Concussion

By: Dr Simon Gonzalez, specialist in sports medicine at the Sports Medicine Centre

A concussion is a brain injury caused by a blow to the head. If the blow is strong enough, it can cause the brain to move within the cranial vault. This abnormal movement results in brain injuries, which can cause symptoms to emerge. It is possible to experience these effects even if there was no initial loss of consciousness. As such, following any blow to the head, it is always advisable to stop the activity and consult a doctor for examination.

Concussions are not visible on ordinary imaging tests such as an MRI, x-ray or scan. Diagnosis is therefore based on clinical assessment only, by looking for typical symptoms such as headaches, dizziness, nausea, sensitivity to light or noise, or a change in vision. Concussion can also affect our thinking (causing confusion, drowsiness, difficulties with concentration, memory loss, fatigue) as well as our emotions (resulting in irritability, nervousness, anxiety, a highly emotional state, sadness) or sleep, which can be altered.

In addition, it is particularly important to watch for the following symptoms – if these appear, it is vital to contact the emergency services for urgent care: neck pain, double vision, loss of consciousness, epileptic seizure or convulsions, repeated vomiting, a headache which is very severe or gets progressively worse, or a feeling of weakness, tingling or burning in the arms or legs.

You should never try to move a person who is unconscious following a blow to their head, or to remove their equipment, such as a helmet or other protective equipment, before the emergency services arrive, as this risks aggravating the damage if they have injured their spine.
It is also important to ensure that the injured person is not left alone at any point in the days following their accident. Concussion can manifest differently in different people, and symptoms may take hours or even days to appear.

Most people get better within 10 to 30 days, but recovery times can vary, and are generally longer for children and teenagers than for adults. If this is not the first concussion or if the person has other medical conditions, they may take longer to recover.

In all cases, the doctor treating the patient will monitor the development of symptoms and advise when it will be possible to resume normal activities. The doctor may also seek support from other healthcare professionals, such as a neurologist, physiotherapist or occupational therapist. 

An immediate return to sport should be avoided to prevent second impact syndrome, a rare but serious complication of concussion. In second impact syndrome, acute and often fatal swelling of the brain occurs when there is a second concussion before complete recovery from a previous concussion.

Over the long term, repeated concussions can lead to the emergence of dementia, including Alzheimer’s disease. This is a particular risk in cases where protocols on recovery time and abstention from sport are not followed.