Jake banged his head hard when he was tackled, and he felt kind
of weird afterward. He thought it was just another hit that he
could shake off - and he wanted to stay on the field. After the
game, though, he felt pretty sick. Should Jake have kept on
Definitely not. Jake may have had a concussion, and it was
actually a bad idea for him to stay in the game.
What Is a Concussion and What Causes It?
The brain is made of soft tissue and is cushioned by spinal
fluid. It is encased in the hard, protective skull. When a person
gets a head injury, the brain can slosh around inside the skull and
even bang against it. This can lead to bruising of the brain,
tearing of blood vessels, and injury to the nerves. When this
happens, a person can get a concussion - a temporary loss of normal
Most people with concussions recover just fine with appropriate
treatment. But it's important to take proper steps if you
suspect a concussion because it can be serious.
Concussions and other brain injuries are fairly common. About
every 21 seconds, someone in the United States has a serious brain
injury. One of the most common reasons people get concussions is
through a sports injury. High-contact sports such as football,
boxing, and hockey pose a higher risk of head injury, even with the
use of protective headgear.
People can also get concussions from falls, car accidents, bike
and blading mishaps, and physical violence, such as fighting. Guys
are more likely to get concussions than girls. However, in certain
sports, like soccer, girls have a higher potential for
What Are the Signs and Symptoms?
The signs of concussion are not always well recognized. Because
of that, people may put themselves at risk for serious injury by
returning to a game before they should, getting back on a
skateboard, or hitting the slopes thinking nothing's wrong.
That's a problem, because if the brain hasn't healed
properly from a concussion and someone gets another brain injury
(even if it's with less force), it can be serious.
Repeated injury to the brain can lead to swelling, and sometimes
people develop long-term disabilities, or even die, as a result of
serious head injuries. So it's really important to recognize
and understand the signals of a concussion.
Although we may think of a concussion as someone passing out, a
person can have a concussion and never lose consciousness.
Symptoms of a concussion may include:
- "seeing stars" and feeling dazed, dizzy, or
- memory loss, such as trouble remembering things that happened
right before and after the injury
- nausea or vomiting
- blurred vision and sensitivity to light
- slurred speech or saying things that don't make
- difficulty concentrating, thinking, or making decisions
- difficulty with coordination or balance (such as being unable
to catch a ball or other easy tasks
- feeling anxious or irritable for no apparent reason
- feeling overly tired
Different Grades of Concussion
The two different types of concussion are:
With a simple concussion, a person's symptoms get better over
With a complex concussion, symptoms last longer than 7-10 days.
Doctors also consider it a complex concussion if a person loses
consciousness (passes out) for more than 1 minute or has seizures
after a blow to the head. It's also a complex concussion if
someone has had a concussion before, no matter how long ago.
Regardless of the level of concussion, it's best to take it
easy for a few days. That means no exercise or activities like
skateboarding or gymnastics. If you play sports,
return to a sports practice or game on the day you are injured.
Wait for all symptoms to disappear before you start playing
sports again - and that doesn't just mean physical symptoms
like headaches or tiredness. In many teens, the physical symptoms
get better before the cognitive ones (such as difficulty thinking
or making decisions). So it's important to feel 100% before
becoming active again.
If You Get a Concussion
Here's what to do if you have a concussion:
If you get a concussion while playing sports, stop
Don't return to play even if you feel fine.
If you've had a complex concussion, contact your
doctor or go to the emergency room.
After a complex concussion, you must see a concussion or brain
injury specialist to help decide whether you need additional
tests and when you can return to activity. Ask your doctor who
you should see for this.
For the first few days, rest both your body and mind: Activities
that require concentration and attention (like studying, test
taking, or even playing videogames) may make the symptoms worse
and delay recovery.
After the symptoms of concussion have gone away,
go back to being more active.
Slowly advance from one step to the next, day by day, ONLY if you
stay symptom free. The steps for return to play are:
No activity until symptoms
Once symptoms disappear, you can start
light aerobic exercise such as walking or stationary cycling
- no resistance training.
