A sports concussion is an injury to the brain which results from a blow to the head. Concussions can range from mild to severe and can alter mental status, as well as cause other symptoms, both physical and mental. Any significant impact to the head, such as a fall, car accident or sports injury can result in a concussion. Concussions are of special concern for athletes who participate in contact sports. Consciousness may be lost with a moderate to severe concussion, while someone with a mild concussion may simply feel dazed. With any forceful blow to the head, the patient should be closely watched for any signs of concussion.
Sports Concussion Statistics:
- 2012: 3 million concussions reported, twice as many as in 2002
- LOC: Loss of consciousness does not occur in 90% of most diagnosed concussions
- When: 33% of sports concussions occur during practice
- High school football: has 47% of reported sports concussions
- Reoccurrence: 33% of high school athletes who suffer a sports concussion report two or more in the same year
- 1 in 5 high school athletes will sustain a sports concussion during the season
- Approximately 5.3 million Americans live with a traumatic brain injury-related disability (CDC)
Signs and Symptoms of a Sports Concussion
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Dizziness or drowsiness
- Problems with balance
- Difficulty concentrating, communicating or remembering
- Confusion or mental fogginess
- Slow response to questions
- Feeling irritable or emotional
- Headache
- Fatigue
- Nausea or vomiting
- Double or blurred vision
- Unusual behavior
- Tingling or numbness
- Light or noise sensitivity
- Trouble sleeping or excessive sleepiness
Signs and symptoms of a concussion usually present shortly after the injury, however, some symptoms may take a few hours or even days before showing up, which can prevent the patient and the initial examiner from realizing how serious the injury actually is. An athlete who has a concussion may be a bit confused immediately after the incident and be completely unable to recall the event an hour later. Because symptoms can be delayed, monitoring for signs of a concussion should continue for several days after a head injury.
Any athlete who sustains a head blow should be evaluated by a trainer, physician or trained coach as quickly as possible.
Sideline Concussion Evaluations should include:
- Review of symptoms list
- Assessment of athlete’s attentiveness
- Focused neurological exam
- Short term memory test (such as recall of the play, the score, and last food eaten)
- Long term memory test (such as name, date, and place of birth)
Danger Signs of a Sports Concussion
In an extremely small percentage of concussion cases, a collection of blood, called a hematoma, can form on the brain causing it to squeeze against the skull. Concussion symptoms which can be a sign of a more serious medical problem are:
- Enlarged pupil on one side
- Seizures or convulsions
- Persistent headache which worsens
- Inability to wake up or extreme grogginess
- Slurred speech
- Repeated vomiting or episodes of nausea
- Increasingly unusual behavior or agitation
- Loss of consciousness
If any of these concussion danger signs arise after a hard blow to the head or body, the patient should be taken to the emergency room or 9-1-1 should be called.
Additional Concussion Symptoms in Small Children
- Inconsolable crying
- Refusal to eat or nurse
- Lack of interest in activities or toys
- Loss of newly acquired skills
Returning to Normal Activity After a Concussion
If a concussion is diagnosed, the doctor will want to ensure that the patient is fully recovered before he or she participates in any activity which could result in another head trauma. An athlete with an unhealed or undiagnosed concussion is at risk for second impact syndrome, a potentially fatal condition in which a second injury occurs before the initial concussion has healed.
Brain Trauma and Diffuse Axonal Injury
Mild traumatic brain injury (mTBI) or “concussion” can induce persistant neurocognitive dysfunction in many individuals. mTBI results in diffuse axonal injury from sudden changes in velocity of the head. Diffuse Axonal Injury is a potentially severe form of TBI, and is the underlying cause of injury in 50% of TBI patients requiring hospitalization.
Post-concussion Testing
- Neurocognitive evaluation –Testing memory, reaction times, problem solving, and brain processing speed
- CT scan
- MRI
Baseline testing, in which an athlete’s physical and cognitive abilities are recorded prior to sustaining any injury, can be extremely helpful in determining if the athlete is healed and ready to resume play. Athletes should be completely free from any concussion symptoms before returning to sports activity.
After a concussion, if any symptoms return during physical activity, the patient should stop and rest for a day. Overdoing or resuming activity too quickly only prolongs recovery time. Getting plenty of rest and avoiding demanding activities, both physical and mental, will aid the healing process.
No matter how mild a concussion is, the patient should undergo a thorough evaluation by one of our qualified medical professionals to ensure that the brain has healed and it is safe to resume recreational activity. Learn more about sports injuries on the Orthopedic and Sports Medicine Institute (OSMI) website.
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