A concussion is a brain injury caused by a blow or jolt to the head that can disrupt the normal function of the brain.

After a concussion, some people may lose consciousness for a short time, but this is not always the case. In fact, you can have a brain injury without losing consciousness. Even a “ding” or a bump on the head can be serious.

Signs and Symptoms of a Concussion

Because the brain is very complex, every brain injury is different. Some symptoms may appear right away, while others may not show up for hours or days after the injury. Sometimes this makes it hard for people to recognize they are having problems.

Often, the best sign and symptom is just not feeling or acting like yourself. Specific sings and symptoms are listed below.

Physical Symptoms of a Concussion

• Headaches
• Nausea or vomiting
• Dizziness/balance problems
• Low energy
• Trouble with vision/seeing
• Bothered by light or noise
• Sleeping problems

Cognitive Symptoms of a Concussion

• Slowed thinking
• Trouble paying attention
• Difficulty remembering
• Acting like "in a fog"
• Easily confused

Behavioral or Emotional Symptoms of a Concussion

• Irritability or grouchiness
• Easily upset or frustrated
• Nervousness
• Sadness
• Acting without thinking

Seeking Care for a Concussion

First and foremost, athletes should never return to play the same day after sustaining a concussion.

Serious problems after a concussion are rare, but can occur. For this reason, a medical doctor should always be involved in a young person’s care after a concussion.

A health care professional will be able to decide how serious the concussion is and when it is safe to return to sports. Returning too soon can result in further injury and possibly death.

In the first one to two days after the injury, you should seek immediate medical help if you notice:

• Increased severity of headaches
• Weakness, numbness, or decreased coordination
• Repeated vomiting
• Extreme sleepiness or trouble waking
• Slurred speech or trouble talking
• Progressive confusion, restlessness, or agitation

Physicians at Duke Sports Medicine are now certified as credentialed consultants of ImPACT (Immediate Post-Concussion Assessment of Cognitive Testing).
 
The certification gives our doctors the tools they need to accurately assess an athlete after concussion and track the patient's recovery so he or she can return to the playing field quickly and with no cumulative effects of concussion.

Recovering from a Concussion

Because all brain injuries are different, so is recovery. Most people can recover fully, but it can take time. Some symptoms can last for days, weeks, or longer.

Rest is very important after a concussion because it helps the brain to heal. Be patient because healing takes time. Returning to daily activities such as school and work should occur at a slow pace and never increase symptoms. As the days go by, you can expect to gradually feel better.

Coaches should know of a recent concussion in any sport. Knowing about the concussion will allow the coach to limit activities that could result in another concussion and help recovery. In addition, teachers should know about a recent concussion to help monitor signs and altered behavior.

Returning to a Sport

A health care professional like a sports medicine physician, certified athletic trainer, or trained physical therapist will be able to decide when to return to sport. As long as there are symptoms caused by the concussion, it is very important to not return to sporting activities until a health care professional says it is okay.

In many cases, law requires a physician to clear an athlete to return to play. A gradual increase in activity with close supervision of the athlete is necessary to limit risk of further injury.

This information was provided by Duke Sports Medicine physical therapist Kelly Hess.