A concussion is a brain injury in which trauma to the head results in a temporary disruption of normal brain function. The injury occurs when a person’s brain is violently rocked back and forth or twisted inside the skull as a result of a direct or indirect force. A concussion disturbs brain activity and should be handled as a serious injury. Proper healing and recovery time following a concussion are crucial in preventing further injury.
Athletes who are not fully recovered from an initial concussion are significantly vulnerable to recurrent, cumulative, and even catastrophic consequences of a second concussive injury. Such difficulties are prevented if the athlete is allowed time to recover from a concussion and if return-to-play decisions are carefully made. No athlete should return to sport or other at-risk participation when symptoms of a concussion are present and recovery is ongoing. In summary, the best way to prevent difficulties with a concussion is to manage the injury properly when it occurs.
A concussion may cause multiple symptoms. Many symptoms appear immediately after the injury, while others can develop over the following days or weeks. The symptoms may be subtle and are often difficult to fully recognize. It is not unusual for symptoms to worsen with physical activity. In many cases, even simple things, such as going to school or reading a book, may worsen symptoms.
Some common symptoms include:
ATHLETES SHOULD NOT RETURN TO PLAY UNTIL SYMPTOM-FREE
Diagnostic testing, which includes CT and MRI, may be needed. While these are helpful in identifying life-threatening brain injuries, such as a skull fracture, hematoma, or a contusion, they are typically normal even in athletes who have sustained a severe concussion.
The symptoms of a concussion will usually go away within 5 to 7 days of the initial injury. However, in some cases, symptoms may last for several weeks or even months. Symptoms such as headaches, memory problems, poor concentration, and mood changes can interfere with school, work, and social interactions. The potential for such long-term symptoms indicates the need for careful management of all concussions.
There is no “magic number” of concussions that determines when an athlete should give up playing contact or collision sports. The circumstances surrounding each individual injury, such as the mechanism of injury and length of symptoms following the concussion, are very important and must be considered when assessing an athlete's risk for further, and potentially more serious, concussions. The decision to “retire” from sports can only be reached following a thorough review of the athlete’s concussion history, coupled with a thorough and frank discussion between the treating physician and the athlete and his or her parents.