Concussions

What is a concussion?

A concussion is a traumatic brain injury that affects your brain function. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. Concussions are usually caused by a blow to the head. Violently shaking of the head and upper body also can cause concussions. Most people get a little amnesia and do not remember the concussion happening. Some patients end up losing consciousness, but this is not as common.

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Signs and Symptoms

Headache
Ringing in the ears
Nausea
Vomiting
Fatigue or drowsiness
Blurry vision
Confusion or feeling as if in a fog
Amnesia surrounding the traumatic event
Dizziness or "seeing stars"

A teammate or coach might observe these symptoms:

Temporary loss of consciousness (though this doesn't always occur)
Slurred speech
Delayed response to questions
Dazed appearance
Forgetfulness, such as repeatedly asking the same question

You could also see any of these symptoms a few days after:

Concentration and memory complaints
Irritability and other personality changes
Sensitivity to light and noise
Sleep disturbances
Psychological adjustment problems and depression
Disorders of taste and smell

Prevention:

Always wear a helmet

Neck strengthening
Enforce safety rules
Making sure everyone knows what you are doing/ the play you will be running so there is not confusion or miscommunications
Education about concussions
Implement “no checks to the head” rule in hockey
Have players wear impact-softening shoulder and elbow pads
Reduce head-to-head contact (i.e., football)

The long lasting impact

Second impact syndrome is one of the most dangerous long term symptoms. This happens when the brain swells rapidly shortly after a person suffers a second concussion before symptoms from an earlier concussion have subsided. True SIS involves brain herniation and death within minutes. Therefore, the odds of seeing acute SIS in the ED are unlikely. If suspected, the patient should be immediately stabilized with special emphasis on airway management, and neurosurgery consulted. Rapid intubation and mannitol to minimize morbidity is also recommended. Long-term effects of concussions are very rare. Moderate to severe traumatic brain injury (TBI) can cause symptoms similar to a concussion, but individuals with these TBIs often experience more severe problems with attention and short-term memory, have difficulty performing daily tasks, and report feeling “slower” overall. Post concussion symptoms include:

Headaches
Disorientation
Fatigue
Ringing in the ears
Increased irritability
Anxiety
Insomnia
Loss of concentration and memory
Blurry vision
Sensitivity to noise and light
Decreases in taste and smell (rare)

In 2013, research presented at the annual meeting of the American Association for the Advancement of Science suggested that brain damage caused by a concussion can last for decades after the original injury. This research highlighted the fact that injuries with no visible abnormalities on MRI or CT scans can cause debilitating symptoms as the years go on. Citing many instances of people suffering from the long-term effects of a concussion, including athletes and soldiers, the research went on to detail the symptoms. These included learning, memory, judgment, and emotional impairments. Each of these symptoms makes daily life more difficult for sufferers, whether in a sense of interpersonal relationships or work performance. Although the British Journal of Sports Medicine agreed at first and said that multiple concussions appear to be a risk factor for cognitive impairment and mental health problems in some individuals. But more research is needed to better understand the prevalence of chronic traumatic encephalopathy and other neurological conditions and diseases, and the extent to which they are related to concussions and/or repetitive neurotrauma sustained in sports.