Concussions: Information on Causes, Diagnosis & Treatments

Concussion Xray Most concussions of the result of a heavy blow caused by a violent shock that leads to temporary unconsciousness. However, some doctors also referred to a concussion as a temporary incapacity or confusion associated with the aftereffects of head trauma. The condition can occur by a blow, jolt, or bump to the head or when the body is hit with such force that causes the brain and head to move back and forth in rapid succession in a whiplash motion. The first noticeable signs of a person might not be obvious and common symptoms can last for many days, weeks or much longer. Some concussions produce severe long-term effects, especially if repeated head injuries exacerbate the condition.

Who Gets Concussions?

According statistics maintained by the CDC, more than 1.4 million individuals suffer traumatic brain injury concussions every year in America. Of these individuals, more than 50,000 will die from the condition and another 235,000 will need to be hospitalized while the remainder received treatment and are released from the hospital’s emergency department. There are likely hundreds of thousands of more cases of concussions that go unreported every year due to a lack of obvious symptoms.

Concussions are considered one of the deadliest injuries one experience when working. Many concussions are the result of some traumatic event including a driving accident, slip, and fall incident, working with faulty equipment, or being hit by a falling object. Most concussed individuals experience similar symptoms including the loss of equilibrium, blurry vision, ringing in the ears, and confusion. The top occupations where workers are more likely to suffer concussions include:

  • Construction workers who can fall, trip, or be harmed by dangerous equipment or falling objects.

  • Firefighters who can be hit in the head or fall from buildings have a high potential of suffering a concussion.

  • Miners who can be hit by falling objects or crushed by walls of dirt can suffer concussions.

  • Sports players and racecar drivers can suffer concussions by blunt force impact involving another player or object.

  • Dockworkers and longshoremen working in shipping ports are susceptible to falls and being hit by objects when loading and unloading ship containers from cargo bins.

  • Children whose developing brains are usually more susceptible to serious injury of a concussion compared to adults. This is because the child’s head is much heavier proportionally in comparison to the rest of the body with thinner skull bones and continuing development of nerve connections.

Every individual who has suffered a concussion is at greater risk of experiencing repeat impact syndrome where any subsequent head injury can cause significantly more damage if the first head injury has yet to be resolved.

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Common Concussion Symptoms

Most of the symptoms associated with a concussion are subtle in nature and are not always immediately obvious. Many individuals who have had a concussion will notice that their symptoms last for many days, weeks or much longer. Common concussive traumatic brain injury symptoms involve confusion, amnesia (loss of memory), headaches and others that include:

  • A foggy or confusing sensation

  • Temporary loss of consciousness

  • Slurred speech

  • Vomiting and nausea

  • “Seeing stars” (dizziness)

  • Fatigue

  • Delayed response when interacting with others

  • Traumatic event-related amnesia

  • A sense of pressure in the head

  • Extreme headaches

Many of the more severe symptoms associated with a concussion will be delayed for minutes, hours, days or longer after the injury has occurred. These more serious concussion symptoms involve:

  • Difficulty in sleeping (sleep disturbance)

  • Memory complaints

  • Complete or partial loss of concentration

  • Unexpected personality changes

  • Increased irritability

  • Smell or taste disorder

  • Psychological adjustment issues

  • Signs of depression

Children have their own unique symptoms after experiencing a concussion, which are often difficult to recognize especially in toddlers, infants, and newborns who are unable to describe the symptoms they are experiencing. Common child concussion symptoms include:

  • Excessive crying

  • Irritability

  • Quick to tire (listlessness)

  • A lack of interest in playing

  • Unsteady walking due to a loss of balance

  • A loss of appetite

  • Changing sleeping patterns

If the child sustained a serious head injury, it is essential to keep them alert and responsive until medical attention arrives. Emergency situations for both children and adults experiencing a concussive head injury often involve:

  • Repeated vomiting

  • Slurred speech

  • Disorientation or ongoing confusion especially in recognizing places or individuals

  • Clumsiness, stumbling, or other balance-associated coordination problem

  • Worsening headaches

  • Increased irritability

  • Changes in behavior

  • Seizures

  • Large bruises and lumps on the head

  • Worsening symptoms

  • Difficulty with physical coordination

  • Challenges with mental function

  • Recurrent or returning dizziness

  • Vision disturbances

  • Dilated pupils

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Diagnosing a Concussion

Advancements in diagnosing procedures has made it much easier for doctors to accurately diagnose a traumatic brain injury concussion to ensure that the patient receives the proper treatment. The diagnosis will usually include:

Physical Examination and Comprehensive Testing

The doctor will want to take a complete medical history to determine what the patient experienced, including a detailed understanding the sequence of events that happened at the time of the injury and afterward. The physical examination can help identify swelling and bleeding in the brain. The patient might have a history of underlying medical problems associated with the injury including elders who follow hit their head before experiencing fall and hit their head causing temporary unconsciousness. The doctor must determine whether the individual hit their head first before being knocked out or passed out because of a medical issue before falling and hitting their head.

In addition, it is important to consider the side effects of taking prescription medications in individuals who have experienced a concussion. If the patient is taking Pradaxa (dabigatran) or Coumadin (warfarin), they are more likely to bleed from a blow to the head. A comprehensive physical and neurological examination can help determine if the patient is suffering from paralysis, weakness, loss of balance, or hearing/visual impairment.

Computerized Tomography Scans

Many individuals will have a minor head injury where they remain fully awake after experiencing trauma to the head. Doctors are now trained to follow specific rules when performing CT (computerized tomography) scans to effectively screen patients that might or might not need an operation. Those with a depressed or open skull fracture, or have a Glasgow Coma Scale result of <15 two hours after the injury occurred likely need some type of neurosurgical intervention.

Injured patients who are 65 years or older and have at least two episodes of vomiting after suffering a traumatic head injury likely need neurosurgical interventions as do injured patients that have had a basal skull fracture typically displayed by bruising around the eyes, blood behind the eardrum or cerebral spinal fluid leaking from the ears or nose.

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Treating a Concussion

Doctors, scientists, and medical researchers have yet to develop a specific procedure to treat a concussion. However, doctors typically recommend restricting activities and ending time resting to ensure that the brain has ample time to recover. This means that the injured individual should temporarily reduce participation in socializing, sports activities, watching TV or playing video games.

The doctor will likely recommend numerous rehabilitation therapies to improve physical and mental functioning following the injury and could likely prescribe an analgesic medication to relieve mild to severe pain.

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Sources:

https://my.clevelandclinic.org/departments/concussion-center

https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm519116.htm

https://my.clevelandclinic.org/health/articles/concussions

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