Concussion Symptoms- Causes and Treatments

Concussion symptoms. Recently, concussions have become the focus of several discussions, research studies, news articles, and even movies. But when concussion symptoms can no longer be ignored in sports or the public eye, it is no surprise why concussions are now at the forefront of so many minds. There are several factors that may contribute to the emergence of concussions as a more common diagnosis than in previous years. One of the factors is that we have advanced in technology through the years, allowing us to be more accurate when making a diagnosis. The resources invested in making CT scans and MRIs more efficient when identifying them allowed us to list and understand each of the concussion symptoms.

Concussion symptoms are now being recognized as serious problems in all levels of sports.

Concussion Symptoms

A concussion is a traumatic brain injury that alters the way your brain functions, with symptoms lasting for days, weeks, and in unusual cases, even longer.

Concussion symptoms include:

• • headaches or pressure in your head: usually a steady pain happening almost everyday and affecting both sides of the head. It clears after minutes or days but when it last longer it’s considered post-traumatic or post-concussion headaches. The pain is similar to a migraine ranging from moderate to severe. Some tension-type headaches may be common due to the strain on the neck from the injury. Some cases report inability to work efficiently, difficulty retaining memory, concentration and attention.

• • nausea and vomiting

• • fatigue

• • memory loss: often causes you to forget the incident that lead to the concussion in the first place.

• • confusion

• • dizziness

• loss of consciousness.

You can also tell if you or someone else has a concussion if they are: slurring their speech, have a delayed response to your questions, or they appear dazed. When a concussion last for weeks and sometimes months after the injury it is called Post-concussion Syndrome. This disorder doesn’t need the loss of consciousness to be diagnosed and is not associated with the severity of the injury. The symptoms include:

• Trouble concentrating
• Irritability
• Loss of coordination
• Seizures
• Draining of blood or clear fluid from the ears or nose
• Sleep disturbances
• Light and noise sensitivity
• Abnormal eye movement and hand eye-coordination
• Slurred speech
• Coma
• Psychological adjustment problems
• Distortions in perception (taste or smell)
• Aggravation of anxiety symptoms
• Depression (intensification of physiological effects of depression)

Studies have found that women are more likely to be diagnosed with this syndrome because they are more likely to seek medical care. The most common injuries that derive in this syndrome are car collisions, assaults, sports and falls. They are diagnosed at older ages than at younger ages.

What causes these concussion symptoms?

Your brain is the leader of your entire body, but on its own, it’s really not that tough. There is a reason that haunted houses use Jello to simulate brains on Halloween. Your brain is protected and cushioned by your skull which in turned is filled with cerebrospinal fluid that prevents everyday bumps and jolts. However, a violent blow to the head, or sudden acceleration or deceleration can cause the brain to slide back and forth and hit the inside of the skull, affecting brain function, and resulting in the symptoms of a brain injury, or concussion. An concussion or injury like this may cause bleeding in or around the brain, which causes drowsiness or confusion. Bleeding in the brain may even be fatal, which is why it’s so important to monitor symptoms after a brain injury.

It is incredibly difficult to study a living brain with all of the body’s protection, like the skull, and the blood-brain barrier that creates a stable environment for the brain. But that doesn’t stop scientists, who have recently found a way to detect concussions using high-resolution brain scans, computational analysis, and self-reported measures. Detecting concussions with brain scans involves looking at the way the different areas in the brain communicate with each other. A recent study using MRI scans found evidence that even mild traumatic injuries to the brain is associated with greater degeneration of neurons and reduced memory performance in people with a genetic risk for Alzheimer’s disease.

Treating concussion symptoms

Traditionally, concussions were only seen as short-term inconveniences, so people would go back to their daily lives and even coaches would simply send players back in the game after a head injury. However there has been a surge in evidence proving that concussions are much more serious than previously thought, and all findings point to concussions causing irreversible changes in the brain with some long-term effects and symptoms. This new knowledge and research has also led to new therapies and methods for rehabilitation of the symptoms.

