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Concussion is a sudden, post-traumatic loss of consciousness, after which the victim returns to full fitness. Usually, the victim does not remember the period of the injury, and the confusion after regaining consciousness is usually very small.
Definition of concussion
Concussion is a temporary disturbance in the functioning of the brain, without changes in its structure. It is classified as a minor brain injury, and its effects are transient in most people, although they may persist for several weeks. Concussion occurs as a result of a direct head injury, but also due to the rapid acceleration and slowing down of head movements, e.g. in a car accident. Shock occurs also in people involved in sports, such as boxers, footballers or skiers. Concussion can occur especially when skiing. It most often happens in children up to the age of 18 and people over 50. It is usually caused by the lack of imagination and not adjusting the driving style to one’s fitness. It is very important that during a concussion the nervous system is not damaged and the symptoms do not leave a trace. A characteristic feature of this condition is a temporary loss of consciousness and memory impairment, both in the period before the accident and after the injury (however, it does not always have to result in loss of consciousness). Patients also complain of pain and dizziness, they are “bewildered” and less fit. After a few hours or days, the sick feel well enough that they want to return to their normal activities.
Concussion – symptoms
The most common symptoms of a concussion include:
- headaches and dizziness (may appear even several hours after the injury),
- temporary (temporary) loss of consciousness,
- problems with memory and concentration,
- hypersensitivity to noise and light,
- nausea and vomiting
- speech impairment,
- problems with maintaining balance,
- tiredness,
- slowing down of movements.
In turn, later it is observed:
- changes in the sense of smell and taste
- trouble sleeping,
- Personality disorder,
- depression
- learning difficulties.
People with a slight head injury should lie down in a supine position. If the symptoms disappear spontaneously – there is no need to consult a doctor. The situation is different when, as a result of a head injury, there is a loss of consciousness and changes in the patient’s behavior, e.g. aggression, irritability or bewilderment. An indication for as soon as possible contact with a doctor is also disorientation as to time, place and people as well as speech disorders. Epileptic seizures and dilated pupils are also of concern.
How to proceed in case of suspected concussion?
In an injured person with suspected concussion, vital signs should be checked, i.e. consciousness, breathing and pulse. If the victim remains unconscious despite breathing, place the victim in the recovery position:
- in the case of the injured person lying on their back, bend the arm closer to us at a right angle, and then place the palm of the hand upwards,
- the victim’s leg located further should be bent and grasped by the knee, the other hand is caught by interlacing the fingers through the patient’s fingers,
- one by one, gently and smoothly, pull the injured’s arm and leg, turning it to the side,
- Place the victim’s hand next to his cheek, rest the knee of the bent leg on the ground, turn the head gently to the side.
The next step is to call an ambulance. After the injured person regains consciousness during this time, he should be calmed down and calmly explain what happened. You must be careful that the patient does not move or make sudden movements until the doctor arrives. If the victim has a head wound – it should be covered with a sterile dressing.
Concussion of the brain – diagnosis
The basis of diagnostics is a medical history of the injury, symptoms and neurological examination. The test performed by choice is the most common computed tomography head, and in rare cases magnetic resonance imagingto see if there has been any brain damage. It is imperative to check whether the injury has resulted in a brain hematoma, a complication characteristic of concussion. During diagnosis, it is also important to determine the patient’s neurological function and determine if there is any neck injury or nose and ear haemorrhage, as this type of bleeding, accompanied by bruising around the eyes, may indicate a fracture of the skull base.
Treatment of concussion
Each head injury with loss of consciousness is an indication for hospitalization for several days in order to observe the patient and perform the necessary tests to exclude the presence of a contusion or hematoma. An ambulance service should be called when the victim has fallen from a great height, has bleeding and lost consciousness for more than 2 minutes, or he has been losing and regaining consciousness alternately. The same is true for children who have sustained a head injury and have passed out. If the patient has not regained consciousness after two minutes – do not move him, so as not to damage the spine. If the patient feels the need to vomit, lay him on his side without moving his head. Treatment includes, first of all, the patient’s rest, avoiding physical activity, avoiding exposure to the sun, and limiting learning and the influence of external stimuli provided by a TV or computer. In case of a severe headache, the doctor may prescribe painkillers, usually paracetamol. It is very important to stay away from preparations that increase the risk of bleeding and impair blood clotting, such as acetylsalicylic acid.
In more than half of the cases, people recover to their original fitness after concussion. However, attention should still be paid to recurrent symptoms as they may suggest more serious complications and disorders than the concussion itself, e.g. intracranial hematoma.
Complications of concussion
Although the symptoms of concussion are usually self-limiting, headaches and dizziness may persist for several months after the injury. A possible but rare complication is hemorrhage into the subarachnoid space. It is characterized by a very severe headache and paralysis. Medical assistance is necessary.
How to avoid concussion?
The basic rule is to avoid head injuries. However, it is not always possible because there are unpredictable situations. Nevertheless, it does not hurt to equip yourself with protective clothing, e.g. a helmet, during sports activities, especially when cycling, skiing or inline skating. If you are a driver – it will not hurt to wear seat belts and comply with road traffic regulations. Being cautious is also important in children. For this purpose, parents should remember to secure home furniture and take care of the child, especially during activity.