Topic Overview

What is a concussion?

A concussion is a type of traumatic brain injury that is caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull. Although there may be cuts or bruises on the head or face, there may be no other visible signs of a brain injury.

You don't have to pass out (lose consciousness) to have a concussion. Some people will have obvious symptoms of a concussion, such as passing out or forgetting what happened right before the injury. But other people won't. With rest, most people fully recover from a concussion. Some people recover within a few hours. Other people take a few weeks to recover.

It's important to know that after a concussion the brain is more sensitive to damage. So while you are recovering, be sure to avoid activities that might injure you again.

In rare cases, concussions cause more serious problems. Repeated concussions or a severe concussion may lead to long-lasting problems with movement, learning, or speaking. Because of the small chance of serious problems, it is important to contact a doctor if you or someone you know has symptoms of a concussion.

What causes a concussion?

Your brain is a soft organ that is surrounded by spinal fluid and protected by your hard skull. Normally, the fluid around your brain acts like a cushion that keeps your brain from banging into your skull. But if your head or your body is hit hard, your brain can crash into your skull and be injured.

There are many ways to get a concussion. Some common ways include fights, falls, playground injuries, car crashes, and bike crashes. Concussions can also happen while participating in any sport or activity such as football, boxing, hockey, soccer, skiing, or snowboarding.

What are the symptoms?

It is not always easy to know if someone has a concussion. You don't have to pass out (lose consciousness) to have a concussion.

Symptoms of a concussion range from mild to severe and can last for hours, days, weeks, or even months. If you notice any symptoms of a concussion, contact your doctor.

Symptoms of a concussion fit into four main categories:

  • Thinking and remembering
    • Not thinking clearly
    • Feeling slowed down
    • Not being able to concentrate
    • Not being able to remember new information
  • Physical
    • Nausea and vomiting
    • Headache
    • Fuzzy or blurry vision
    • Dizziness
    • Sensitivity to light or noise
    • Balance problems
    • Feeling tired or having no energy
  • Emotional and mood
    • Easily upset or angered
    • Sad
    • Nervous or anxious
    • More emotional
  • Sleep
    • Sleeping more than usual
    • Sleeping less than usual
    • Having a hard time falling asleep

Young children can have the same symptoms of a concussion as older children and adults. But sometimes it can be hard to tell if a small child has a concussion. Young children may also have symptoms like:

  • Crying more than usual.
  • Headache that does not go away.
  • Changes in the way they play or act.
  • Changes in the way they nurse, eat, or sleep.
  • Being upset easily or having more temper tantrums.
  • A sad mood.
  • Lack of interest in their usual activities or favourite toys.
  • Loss of new skills, such as toilet training.
  • Loss of balance and trouble walking.
  • Not being able to pay attention.

Concussions in older adults can also be dangerous. This is because concussions in older adults are often missed. If you are caring for an older adult who has had a fall, check him or her for symptoms of a concussion. Signs of a serious problem include a headache that gets worse or increasing confusion or both. See a doctor right away if you notice these signs. If you are caring for an older adult who takes a blood thinner and who has had a fall, take him or her to a doctor right away, even if you don't see any symptoms of a concussion.

Sometimes days or weeks after a concussion you may still feel as if you are not functioning as well as you did before the injury. This is called post-concussive syndrome. New symptoms may develop, or you may continue to be bothered by symptoms from the injury, such as:

  • Changes in your ability to think, concentrate, or remember.
  • Headaches or blurry vision.
  • Changes in your sleep patterns, such as not being able to sleep or sleeping all the time.
  • Changes in your personality such as becoming angry or anxious for no clear reason.
  • Lack of interest in your usual activities.
  • Changes in your sex drive.
  • Dizziness, light-headedness, or unsteadiness that makes standing or walking difficult.

If you have symptoms of post-concussive syndrome, call your doctor.

How is a concussion diagnosed?

Any person who may have had a concussion needs to see a doctor. If a doctor thinks that you have a concussion, he or she will ask questions about the injury. Your doctor may ask you questions that test your ability to pay attention and your learning and memory. Your doctor may also try to find out how quickly you can solve problems. He or she may also show you objects and then hide them and ask you to recall what they are. Then the doctor will check your strength, balance, coordination, reflexes, and sensation.

Neuropsychological tests have become more widely used after a concussion. These tests are only one of many ways that your doctor can find out how well you are thinking and remembering after a concussion. These tests can also show if you have any changes in emotions or mood after a concussion.

Sometimes a doctor will order imaging tests such as a CT scan or an MRI to make sure your brain is not bruised or bleeding.

How is it treated?

