Woman is holding a wet cloth on her forehead
A head injury could be much more serious than it seems at first.
Photo Credit: JackF / iStockphoto.com

Do I Have a Concussion?

You’ve probably had a bump on the head at some point in your life, but haven’t thought much of it. Aside from the initial sting and a lingering sore spot, it’s easy to get on with your life as you let your body take care of the healing.

On the other hand, a head injury could be much more serious than it seems at first. The damage on the inside doesn’t always show up on the outside, and in turn, many people underestimate the danger and delay treatment — which can be life-threatening.

Luckily, concussions can be treated, and most people will recover fully. The key to better healing is a swift diagnosis, close monitoring, and the right recovery plan, but everything hinges on spotting the signs and symptoms as soon as possible.

What Happens During a Concussion?

Your brain is not connected to your skull, but rather floats in cerebrospinal fluid, a tough membrane that protects the delicate tissue from any impact. When your head is struck or jerked hard enough, the brain may suddenly rotate, hit a point on the inner skull, and then bounce back to hit the opposite side of the skull. Bruises develop on the parts of the brain that bumped against the skull, and these bruises are the hallmarks of a concussion.

Although a concussion develops from a single event, there are two phases to the trauma:

Primary Injury

The immediate impact of the brain against the skull is the primary injury; that’s what causes the bruising and initial pain. In some cases, the trauma can cause bleeding in or around your brain, which comes with a distinct set of symptoms. The primary injury is certainly uncomfortable, but it’s only part of the problem.

Secondary Injuries

The secondary injuries are just as serious, if not more serious, than the primary injury. These happen several hours or days after the head trauma, and without close attention and careful treatment, they can develop into long-term cognitive problems, emotional disorders, tissue damage, and even spark permanent changes at the cellular level.

Common Causes of Concussions

Any sudden, extreme impact can cause the brain to shake or bump against the skull, but certain activities and events are more likely to lead to this specific type of trauma, including:

  • Car crash. The sudden impact and deceleration of a car hitting another object creates the perfect conditions for a concussion. Your seatbelt may keep your body from surging forward, but your head is whipped forward and snapped back so quickly, you may not even realize it.
  • Violent shaking. Shaking your head from side to side won’t cause your brain to move around much, but being shaken severely and repeatedly by someone or something could cause problems. Of course, babies and small children have more delicate skulls and brains, so intense shaking could cause serious injury or death in much less time than it would take for an adult to sustain injury.
  • Serious fall. Your skull and cerebrospinal fluid do a good job of cushioning, but an extreme fall on the head is just like being hit with a blunt object — only your head is doing the hitting. It should come as no surprise that any forceful impact ono your head will put you at risk for concussion.
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Concussions often involve a blow to the head, but the head isn’t always the point of impact. In some cases, a blow to another part of the body can create a huge force that is transmitted to the head, and that may result in a concussion. This most often occurs in high-risk or high-contact sports.

Warning Signs and Symptoms

There are some predictable concussion symptoms, but they don’t always follow the same pattern. You may experience clear symptoms right away, or they may not be noticeable for days. Also, keep in mind that each concussion can manifest differently, so don’t expect to see the very same set of symptoms as you noticed before.

Concussion symptoms can be divided into four main categories, according to the area of brain function that’s affected:

Thinking Problems

Some cognitive changes are common in most concussions. You might feel a bit confused, or forget certain details about your life or situation. Sometimes it takes more time to recall a fact or formulate an answer to a question. Your concentration may falter, leaving you to lose focus repeatedly.

Physical Symptoms

Headache is one of the most obvious symptoms, but pain in the neck or upper back could also indicate a concussion. Blurry vision is another common physical change, which may come with dizziness, drowsiness, sensitivity to light, or problems keeping your balance. Nausea and vomiting may occur, too. Loss of consciousness is often immediate — if you’re out for more than 30 seconds, a trip to the emergency room is required.

Emotional Symptoms

Feeling irritable or suddenly sad (after a blow or jolt to the head) may point to brain injury. Feelings of nervousness and anxiety are also natural following a traumatic event, but if you’re clearly more emotional — and that heightened state continues — it’s time to seek medical attention.

Sleep Changes

Any changes in your sleep patterns following a head injury are causes for concern. Concussion can lead people to sleep more than usual, less than usual, or at strange intervals. If you have difficulty falling asleep, it can be a serious sign; those who have difficulty waking up should be taken to the emergency room right away.

Fatigue, dizziness, headache, nausea, and foggy thinking tend to hit shortly after the incident, but other symptoms may come hours or days later. Personality changes, concentration problems, sleep disturbances, and physical sensations (like sensitivity to light and noise, or taste disorders) can be delayed, or may get worse over time.

When it comes to brain injury, always play it safe. Anything more than a slight bump on the head calls for a doctor’s visit because there's a chance you could have a concussion. If seizures, extreme confusion or loss of consciousness are involved, seek emergency attention. In a hospital, you can get the monitoring and treatment to resolve many of your symptoms and prevent long-term damage.