A concussion is a type of traumatic brain injury—or TBI—as a result of a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can result in the brain to bouncing around or twisting in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells. (CDC)
Often the head is struck, as in a car accident, fall, blow to the head or in a blast injury. But a concussion may occur as a result of sudden violent motion – such as a whiplash injury – without the head actually hitting anything.
Not always. Brief loss of consciousness is common but a concussion can occur even without loss of consciousness.
The damage during concussion occurs when the soft, movable brain twists and/or collides with the interior surface of the skull during violent motion to the head. This may cause neurochemical changes which affect how cells function. Nerve fibers may be stretched and torn. Loss of consciousness occurs if the activation system in the brain is temporarily “knocked out”.
Because even though physical recovery may be complete, and the person may look fine, problems in thinking, behavior, and emotions may continue as a result of injury to the brain.
No, most people who suffer concussions will be okay. They will have temporary symptoms, which will disappear with time- 85% clearing within 90 days. Many factors can contribute to persistent symptoms, leading to longer recovery. Often these problems are not noticed until a person returns to the demands of work, school, or home.
Although recovery differs between individuals, many people will experience headaches, dizziness, nausea, vomiting, confusion, disorientation, fatigue, and slowness immediately after the injury. In some instances, these symptoms develop over time. Sometimes the events immediately preceding the accident, and for a period of time afterwards, are not remembered, even though the person may not have lost consciousness. For some time after the injury, people may have problems with learning and memory, attention and concentration, a slower thinking process and physical and mental fatigue. Usually these symptoms will gradually disappear over a period of days, weeks or sometimes even months.
You will notice, “something is off,” things just “aren’t the same.” Memory problems are common, not for things already known, but for new learning. You may be more forgetful of names, where you put things, appointments, etc., may be harder to learn new information or routines. Your attention may be shorter, you may be easily distracted, or forget things or lose your place when you have to shift back and forth between two things. You may find it harder to concentrate for long periods of time, and become mentally fatigued, e.g., when reading. Vision and perceiving what you see may have changed. Headaches and difficulty sleeping are other common symptoms as well as problems with walking and balance.
You may find it harder to find the right word or express exactly what you are thinking. You may think and respond more slowly, and it may take more effort to do the things you used to do automatically. You may not have the same insights or spontaneous ideas as you did before.
Finally, you may find it more difficult to make plans, get organized, and set and carry out realistic goals. You may feel like you are “spinning your wheels” or are not accomplish anything. You may say and do things you wouldn’t have said before. Your judgment may be off. You may miss the subtle cues that others give you that indicate how they’re reacting to what you’re doing. Often you will hear these observations from others who are concerned about you, rather than noticing them yourself. Your friends and family may comment that “you’re not the same person,” since your injury.
Emotionally, you may find yourself more irritable, anger more quickly, or be more emotional. You may find yourself in conflict with your friends or co-workers, even when it doesn’t seem like your fault. You may get depressed more easily, or laugh or cry when you don’t expect to. Stronger emotions may come and go very quickly. You may feel more argumentative. All these emotional reactions are a direct result in changes to nerve cell function suffered as a result of your accident, and do not mean you are crazy or abnormal.
You should speak with your doctor and seek help to learn to overcome or adapt to the changes that have occurred. Some professionals who can treat these areas include physical therapy, occupational therapy, speech therapy, and counseling. You can contact the Concussion Resource Center for information and support.
Not necessarily. The injury that occurs generally is at a microscopic level, so that it does not appear on x-rays, CAT scans, MRIs, or on neurological exams. Also, your intelligence may still be measured as average or above average. Your problems may be real and caused by the concussion even if not medically obvious. Do not accept being told you are faking or imagining your symptoms.
No. When you cannot function the same as you used to, and do not understand why, it is natural to become frustrated, depressed, and avoid situations where you might fail. If you are told you have no real problems and are just imagining things, it is easy to feel guilty, angry, frightened, or uncertain. These feelings all complicate the problems you encounter because of the injury to your brain. It does not mean you are crazy or neurotic. It means you should seek the proper help.
Occasionally, some persons who have pre-existing personality problems, or who are unconsciously tempted by the rewards of being incapacitated, may exaggerate or create their symptoms after a minor injury. However, this happens much less often than is commonly thought.
First, re-contact your medical professional. Explain your problems and ask for a referral to an occupational therapist, a speech–language pathologist, a physical therapist, and/or a counselor with experience in treating mild head injury.
Second, in Bozeman or surrounding area, contact the Concussion Resource Center (406) 219-7026 for more information and resources for recovery.
Third, contact the National Head Injury Foundation (800) 444-6443. They will provide you with information about head injury.
No. Most people recover after mild injuries with time. Don’t be so anxious that you start avoiding situations. Return slowly and gradually to your normal routine. But if your problems exist beyond three months, seek help from your physician. You may want to contact a therapist sooner than 3 months, early evaluation and treatment can head off many of the problems.