A concussion is an injury to the brain’s cells that causes a disturbance in normal brain function. Concussions can be caused by either getting hit directly on the head or by a hit to another part of the body that causes the head to accelerate forward or backward (like whiplash).
Most people who experience a concussion will exhibit any one or more of a variety of symptoms. Loss of consciousness is not always present. Headache is the most common symptom, however all patients will experience concussion differently. So, while one patient may have a headache, another may not. Other signs and symptoms can include being nauseous, having poor balance or coordination, being dizzy, dazed or confused, and suffering from memory deficits. Headaches may linger, but so can not-so-obvious symptoms. These can include sensitivity to light or noise, emotional changes, sleep disturbances and personality changes. Often, the signs and symptoms of a concussion are not evident until several minutes to hours later. The severity of the symptoms will vary by patient as will the duration of symptoms.
If an athlete sustains a blow to the head during activity, they would be immediately removed from activity and evaluated using a standardized test for sideline evaluations. If the athlete is experiencing one or more symptoms they will not return to play until all symptoms resolve. Once symptoms have resolved, the athlete would follow a six step gradual return to play program before being allowed to participate in full, unrestricted activity again.
It is extremely important not to return to play too soon after sustaining a concussion. Returning before fully healed and sustaining a second blow to the head can result in a condition known as Second Impact Syndrome (SIS). Though rare, SIS is characterized by rapid swelling of the brain. Surgery does not help and there is little hope for recovery. Most die, but those who live through SIS are often severely disabled. The first concussion does not need to be severe in order for SIS to occur. And, in many instances, it does not take a crushing second blow either to spark the onset of SIS. In fact, typically it is a subtle blow and it can occur days or even weeks after the initial concussion is sustained.
Aaron Armstrong, MPE, ATC
Athletic Trainer
Elite Sports Medicine Clinic at the Sports, Spine and Rehabilitation Centre
esmbahamas@gmail.com
Aaron Armstrong holds a Bachelor of Science degree from Temple University in Philadelphia, PA in Athletic Training and has been a Board Certified Athletic Trainer since 2012. He also earned a Master of Physical Education degree in Athletic Administration from Idaho State University in Pocatello, ID.
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