How to Tell If You Have a Concussion

A concussion is a mild traumatic brain injury (TBI) that temporarily disrupts how your brain functions. It’s crucial to know how to recognize a concussion because prompt identification and proper care are essential for recovery and preventing further complications. If you’ve experienced a blow to the head or body, understanding the signs and symptoms of a concussion is the first step in ensuring your well-being.

Understanding Concussions

A concussion occurs when a bump, blow, or jolt to the head or body causes the brain to move rapidly back and forth inside the skull. This sudden movement can stretch and damage brain cells, leading to chemical changes in the brain. It’s important to remember that while concussions are considered “mild” TBIs, they still require careful attention and management.

Concussions are not always caused by direct hits to the head. A forceful impact to the body can also transmit force to the head and brain, resulting in a concussion. Not everyone who experiences a head or body impact will sustain a concussion, but it’s vital to be vigilant about potential symptoms after such an event.

Falls are the most frequent cause of concussions across all age groups. Concussions are also prevalent in contact sports like football, soccer, and hockey. The good news is that most people who experience a concussion recover fully, especially when the injury is recognized and managed appropriately.

Recognizing Concussion Symptoms: What to Look For

Concussion symptoms can be subtle and may not appear immediately after the injury. They can develop within minutes or hours and sometimes even days later. Symptoms can also vary in severity and duration, lasting from days to weeks, or in some cases, even longer.

It’s helpful to categorize concussion symptoms to better understand what to look for:

Immediate vs. Delayed Symptoms

Some symptoms are evident right away, while others may take time to manifest. Being aware of both types is crucial for timely identification.

Physical Symptoms

These are often the most noticeable signs of a concussion:

Headache: This is a very common symptom after a concussion. The headache can vary in intensity and location.
Ringing in the ears (Tinnitus): A persistent ringing, buzzing, or hissing sound in one or both ears can indicate a concussion.
Nausea and Vomiting: Feeling sick to your stomach or throwing up, especially shortly after a head injury, is a significant sign.
Fatigue or Drowsiness: Feeling unusually tired, sluggish, or excessively sleepy is a common symptom.
Blurred Vision or Double Vision: Changes in vision, such as blurry or double vision, can occur after a concussion.

Damage in different areas of the brain based on injury type: Illustration showing how different types of injuries, like falls, car accidents, and blasts, can cause concussions and affect various brain regions.

Cognitive Symptoms

These symptoms affect your thinking and mental processes:

Confusion or Feeling “Foggy”: You may feel disoriented, unclear in your thinking, or as if you’re in a fog.
Amnesia Surrounding the Event: Difficulty remembering what happened immediately before or after the injury is a hallmark sign of concussion.
Dizziness or “Seeing Stars”: Feeling lightheaded, unsteady, or experiencing visual disturbances like seeing stars are common.

Observable Signs

These are symptoms that someone else might notice in a person who has sustained a concussion:

Temporary Loss of Consciousness: While not always present, a brief loss of consciousness can occur with a concussion.
Slurred Speech: Difficulty speaking clearly or speaking in a slow, mumbled manner.
Delayed Response to Questions: Answering questions slowly or appearing slow to process information.
Dazed Appearance: Looking blank, confused, or glassy-eyed.
Forgetfulness and Repetitive Questions: Asking the same question repeatedly or showing significant memory lapses.

Concussion Symptoms in Children: Special Considerations

Recognizing concussions in infants and young children can be more challenging because they cannot verbally express their symptoms. Parents and caregivers need to be particularly observant for behavioral changes and physical signs.

Concussion clues in children may include:

Dazed Appearance: Appearing confused or out of it.
Listlessness and Tiring Easily: Showing a lack of energy or becoming fatigued much quicker than usual.
Irritability and Crankiness: Being unusually fussy, easily agitated, or crying more than normal.
Loss of Balance and Unsteady Walking: Stumbling, clumsiness, or difficulty maintaining balance.
Excessive Crying: Inconsolable or prolonged crying, especially in infants.
Changes in Eating or Sleeping Patterns: Refusing to eat, changes in feeding habits, or disruptions in normal sleep patterns.
Lack of Interest in Favorite Toys or Activities: Reduced engagement with things they usually enjoy.
Vomiting: Especially repeated vomiting, can be a critical sign in children.

When to Seek Medical Attention: Don’t Wait

It’s always best to err on the side of caution when it comes to head injuries. Even if symptoms seem mild, it’s important to seek professional medical advice.

See a healthcare professional within 1 to 2 days if:

You or your child has experienced any head injury, even if you don’t believe it’s an emergency. A medical professional can properly assess the situation and provide guidance.
Children and adolescents should be evaluated by a healthcare professional specifically trained in managing pediatric concussions.