Right away

After being seen by a doctor, some people have to stay in the hospital to be watched. Others can go home safely. If you go home, follow your doctor's instructions. He or she will tell you if you need someone to watch you closely for the next 24 hours or longer.

Call 911 or seek emergency care right away if you are watching a person after a concussion and the person has:

  • A headache that gets worse or does not go away.
  • Weakness, numbness, or decreased coordination.
  • Repeated vomiting or nausea.
  • Slurred speech.
  • Extreme drowsiness or you cannot wake them.
  • One pupil that is larger than the other.
  • Convulsions or seizures.
  • A problem recognizing people or places.
  • Increasing confusion, restlessness, or agitation.
  • Loss of consciousness.

Warning signs in children are the same as those listed above for adults. Take your child to the emergency department if he or she has any of the warnings signs listed above or:

  • Will not stop crying.
  • Will not nurse or eat.

In the days or weeks after

Some people feel normal again in a few hours. Others have symptoms for weeks or months. It is very important to allow yourself time to get better and to slowly return to your regular activities. If your symptoms come back when you are doing an activity, stop and rest for a day. This is a sign that you are pushing yourself too hard. It is also important to call your doctor if you are not improving as expected or if you think that you are getting worse instead of better.

Rest is the best way to recover from a concussion. You need to rest your body and your brain. Here are some tips to help you get better:

  • Get plenty of sleep at night, and take it easy during the day.
  • Avoid alcohol and illegal drugs.
  • Do not take any other medicines unless your doctor says it is okay.
  • Avoid activities that are physically or mentally demanding (including housework, exercise, schoolwork, video games, text messaging, or using the computer). You may need to change your school or work schedule while you recover.
  • Ask your doctor when it's okay for you to drive a car, ride a bike, or operate machinery.
  • Use ice or a cold pack on any swelling for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
  • Use pain medicine as directed. Your doctor may give you a prescription for pain medicine or recommend you use a pain medicine that you can buy without a prescription, such as acetaminophen (for example, Tylenol).

Concussion and sports

A person who might have a concussion needs to immediately stop any kind of activity or sport. Being active again too soon increases the person's risk of having a more serious brain injury. Be sure to see a doctor before returning to play.

How can you prevent a concussion?

Reduce your chances of getting a concussion:

  • Wear a seat belt every time you drive or ride in a car or other motor vehicle.
  • Never drive when you are under the influence of drugs or alcohol.
  • Make your home safer to prevent falls.

Wear a helmet for any activity that can cause a fall or impact to the head or neck. Examples include bike riding, football, baseball, hockey, ATV riding, skateboarding, skiing, snowboarding, inline skating, and horseback riding. Helmets help protect your skull from injury. But brain damage can occur even when a helmet is worn.

Reduce your child's chances of getting a concussion:

Other Places To Get Help

Organizations

Canadian Paediatric Society: Caring for Kids
www.caringforkids.cps.ca
Provincial and Territorial Helplines and Websites (Canada)

If you want to save this information but don't think it is safe to take it home, see if a trusted friend can keep it for you. Plan ahead. Know who you can call for help, and memorize the phone number.

Be careful online too. Your online activity may be seen by others. Do not use your personal computer or device to read about this topic. Use a safe computer such as one at work, a friend's house, or a library.

Many of the resources below have toll-free phone numbers and provide help 24 hours a day, 7 days a week in multiple languages. In an emergency, call 911.

Canada-wide resources

  • To find a suicide prevention crisis centre phone number or website in your province, visit the Canadian Association for Suicide Prevention's webpage at http://suicideprevention.ca/thinking-about-suicide.
  • To find a rape crisis or women's centre phone number or website in your province, visit the Canadian Association of Sexual Assault Centres' webpage at www.casac.ca/content/anti-violence-centres.
  • Kids and teens can call Kids Help Phone at 1-800-668-6868 or visit http://org.kidshelpphone.ca.

Alberta

  • Provincial Health Information Line. HEALTHLink Alberta. Call 8-1-1 or visit https://myhealth.alberta.ca.
  • Alberta Human Services: Connect to Support and Services. Call one of the numbers below or visit http://humanservices.alberta.ca/abuse-bullying/14839.html.
    • Family Violence Info Line. Call 310-1818.
    • Child Abuse Hotline. Call 1-800-387-5437.
    • Bullying Helpline. Call 1-888-456-2323.
  • Sexual Assault Centre of Edmonton (SACE). Call 780-423-4121 or visit www.sace.ab.ca.
  • Mental Health Helpline. Call 1-877-303-2642.
  • Addiction Services Helpline. Call 1-866-332-2322.

