Sign and Symptoms of Concussion

 

Most people with a concussion recover quickly and fully. But for some people, symptoms can last for days, weeks, or longer. In general, recovery may be slower among older adults, young children, and teens. Those who have had a concussion in the past are also at risk of having another one and may find that it takes longer to recover if they have another concussion.

 

Symptoms of concussion usually fall into four categories:

 

Thinking/Remembering

• Difficulty thinking clearly

• Feeling slowed down

• Difficulty concentrating

• Difficulty remembering new information

 

Physical

• Headache

• Fuzzy or blurry vision

• Nausea or vomiting (early on)

• Dizziness

• Sensitivity to noise or light

• Balance problems

• Feeling tired, having no energy

 

Emotional/Mood

• Irritability

• Sadness

• More emotional

• Nervousness or anxiety

 

Sleep

• Sleeping more than usual

• Sleep less than usual

• Trouble falling asleep

 

Some of these symptoms may appear right away, while others may not be noticed for days or months after the injury, or until the person starts resuming their everyday life and more demands are placed upon them. Sometimes, people do not recognize or admit that they are having problems. Others may not understand why they are having problems and what their problems really are, which can make them nervous and upset.

 

The signs and symptoms of a concussion can be difficult to sort out. Early on, problems may be missed by the person with the concussion, family members, or doctors. People may look fine even though they are acting or feeling differently.

 

When to Seek Immediate Medical Attention:

 

Danger Signs in Adults

 

In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. Contact your health care professional or emergency department right away if you have any of the following danger signs after a bump, blow, or jolt to the head or body:

 

• Headache that gets worse and does not go away

• Weakness, numbness or decreased coordination

• Repeated vomiting or nausea

• Slurred speech

 

The people checking on you should take you to an emergency department right away if you:

 

• Look very drowsy or cannot be awakened

• Have one pupil (the black part in the middle of the eye) larger than the other

• Have convulsions or seizures

• Cannot recognize people or places

• Are getting more and more confused, restless, or agitated

• Have unusual behavior

• Lose consciousness (a brief loss of consciousness should be taken seriously and the person should be carefully monitored)

 

Danger Signs in Children

Take your child to the emergency department right away if they received a bump, blow, or jolt to the head or body, and:

 

• Have any of the danger signs for adults listed above

• Will not stop crying and cannot be consoled

• Will not nurse or eat

 

What Should I do If a Concussion Occurs?

 

People with a concussion need to be seen by a health care professional.  If you think you or someone you know has a concussion, contact your health care professional. Your health care professional can refer you to a neurologist, neuropsychologist, neurosurgeon, or specialist in rehabilitation (such as a speech pathologist). Getting help soon after the injury by trained specialists may speed recovery.

 

What to Expect When You See a Health Care Professional

While most are seen in an emergency department or medical office, some people must stay in the hospital overnight. Your health care professional may do a scan of your brain (such as a CT scan) or other tests. Other tests, known as “neuropsychological” or “neurocognitive” tests, assess your learning and memory skills, your ability to pay attention or concentrate, and how quickly you can think and solve problems. These tests can help your health care professional identify the effects of a concussion. Even if the concussion doesn’t show up on these tests, you may still have a concussion.

 

Your health care professional will send you home with important instructions to follow. Be sure to follow all of your health care professional’s instructions carefully.

 

If you are taking medications—prescription, over-thecounter medicines, or “natural remedies”—or if you drink alcohol or take illicit drugs, tell your health care professional. Also, tell your health care professional if you are taking blood thinners (anticoagulant drugs), such as Coumadin and aspirin, because they can increase the chance of complications.

 

What Can I Do to Help Feel Better After a Concussion?

 

Although most people recover fully after a concussion, how quickly they improve depends on many factors. These factors include how severe their concussion was, their age, how healthy they were before the concussion, and how they take care of themselves after the injury.

 

Some people who have had a concussion find that at first it is hard to do their daily activities, their job, to get along with everyone at home, or to relax.

 

Rest is very important after a concussion because it helps the brain to heal. Ignoring your symptoms and trying to “tough it out” often makes symptoms worse. Be patient because healing takes time. Only when your symptoms have reduced significantly, in consultation with your health care professional, should you slowly and gradually return to your daily activities, such as work or school. If your symptoms come back or you get new symptoms as you become more active, this is a sign that you are pushing yourself too hard. Stop these activities and take more time to rest and recover. As the days go by, you can expect to gradually feel better.

 

Getting Better: Tips for Adults

 

• Get plenty of sleep at night, and rest during the day.

• Avoid activities that are physically demanding (e.g., heavy housecleaning, weightlifting/working-out) or require a lot of concentration (e.g., balancing your checkbook). They can make your symptoms worse and slow your recovery.

• Avoid activities, such as contact or recreational sports, that could lead to another concussion. (It is best to avoid roller coasters or other high speed rides that can make your symptoms worse or even cause a concussion.)

• When your health care professional says you are well enough, return to your normal activities gradually, not all at once.

• Because your ability to react may be slower after a concussion, ask your health care professional when you can safely drive a car, ride a bike, or operate heavy equipment.

• Talk with your health care professional about when you can return to work. Ask about how you can help your employer understand what has happened to you.

• Consider talking with your employer about returning to work gradually and about changing your work activities or schedule until you recover (e.g., work half-days).

• Take only those drugs that your health care professional has approved.

• Do not drink alcoholic beverages until your health care professional says you are well enough. Alcohol and other drugs may slow your recovery and put you at risk of further injury.

• Write down the things that may be harder than usual for you to remember.

• If you’re easily distracted, try to do one thing at a time. For example, don’t try to watch TV while fixing dinner.

• Consult with family members or close friends when making important decisions.

• Do not neglect your basic needs, such as eating well and getting enough rest.

• Avoid sustained computer use, including computer/video games early in the recovery process.

• Some people report that flying in airplanes makes their symptoms worse shortly after a concussion.

 

Getting Better: Tips for Children

 

Parents and caregivers of children who have had a concussion can help them recover by taking an active role in their recovery:

 

• Having the child get plenty of rest. Keep a regular sleep schedule, including no late nights and no sleepovers.

• Making sure the child avoids high-risk/ high-speed activities such as riding a bicycle, playing sports, or climbing playground equipment, roller coasters or rides that could result in another bump, blow, or jolt to the head or body. Children should not return to these types of activities until their health care professional says they are well enough.

• Giving the child only those drugs that are approved by the pediatrician or family physician.

• Talking with their health care professional about when the child should return to school and other activities and how the parent or caregiver can help the child deal with the challenges that the child may face. For example, your child may need to spend fewer hours at school, rest often, or require more time to take tests.

• Sharing information about concussion with parents, siblings, teachers, counselors, babysitters, coaches, and others who interact with the child helps them understand what has happened and how to meet the child’s needs.

 

Help Prevent Long-Term Problems

 

If you already had a medical condition at the time of your concussion (such as chronic headaches), it may take longer for you to recover from the concussion. Anxiety and depression may also make it harder to adjust to the symptoms of a concussion. While you are healing, you should be very careful to avoid doing anything that could cause a bump, blow, or jolt to the head or body. On rare occasions, receiving another concussion before the brain has healed can result in brain swelling, permanent brain damage, and even death, particularly among children and teens.

 

After you have recovered from your concussion, you should protect yourself from having another one. People who have had repeated concussions may have serious long-term problems, including chronic difficulty with concentration, memory, headache, and occasionally, physical skills, such as keeping one’s balance.

 

Source: Centers for Disease Control and Prevention (2015)