What is a concussion?
A concussion is a traumatic brain injury, caused by a blow to the head or to the body. It injures the brain on a metabolic level, and changes the way it functions, causing a variety of symptoms and signs. It can happen without a loss of consciousness, can range from mild to severe, and can present in different ways in different people.
Why do we worry about concussions?
Rarely, if somebody has had a concussion, and sustains a second concussion before the first heals, it can lead to Second Impact Syndrome, where the brain swells uncontrollably and irreversibly, potentially leading to death. More commonly, concussions produce bothersome symptoms that make it difficult to think and to be active; they can wreak havoc on going to class, doing homework, doing all the physical activity that we love to do. Multiple concussions may result in permanent brain damage.
What are the symptoms of a concussion?
Symptoms can appear immediately, or show up several days later. The symptoms can vary widely from person to person. Symptoms can be worse if you have had a previous concussion, a history of headaches, a history of ADHD, or a history of anxiety or mood disorders. They can include:
|Balance difficulty||Visual problems||Fatigue||Light sensitive|
|Sound sensitive||Numbness/tingling||Mental fog||Feeling slowed|
|Decreased concentration||Decreased memory||Irritability||Sadness|
What should you do if you think you have a concussion?
- Stop what you’re doing. If you are playing a sport or a game, remove yourself from the activity. Get yourself out of any situation where you might get hit on the head again. Once you have had one concussion, it’s easier to get another one!
- Get checked out. If you find that symptoms are worsening, such as increasing headache, increasing confusion or disorientation, vomiting more than once, muscle weakness, double vision, loss of vision, change in pupil size, trouble with coordination, sudden collapse or change in consciousness, go to the Emergency Room at St Joseph Hospital. If you find that symptoms are persistent but not rapidly worsening, call the Student Health Center at 650-3400 to be evaluated.
- Have a responsible adult (roommate, friend, parent) stay with you to watch for deterioration, so that they can take you to the ER if you get worse
- Use Tylenol or acetaminophen for headache; avoid aspirin, ibuprofen, or naproxen as they can possibly increase the chance of delayed intracranial bleeding.
- Don’t drive.
- Avoid alcohol, recreational drugs, or narcotics; all these things can affect the brain’s ability to heal after injury, and can make it harder for somebody watching you to tell if you’re getting worse.
What will the Student Health Center do for me?
Your vital signs and vision will be checked, and you will be asked about any symptoms that you’re having. You’ll then be asked other health history about concussions, other factors that may delay healing, and have a physical exam that will include neurological, cognitive, and balance assessments.
Once an assessment is done, an individualized plan will be made about any further needed testing, going to class, dealing with professors and/or employers, whether or not to return to physical activity, and what your further follow up should be.
Should I go to class?
If your symptoms are minimal, and you think you can concentrate in class and get something out of it, go ahead. If the symptoms are severe, or if going to class produces worsening headaches, fatigue, nausea, difficulty concentrating, dizziness, or other symptoms, leave class and rest. Trying to learn/study while your brain is needing rest can delay the healing. Then get checked out at the Student Health Center to make a plan for the future.
Can I work out?
As described above, exercising when trying to heal from a concussion can do more harm than good. Get checked out and your health care provider can provide guidance about when and how to return to activity safely.
What can I do while I’m resting?
Get as much physical and cognitive rest as possible, avoiding reading for pleasure, rapidly moving images (from video games, television, movies), but do hang out with friends and be quietly sociable. It’s not unusual to feel tired all the time, or to feel tired suddenly with minimal exertion. If the fatigue lasts longer than a month, we may want to check some hormone levels, such as thyroid.
Are there any other treatments for the different symptoms?
Sleep Disruption. You may find it hard to sleep even when tired. Try to maintain a routine bedtime and awakening time. Try to avoid caffeine (in coffee, tea, energy drinks) and large meals in the evening. When you do nap, try to nap prior to 3 PM and limit the naps to 30 minutes at a time; sleep in your bed rather than in front of the TV! If still having difficulty after several weeks, there are some medications we can use (melatonin, trazodone).
Mood Changes. People often feel emotional after a head injury, and depression and anxiety can get worse. Stress management can help through the counseling center, especially if symptoms are prolonged. This will improve as you heal.
Dizziness. If your dizziness consists of spinning, rather than a rocking or unsteady sensation, physical therapy might help.
Headaches. Continue to avoid ibuprofen (Advil, Motrin), aspirin, and naproxen (Aleve), as these can thin the blood and promote bleeding. Use Tylenol 650-1000mg up to 4 times daily for the headache. If you have a history of migraine headaches, they may need other treatment. If you also have neck tension and pain, physical therapy might help.
What should I avoid while healing?
Avoid Driving. Your vision, balance, attention, reaction times and judgment may be affected, so try to avoid driving whenever possible. It will also allow your brain to rest more.
Avoid Alcohol and Recreational Drugs. Mind-altering substances can delay the brain’s ability to heal, even if you normally tolerate them. To maximize recovery, avoid any alcohol (even “just beer”) and any drugs (even “just marijuana”) until you’re completely healed.
How long does it take to heal from a concussion?
It varies from person to person, depending on the number of previous concussions, other conditions such as migraines, mood disorders, ADHD, and the like. It also depends on how well you can rest. However, many concussions will heal within a week, and 85% of concussions will resolve within 2 weeks – it will get better!