Seek emergency care immediately for an adult or child who experiences a head injury and any of these warning signs:

Repeated Vomiting or Nausea: More than one instance of vomiting after a head injury is concerning.
Loss of Consciousness Lasting Longer Than 30 Seconds: Prolonged unconsciousness is a serious indicator.
A Headache That Gets Worse Over Time: A headache that steadily intensifies despite rest or over-the-counter pain medication.
Fluid or Blood Draining From the Nose or Ears: This could indicate a skull fracture.
Vision or Eye Changes: Double vision, blurred vision, or pupils becoming larger than usual or unequal in size.
Ringing in the Ears That Doesn’t Go Away: Persistent tinnitus that is not improving.
Weakness in the Arms or Legs: New onset weakness or numbness in the limbs.
Changes in Behavior or Personality: Becoming unusually irritable, agitated, confused, or exhibiting other personality changes.
Confusion or Disorientation: Not recognizing people or places, being confused about location or time.
Slurred Speech or Other Changes in Speech: Difficulty speaking clearly or finding words.
Obvious Changes to Mental Function: Significant decline in thinking, memory, or reasoning.
Changes in Physical Coordination: Stumbling, clumsiness, or difficulty walking.
Seizures or Convulsions: Uncontrolled shaking or jerking movements.
Dizziness That Doesn’t Go Away or That Goes Away and Comes Back: Persistent or recurring dizziness.
Symptoms That Worsen Over Time: Any concussion symptom that is getting progressively worse.
Large Head Bumps or Bruises: Significant swelling or bruising on the head, especially around the eyes (raccoon eyes) or behind the ears (Battle’s sign). These are particularly concerning in infants under 12 months of age.

Concussion and Athletes: Return to Play

It is critical for athletes of all ages to be properly evaluated and cleared by a healthcare professional before returning to sports after a concussion. Never return to play or vigorous activity immediately following a suspected concussion. Experts strongly recommend that athletes, whether adults, children, or adolescents, do not return to play on the same day as a concussion injury. Even if a concussion is only suspected, athletes should be removed from play to prevent the risk of further injury.

A gradual and supervised return to learning and physical activity is essential and should be individualized based on the athlete’s specific symptoms and recovery progress. This process must always be overseen by a healthcare professional trained in concussion management.

Causes and Risk Factors of Concussions

Concussions are caused by forces that shake the brain within the skull. Common causes include:

Falls: The most common cause, especially for young children and older adults.
Sports Injuries: Contact sports like football, hockey, soccer, and boxing carry a higher risk.
Motor Vehicle Accidents: Car crashes, bicycle accidents, and pedestrian accidents.
Blast Injuries: Explosions, particularly in military settings.
Physical Abuse: Shaken baby syndrome and other forms of head trauma due to violence.

Risk factors that increase the likelihood of concussion include:

Age: Young children and older adults are more prone to falls.
Participation in High-Risk Sports: Contact sports significantly increase concussion risk.
Lack of Proper Safety Equipment: Not using helmets or other protective gear during sports and activities.
History of Previous Concussion: Having had a concussion before increases the risk of future concussions.

Potential Complications of Concussions

While most people recover fully from a single concussion, potential complications can arise, especially with repeated concussions or inadequate management:

Post-Traumatic Headaches: Persistent headaches that can last for days or weeks after the injury.
Post-Traumatic Vertigo: A sensation of spinning or dizziness that can linger for days or weeks.
Post-Concussion Syndrome: A condition where concussion symptoms, such as headaches, dizziness, and cognitive difficulties, persist for weeks, months, or even longer. Symptoms lasting beyond three months are classified as persistent post-concussive symptoms.
Second Impact Syndrome: A rare but potentially fatal condition where a second concussion occurs before the symptoms of a previous concussion have resolved. This can lead to rapid and severe brain swelling.
Effects of Multiple Brain Injuries: Research is ongoing into the long-term effects of repeated head impacts, even those that don’t cause immediate symptoms (subconcussive injuries).

Concussion Prevention Strategies

Preventing concussions is always preferable to treating them. Here are key strategies to minimize your risk:

Wear Protective Gear: Always use appropriate helmets and protective equipment when participating in sports, cycling, skateboarding, skiing, snowboarding, and other recreational activities. Ensure equipment fits properly and is well-maintained.
Buckle Your Seat Belt: Seat belts are crucial for preventing head injuries in car accidents.
Make Your Home Safe: Ensure good lighting, remove tripping hazards, and secure rugs to prevent falls, especially for older adults and young children.
Protect Children: Use safety gates on stairs and install window guards to prevent falls.
Exercise Regularly: Improve balance and leg strength through regular exercise, which can reduce the risk of falls.
Educate Others About Concussions: Increase awareness among coaches, athletes, parents, and the community about concussion recognition, prevention, and proper management.

Recognizing the signs and symptoms of a concussion is vital for ensuring timely medical attention and proper management. If you suspect you or someone you know has a concussion, seek medical advice promptly. Early diagnosis and appropriate care are the best ways to facilitate recovery and prevent potential complications.