Conquering the Concussion: Part 1 - Recognizing the Symptoms

      The concussion is an injury that is gaining more attention over the past few years, especially with the increase in exposure in the media. It is estimated that concussions account for 8.9% of all high school athletic injuries and about 7% of all sports-related injuries. However, it is likely that the total number of concussions estimated is low due to under-reporting of injuries as many athletes will not seek medical attention following a concussion.

      So you had an athlete get a hit to the head during practice. Maybe they were basing a stunt and the flyer came down on their head, or they were tumbling and collided with a teammate. What should you do? One thing about concussions is that not everyone presents the same way. There are many different possible symptoms that can be present, and any one person can have any possible combination of those symptoms.

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Mechanism of Injury
2 most common mechanisms of injury (how the injury occurred)

• Impact
  • Direct impact of the athlete to the ground/object/another athlete
  • Rapid deceleration of the brain
• Non-impact
  • Rotational injuries - athlete doesn't need to have a direct impact
  • May take longer to recover

A concussion is not a direct injury to the brain tissue itself, rather a chemical reaction and alterations that cause the symptoms that we typically see.

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Common Symptoms

    The most common symptoms to look out for include the following:

• Headache or migraine
• Blurred vision
• Irritability
• Difficulty concentrating
• Confusion
• Loss of balance or coordination
• Impaired hearing
• Increased fatigue
• Dizziness
• Nausea and/or vomiting
• Impaired memory
• Sensitivity to light or sound
• Depression
• Anxiety
• Slurred speech
• Impaired reaction time

If any of these symptoms are present following a blow to the head, it is crucial for the athlete to see a medical professional to be assessed for a concussion. It is imperative that an athlete that is displaying any signs or symptoms of a concussion to sit out for the remainder of the day until they are cleared by a medical professional.

      While it is very rare for someone to have every one of these symptoms, it is possible. A common misconception is that someone must lose consciousness for a concussion to take place. It is important to note that less than 10% of concussions are associated with a loss of consciousness. So even if the athlete did not get “knocked out”, they very well may still have a concussion.

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Diagnosing a Concussion
    The diagnosis of a concussion is typically based on the signs and symptoms that are present, as it will not show up on any type of imaging. MRI and CT scans may be used to detect skull fractures or bleeding in the brain. Physical therapists and athletic trainers are trained in conducting several different tests that can be used to aid in the diagnosis of a concussion. 
     Many programs and athletic associations have begun to implement baseline concussion testing. What this does is provides the information of an athlete's normal cognitive and physical functioning. So if there is a question of a possible concussion, the same test can be repeated to compare the athlete to their baseline.

    A concussion is classified as a mild traumatic brain injury and needs to be treated as such. Many times the symptoms of a concussion do not show up right away and can even take a few hours to a few days to present. This is why it is important to make sure that the athlete is examined by a healthcare professional if there is any suspicion of a possible concussion.

This is Part I of a 3 part series, Click Here for Part 2

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