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What is a concussion?

A concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head, or a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.

How do concussions effect the brain?

The pathophysiology of a concussion is not well understood, but it is believed to be caused by an acceleration-deceleration force on the brain. This force is thought to cause a shearing of the nerve fibers within the brain, leading to decreased functioning of the affected areas. Additionally, the force causes an increase in intracranial pressure and can cause a disruption of the blood-brain barrier, resulting in abnormal levels of neurotransmitters and inflammation.

What are the typical symptoms of a concussion?

Typical signs and symptoms of a concussion include headache, dizziness, confusion, nausea and vomiting, sensitivity to light or noise, memory problems, difficulty concentrating, blurred vision, balance problems, fatigue, and irritability. These symptoms can range from mild to profound. A concussion may cause decreased cognitive functioning such as slurred speech, confusion, difficulty following commands, and disorientation.

How is a concussion diagnosed?

The diagnosis of a concussion is typically made through physical and neurological examination by a trained professional. Imaging tests such as CT scans or MRIs may be used to rule out a more severe injury such as intracranial bleed, but do not show any abnormality in the presence of a concussion.

How are concussions treated?

• Rest and reduce both physical and mental activity: Avoid activities that require concentration or involve physical exertion, such as sports and exercise.

• Follow a stepwise return to activity as guided by your medical professional: If symptoms worsen, return to the previous level of activity and wait for symptoms to improve. Any attempt to rush recovery will often result only in getting worse.

• Monitor symptoms: Check regularly for persistent or worsening symptoms, such as headaches, nausea, or difficulty concentrating.

• Gradually increase physical and mental activity: Increase physical and mental activity as symptoms improve. In some cases, cognitive rehabilitation may be necessary to help with memory, concentration, and other cognitive functions.

• Practice relaxation techniques: Use relaxation techniques, such as meditation or yoga, to help reduce stress and anxiety.

• Remain alert for signs of post-concussion syndrome: This includes persistent symptoms or symptoms that worsen over time.

What are reasons to seek care immediately?

Warning signs of a more serious injury that require immediate evaluation include:

•  Loss of consciousness.

• Severe or worsening headache

• Nausea or vomiting.

• Slurred speech

• Weakness or numbness in the arms or legs

• Dizziness or balance problems greater than just mild lightheadedness

• Difficulty concentrating or remembering of basic information

• Changes in vision beyond vague slowness in focusing

• Seizures or convulsions (Call 911)

• Increased confusion or irritability

My child was diagnosed with a concussion. Should I not let my child fall asleep?

Once your child has been evaluated he or she can and should sleep. If there was any concern about a more serious injury a CT scan would be done. Sleep is vital in the healing process of the brain, so breaking the sleep cycle repeatedly to check on your child will hinder this process.

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