Concussion history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Common symptoms in MTBI include headache and difficulty concentrating.

Concussion can be associated with a variety of symptoms, which typically occur rapidly after the injury.[1] Early symptoms usually subside within days or weeks. The number and type of symptoms a person suffers varies widely.

History and Symptoms

Concussion may be under-diagnosed. The lack of the highly noticeable signs and symptoms that are frequently present in other forms of head injury could lead clinicians to miss the injury, and athletes may cover up their injuries in order to be allowed to remain in the competition. A retrospective survey in 2005 found that more than 88% of concussions go unrecognized.[2]

Physical

Headache is the most common MTBI symptom. Other symptoms include dizziness, vomiting, nausea, lack of motor coordination, difficulty balancing, or other problems with movement or sensation. Visual symptoms include light sensitivity, seeing bright lights, blurred vision, and double vision.[3] Tinnitus, or a ringing in the ears, is also commonly reported. In about one in seventy concussions, concussive convulsions occur, but these are not actual post-traumatic epilepsy, which is a symptom of more serious injury. Concussive convulsions are thought to result from temporary loss of brain function rather than from structural damage and are usually associated with a good outcome.[4]

Cognitive and Emotional

Cognitive symptoms include confusion, disorientation, and difficulty focusing attention. Loss of consciousness may occur but is not necessarily correlated with the severity of the concussion if it is brief. Post-traumatic amnesia, in which the person cannot remember events leading up to the injury or after it, or both, is a hallmark of concussion. Confusion, another concussion hallmark, may be present immediately or may develop over several minutes. A patient may, for example, repeatedly ask the same questions, be slow to respond to questions or directions, have a vacant stare, or have slurred or incoherent speech.[5] Other MTBI symptoms include changes in sleeping patterns and difficulty with reasoning,[3] concentrating, and performing everyday activities.

Affective results of concussion include crankiness, loss of interest in favorite activities or items, tearfulness, and displays of emotion that are inappropriate to the situation.[5] Common symptoms in concussed children include restlessness, lethargy, and irritability.

References

  1. Aubry M, Cantu R, Dvorak J, Graf-Baumann T, Johnston K, Kelly J, Lovell M, McCrory P, Meeuwisse W, Schamasch P; Concussion in Sport Group. (2002). "Summary and agreement statement of the first international conference on concussion in sport, Vienna 2001. Recommendations for the improvement of safety and health of athletes who may suffer concussive injuries (requires free registration)". British Journal of Sports Medicine. 36 (1): 6–10. PMID 11867482. External link in |title= (help)
  2. Delaney JS, Abuzeyad F, Correa JA, Foxford R (2005). "Recognition and characteristics of concussions in the emergency department population". Journal of Emergency Medicine. 29 (2): 189–197. doi:10.1016/j.jemermed.2005.01.020. PMID 16029831.
  3. 3.0 3.1 Erlanger DM, Kutner KC, Barth JT, Barnes R (1999). "Neuropsychology of sports-related head enjury: Dementia pugilistica to post concussion syndrome". The Clinical Neuropsychologist. 13 (2): 193–209. doi:10.1076/clin.13.2.193.1963. PMID 10949160.
  4. Perron AD, Brady WJ, Huff JS (2001). "Concussive convulsions: Emergency department assessment and management of a frequently misunderstood entity". Academic Emergency Medicine. 8 (3): 296–298. PMID 11229957.
  5. 5.0 5.1 Anderson MK, Hall SJ, Martin M (2004). Foundations of Athletic Training: Prevention, Assessment, and Management. Lippincott Williams & Wilkins. ISBN 0781750016. Retrieved 2008-01-09. Unknown parameter |Pages= ignored (|pages= suggested) (help)

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