The slightly more severe form occurs when the person does not lose consciousness but has a period of confusion and does not recall the event.

Grade 3
The classic concussion, which is the most severe form, occurs when the person loses consciousness for a brief period of time and has no memory of the event. Evaluation from a health-care provider should be performed as soon as possible after the injury.

Signs and Symptoms of a concussion

• Loss of consciousness after any trauma to the head
• Confusion
• Headache
• Nausea or vomiting
• Blurred vision
• Loss of short–term memory (you may not remember the actual injury and the events some time before or after the impact)
• Perseverating (repeating the same thing over and over, despite being told the answer each time).

Treatment

The treatment for a concussion is usually to watch the person closely for any change in level of consciousness. The person may need to stay in the hospital for close observation. Surgery is usually not necessary. Headache and dizziness are common, but if the headache persists or becomes severe, it is best to seek medical attention.

Post-concussion syndrome may occur in some people. The syndrome generally consists of a persistent headache, dizziness, irritability, memory changes and vision changes. The person may seem overly emotional or unable to control their emotions. Some people experience unexplained depression. Difficulty with concentration or problems with thinking and planning ahead also are reported. Symptoms may begin weeks or even months after the initial injury. Although the symptoms generally resolve over time, some people need a rehabilitation specialist to oversee a program for recovery.

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