British Columbia

  • Provincial Health Information Line. HealthLinkBC. Call 8-1-1 or visit www.healthlinkbc.ca.
  • VictimLink BC. Call 1-800-563-0808 or visit http://www2.gov.bc.ca/gov/content/justice/criminal-justice/victims-of-crime/victimlinkbc.
  • Child Abuse Prevention Website: Helpline. Call 310-1234 or visit www.safekidsbc.ca/helpline.htm.
  • BC Mental Health and Substance Use Services. Call 310-6789 or visit www.bcmhsus.ca.
  • Crisis Intervention and Suicide Prevention Centre of British Columbia. Call 1-800-784-2433 or visit http://crisiscentre.bc.ca.

New Brunswick

  • Provincial Health Information Line. Tele-Care: Call 8-1-1 or visit www2.gnb.ca/content/gnb/en/departments/health/Tele-Care.html.
  • Emergency Social Services. Visit www2.gnb.ca/content/gnb/en/departments/social_development/about_us/emergency_socialservices.html to find the number for the office nearest you or call 1-800-442-9799.
  • Fredericton Sexual Assault Crisis Centre. Call (506) 454-0437 or visit www.fsacc.ca.
  • Suicide Prevention CHIMO Helpline. Call 1-800-667-5005 or visit www2.gnb.ca/content/gnb/en/departments/health/Suicide_Prevention.html.

Ontario

  • Provincial Health Information Line. Telehealth Ontario: Call 1-866-797-0000 or visit www.ontario.ca/page/get-medical-advice-telehealth-ontario .
  • Assaulted Women's Helpline. Call 1-866-863-0511 or visit www.awhl.org.
  • Distress Centres Ontario. Visit www.dcontario.org/help.html to find the phone number for a crisis line in your calling area.
  • Drug and Alcohol Helpline. Call 1-800-565-8603 or visit www.drugandalcoholhelpline.ca.
  • Mental Health Helpline. Call 1-866-531-2600 or visit www.mentalhealthhelpline.ca.

Saskatchewan

  • Provincial Health Information Line. HealthLine. Call 8-1-1 or visit www.saskatchewan.ca/residents/health/accessing-health-care-services/healthline.
  • Family Violence Outreach. Go to www.justice.gov.sk.ca/FVO for a list of community-based organizations and their contact information, or visit www.justice.gov.sk.ca/IVAP.
  • Child Abuse and Neglect. Go to www.saskatchewan.ca/residents/justice-crime-and-the-law/child-protection/child-abuse-and-neglect for a list of local child protection offices and their contact information.
  • Mental Health and Addiction Services. Go to www.saskatchewan.ca/residents/health/accessing-health-care-services/mental-health-and-addictions-support-services for a list of local mental health and addictions services.

Yukon

  • Provincial Health Information Line. HealthLine: Call 8-1-1 or visit www.hss.gov.yk.ca/811.php. If you are calling from a satellite phone, you can dial 1-604-215-4700 to reach the Health Services Representative at HealthLink BC.
  • Family and Children's Services. Call 1-800-661-0408, ext. 3002, or visit www.hss.gov.yk.ca/family_children.php.
  • Victim Services/Family Violence Prevention Unit. Call 1-800-563-0808. Or visit the Department of Justice "Need Help? Phone Directory" at www.justice.gov.yk.ca/prog/cor/vs/phonedir.html.
  • Alcohol and Drug Services. Call 1-855-667-5777 or visit http://hss.gov.yk.ca/ads.php.

Other provinces

Check your local phone book or provincial or territorial website.

ThinkFirst Canada
www.parachutecanada.org/thinkfirstcanada

References

Other Works Consulted

  • American College of Sports Medicine (2006). Concussion (mild traumatic brain injury) and the team physician: A consensus statement. Medicine and Science in Sports and Exercise, 39(2): 395–399.
  • Giza CC, et al. (2013). Summary of evidence-based guideline update: Evaluation and management of concussion in sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 80(24): 2250–2257. Also available online: http://www.neurology.org/content/80/24/2250.full.
  • Halstead ME, et al. (2010). Sport-related concussion in children and adolescents. Pediatrics, 126(3): 597–615.
  • Halstead ME, et al. (2013). Returning to learning following a concussion. Pediatrics,132(5): 948–957.
  • McCrory P, et al. (2013). Consensus statement on concussion in sport: The 4th International Conference on Concussion in Sport held in Zurich, November 2012. British Journal of Sports Medicine, 47(5): 250–258. Also available online: http://bjsm.bmj.com/content/47/5/250.full.

Credits

ByHealthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Donald Sproule, MDCM, CCFP - Family Medicine
E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine

Current as ofApril 26, 2016