A growing debate in the sports medicine world is if the current guidelines of resting after a concussion is really the best therapy. More and more concussion specialists are encouraging patients to return to normal activities, as long as their symptoms don’t worsen. A recent study found that subjects aged 5-18 experienced fewer persistent postconcussive symptoms (PPCS) when they participated in light physical activity within 7 days of their brain injury, including light aerobics, or their sport-specific training. This technique has also been successful in treating stroke victims, possibly because of the increased blood flow to the brain, aiding healing. However, several things seem to contribute to the best choice of therapy, including age, symptom duration, incidence, and risk of recurrent brain injuries. More clinical tests are needed to determine the best practices in treating concussions.

Another factor in the rise of concussions, specifically in sports, may be that today’s athletes are bigger, stronger, and faster, so that when collisions do happen, the impact on the brain and body is so much more significant. Even with better pads and equipment available for players, it’s important to keep improving personal protection in order to best protect the brain health of professionals, children, and adolescents who play sports.

Though concussions can occur from several everyday events such as falls or car accidents, athletes and military members are at the greatest risk for long term impairment from concussions. This is mostly because of their propensity for multiple brain injuries without adequate time for recovery between injuries. A study shows that the brains of otherwise healthy athletes who competed in their early adulthood have signs of abnormal aging, such as cortical thinning and memory and verbal decline about 30 years after they competed in contact sports in college.

When treating concussion symptoms it’s important to seek immediate medical treatment if serious symptoms start to appear. There are some self care methods for mild symptoms such as:

• • Put cold compress on the injury: a frozen steak, or bag of frozen vegetables wrapped in a towel can work. Apply 2-4 hours for 20-30 minutes but never on the skin directly.

• • Take paracetamol for the pain: avoid using painkillers such as ibuprofen or aspirin since they can cause bleeding.

• • Avoid drinking alcohol or taking any drugs

• • Get plenty of rest and avoid stress

• • Only resume your daily activities (school, work, driving, playing sports, etc…) when you feel you have fully recovered.

• Make sure someone is with you the first 48 hours after the injury to monitor your symptoms.

Chronic Traumatic Encephalopathy (CTE)

Chronic traumatic encephalopathy (CTE) is a progressive degenerative disease caused by repeated, hard blows to the head or repeated concussions. Symptoms can generally begin 8-10 years after the multiple injuries. It is characterised for having four stages of symptoms:

• • First stage: disorientation and deterioration in attention, headaches and dizziness.

• • Second stage: includes the symptoms of the first stage and expands to include short memory impairment, depression and irritable almost explosive.

• • Third stage: symptoms start getting more complicated such as cognitive impairment and issues in executive functions (planning, organization, multitasking and judgment).

• Fourth stage: in this stage there is evidence of complete dementia, including symptoms such as hypomimia, impeded speech, tremors, vertigo, deafness, dysarthria, dysphagia, ptosis and suicide risk.

For CTE to be diagnosed a direct tissue examination is necessary (autopsies and immunohistochemical brain analyses), therefore most diagnoses are done postmortem. CTE has received great attention recently due to the tragic suicide of baseball player Ryan Freel in 2012. It was linked to CTE and his several concussions over the course of his baseball career, starting from when he was a child. Ryan Freel’s brain showed he was in the second out of the four stages of CTE. Former Raiders and 49ers running back Charlie Garner is said to have CTE, he has estimated to have had at least a dozen concussions in a year due to impact with other players.  Researchers are hoping brain imaging will eventually lead to the ability to diagnose CTE in people when they are alive.

There are so many aspects of brain injuries that were not previously known, and so many that are yet to be discovered. Increasing awareness and understanding concussion symptoms is important, especially now that we know more about the long term effects of concussions on the brain. Hopefully, with further research, we can all be better at recognizing  and treating concussions  in order to prevent further suffering for athletes and veterans.

Do you have any questions? Leave me a comment below 😉

References:

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Elsie Divinagracia, MPH

Elsie is a public health professional working in education and research. She is a lifelong learner, and is especially interested in mental and behavioral health. She loves travelling and spending time with her dog.