If there's still no sign of
symptoms, you can begin sport-specific exercise (such as
skating in hockey, running in soccer).
If you're still symptom free, you
can start non-contact training drills (i.e., drills in which
there's no chance you will fall, flip, or collide with
If steps 1-4 go well, see your doctor
to get approval to go back to full activity or training.
If a Friend Has a Concussion
If a friend or teammate seems to have a concussion, tell an
adult or coach immediately. Even if the concussion seems mild, a
player should sit out the rest of the game.
If the symptoms are severe (such as seizures or a very long
period of unconsciousness) or they seem to be getting worse,
that's an indication of a serious head injury. Get medical help
What Do Doctors Do?
If a doctor suspects that someone may have a concussion, he or
she will ask about the head injury (such as how it happened and
when) and the symptoms. The doctor may ask what seem like silly
questions - things like "Who are you?" or "Where are
you?" or "What day is it?" and "Who is the
President?" Doctors ask these questions to check the
person's level of consciousness and memory and concentration
The doctor will perform a thorough examination of the nervous
system, including testing balance, coordination of movement, and
reflexes. Sometimes a doctor may order a CT scan (a special brain
X-ray) or an MRI (a special non-X-ray brain image) to rule out
bleeding or other serious injury involving the brain.
If a person's symptoms last longer than a week, the doctor
will likely recommend further testing of thinking, memory, reaction
time, and other brain functions.
If the concussion isn't serious enough to require
hospitalization, the doctor will give instructions on what to do at
home, like having someone wake the person up at least once during
the night. If a person with a concussion cannot be easily awakened,
becomes increasingly confused, or has other symptoms such as
vomiting, it may mean there is a more severe problem that requires
contacting the doctor again.
If someone has a concussion, the doctor will recommend rest.
Resting and avoiding physical exertion or sports is essential to
the healing process. It is also important to avoid loud, bright,
busy environments. People who are getting over a concussion should
also avoid activities that require lots of thinking and
concentration, so a doctor may recommend that the person stay home
from school or work.
The doctor will probably recommend that someone with a
concussion take acetaminophen or other aspirin-free medications for
After a Concussion
After a concussion, the brain needs time to heal. It's
really important to wait until all symptoms of a concussion have
cleared up before returning to normal activities. The amount of
time someone needs to recover depends on how long the symptoms
last. Healthy teens can usually resume their normal activities
within a few weeks, but each situation is different. A doctor will
monitor the person closely to make sure everything's OK.
Someone who has had a concussion and has not recovered within a
few months is said to have post-concussion syndrome. The person may
have the same problems described earlier - such as poor memory,
headaches, dizziness, and irritability - but these will last for
longer periods of time and may even be permanent.
If someone has continuing problems after a concussion, the
doctor may refer him or her to a rehabilitation specialist for
Some accidents can't be avoided. But you can do a lot to
prevent a concussion by taking simple precautions:
Always use a seat belt.
If you drive, be attentive at all times, and obey speed limits,
signs, and safe-driving laws to reduce the chances of having an
accident. Driving rules and regulations were created to protect
everyone. Never use alcohol or other drugs when you're behind
the wheel. There's a reason it's illegal: Alcohol and
drugs make your reaction time slower and impair your judgment,
making you much more likely to have an accident.
Wear your helmet.
Wearing appropriate headgear and safety equipment when biking,
blading, skateboarding, snowboarding or skiing, and playing
contact sports can significantly reduce your chances of having a
concussion. By wearing a bike helmet, for instance, you can
reduce your risk of having a concussion by about 85%.
It's vital to take good care of yourself after a concussion.
If you reinjure your brain during the time it is still healing, it
will take even more time to completely heal. Each time a person has
a concussion, it does additional damage - and since it's damage
no one can see on the outside, there's no way of knowing how
serious it might be. If someone has multiple concussions over a
period of time, it can affect the person's brain as much as
being knocked unconscious for several hours.
Preventing concussions is mostly common sense. The best thing
you can do to protect your head is to use it.
Yamini Durani, MD
Date reviewed: April 2009
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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