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Overview - Symptoms - Diagnosis - Treatment - Long-term - Prevention

Concussion

General Overview:

A concussion is a type of Traumatic Brain Injury caused by impact towards the head, neck or elsewhere on the body with impulsive forces transmitted towards the head. The consequences of a concussion can be very serious. Research shows that repeated concussions may increase an individual's long-term risk of developing neurodegenerative diseases such as chronic traumatic encephalopathy (CTE), and Alzheimer's disease (AD). Furthermore, up to 30% of patients who have received a concussion may experience persisting symptoms for months or years, suffering from a condition known as Post-Concussion Syndrome (PCS)

 

Symptoms:

The damage sustained in a concussion occurs at a microscopic level. Ions and other substances move in and out of your brain cells uncontrollably, due to the neurones becoming stretched on impact. This chemical disruption is compounded by restricted blood flow to the affected areas of the brain, meaning the brain is not getting enough glucose to provide the energy needed for the brain to repair. This mismatch in energy supply vs demand can lead to symtoms associated with a concussion. It is also the reason why people are at greater risk for further injury if another concussion is sustained in the following days. In the majority of cases, symptoms will resolve within 2 weeks. However, in 30% of patients, symptoms may persist for months or years - this is known as Post Concussion Syndrome. Relevant treatment, such as vestibular or ocular-motor therapy may be necessary to improve symptoms. For more information on rehabilitation and treatment for persistent concussion symptoms, click here.

Common concussion symptoms include:

  • Headaches 

  • Dizziness 

  • Fatigue/ drowsiness 

  • Irritability 

  • Anxiety

  • Insomnia 

  • Concentration difficulties  

  • Memory difficulties 

  • Tinnitus (ringing in the ears) 

  • Blurred vision 

  • Noise and light sensitivity 

  • Decrease in taste and smell 

 

Diagnosis:

Currently, there is no perfect diagnostic test or marker that clinicians can rely on for an immediate diagnosis of concussion - a concussion causes metabolic disruption, rather than visible structural abnormalities. A diagnosis is normally made following an evaluation of cognitive function. Scans may used to rule out other possible structural injuries.

 

There are several tests that exist to aid clinicians, the most popular being the SCAT5. The SCAT5 is a standardised test used by healthcare professionals to assess a concussion. It is used on patients above the age of 12, with the Child SCAT being use on those who are younger. For full guidelines regarding the SCAT5, click here.

Baseline testing assesses a person’s neurological and cognitive function when they are in full health. This data can then be used as a comparison for a person who is suspected to have suffered a concussion. A popular baseline test is the ImPACT test, which should ideally be used on players in all sports teams in preseason

 

Treatment:

Most concussions will resolve by themselves within a matter of weeks. However, there are measures you can take that can increase your rate of recovery and decrease your chance of  developing post-concussion syndrome. For instance, recent evidence suggests that adhering to a controlled aerobic exercise programme, is safe and can aid in concussion recovery. Any treatment you undertake must be overseen by a healthcare professional and therefore we urge you to consult a doctor or physio (specialised in concussions) immediately if you suspect you have sustained a concussion. Read more about this and other treatment options here.

 

Concussion Prevention:

Most concussions are unavoidable. However, there are a number of precautions that both athletes and civilians can take in order to reduce the risk of suffering a concussion. 

 

These measures may include:  

  • Do not play sport when excessively tired

  • Wear properly fitting headgear when cycling, skiing etc.

  • Remove trip hazards from your home and avoid walking around in the dark - (50% of TBI's are causes by falls)

  • Drink plenty of fluids and stay hydrated in hot weather in order to reduce risk of fainting

  • Avoid rising quickly after having been sitting / lying for a period of time - again, this can cause fainting

  • Always wear a seatbelt when driving, and do not drive under the influence of alcohol / drugs

  • If you are involved in sport, ask your coach to perform a baseline test on you, as this can be used as a reference point if you sustain a concussion during the season

Further Resources:

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