What to Do for a Concussion

Being reinjured while recovering from a bash on the head can lead to permanent brain damage. Here's how to tell if you have a concussion and what to do about a concussion.

The word “concussion” is tossed around casually. Most people think of it as a head injury that doesn’t affect their brain, with a very brief loss of consciousness. In fact, you should treat any blow that leads to symptoms of concussion with care.

There is also growing concern that even impacts to the head that don’t cause symptoms — for example, bouncing a ball on your head playing soccer — can cause damage over time.  

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Signs of a concussion

Concussions can occur when your brain is shaken violently. Your brain may have been injured even if you never lost consciousness.

Symptoms of concussion include:

• Dizziness
• Nausea
• Vomiting
• Balance problems
• Fatigue
• Disturbed sleep
• Sensitivity to light and noise
• Mood changes
• Difficulty with concentration or memory

The medical definition is head trauma resulting in short-lived impairment of neurologic function. Many different official scales measure severity.

Although we think of concussions as a mild injury, in a study of 434 traumatic brain injury (TBI) patients at a Canadian children’s hospital, 23.5 percent of the kids with injuries rated severe were diagnosed as with concussions.

The researchers titled their study, “My Child Doesn't Have a Brain Injury, He Only Has a Concussion,” arguing that doctors preferred the term concussion because it was less alarming to parents.

Concussions are a hazard of football, ice hockey, rugby, soccer, and basketball. The Centers for Disease Control and Prevention estimates that approximately 1.6 million to 3.8 million sports-related concussions occur yearly in the United States.

As many as half go unreported, according to the American Medical Society for Sports Medicine. Players and coaches are known to downplay symptoms so players can keep competing.

What to do about a concussion

Immediately after an injury, you should be monitored every 15 to 30 minutes; go to an emergency room if symptoms worsen. Rest — no sports and no schoolwork — for the next two days, until you are reexamined.

Once the symptoms are gone, you can gradually reintroduce activities over the next five days, resting if any symptoms return. Students may need to delay tests and, if symptoms persist, arrange for a lighter workload. Symptoms can sometimes last for weeks or longer.

Women and younger players are more vulnerable to serious consequences. People who had mood or learning disorders or migraine headaches before their injury may not recognize new symptoms.

Rushing back into sports is taking a big risk. A history of concussion makes it more likely you’ll have another one. Your reaction time may be slower, so you’re less able to protect yourself. If you’re still recovering from the last concussion when your head is slammed again, your brain could swell, leading to permanent damage or even death.

Hospitals may be undertreating people who show up after a TBI, according to several studies. In one study of 395 patients age 14 and older who came to an urban hospital with a mild traumatic brain injury, 27 percent who met the usual criteria to be sent home without a follow-up actually turned out to have lasting cognitive problems and needed therapy. The study was alarmingly titled, “You Cannot Go Home: Routine Concussion Evaluation Is Not Enough.”

Can you really protect against concussion?

According to the American Medical Society for Sports Medicine, neither helmets nor mouth guards have been shown to protect players against concussions or make them less severe. The best — though still controversial — answer may be to change the rules of each sport. It may become too expensive to allow professional players to get injured at current rates.

The National Football League (NFL), facing a lawsuit on behalf of thousands of former players, agreed to a settlement meant to cover compensation to retirees who develop neurological conditions and to pay for testing and medical research about concussions. The NFL has been changing the rules for years. Expect more changes to come — maybe even the end of kickoffs.

What will Super Bowls be without kickoffs? Safer.

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