Concussion

• Overview
• Causes
• Symptoms
• Diagnosis
• Treatment
• Prevention

Overview 

The brain is a very sensitive organ. It is surrounded in the skull by cerebrospinal fluid, which acts as a natural protection against knocks and shocks. If a particularly strong force is applied, for example as a result of an accident, a fall or a blow to the head, the cerebrospinal fluid is not able to cushion the impact adequately. The brain can hit the inside of the cranium and become temporarily impaired in its function. This injury is referred to as a concussion and is considered to be the mildest form of traumatic brain injury.

A concussion can cause a temporary loss of consciousness. In addition, it occurs without obvious damage to the brain structure and usually does not cause permanent damage. However, if you suspect a concussion, you should look out for possible warning signs. These include loss of consciousness, repeated vomiting, severe or worsening headaches, disordered speech, seizures, severe confusion, or a worsening of the general condition of the person affected. 

Causes

A concussion is usually caused by a blow, impact or fall on the head. Alternatively, if the body is shaken hard, such as in a traffic or sports accident, this can lead the brain to suddenly accelerate in the skull and then abruptly slow down, leading to a concussion.

Head injuries such as concussions are particularly common in high-speed sports such as motor sports, skiing, cycling and mountain biking. They are also not uncommon in contact sports such as ice hockey, football or basketball, as well as in sports with a high risk of falling.

Blows to the head as a result of physical conflicts can also cause serious injuries. Both in sport and in such situations, there is a risk of severe traumatic brain injury.

Symptoms

Although no structural changes in the brain can be detected in a concussion using imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI), a temporary impairment of brain function usually occurs, resulting in symptoms that can vary in severity.

If concussion is suspected, you should always consult a doctor, especially if the patient experiences repeated vomiting, loss of consciousness, disordered speech, significant dizziness or severe headaches. 

Symptoms and signs of concussion

• Headaches
• Confusion
• Memory loss
• Double vision
• Light sensitivity
• Dizziness, sluggish movements and balance problems:
• Nausea and vomiting
• Tinnitus (ringing in the ears), usually temporary
• Loss of the sense of smell or taste (this is rare and usually temporary)

Symptoms can occur immediately after the injury or may develop over several hours or days. 

Certain syndromes that can occur up to a few weeks after concussion are called post-traumatic syndromes. These syndromes may include one or more of the following:

• Exhaustion
• Headaches
• Difficulty concentrating
• Problems with short-term memory
• Difficulty sleeping
• Sensitivity to light or noise
• Personality changes, such as irritability or mood swings 

Post-traumatic syndrome often occurs within the first week after concussion and, in most cases, disappears in the following week. In some cases, however, the symptoms can last for months or years. 

Diagnosis

Imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) are used to diagnose concussion after an accident. If there are no structural brain injuries, the focus is on treating the individual symptoms.  

Treatment

After a concussion has been diagnosed, the attending doctor explains important behavioural measures to patients.  

Treatment of concussion

In general, it is advisable to give the brain time and rest to recover. The following measures can be taken: 

• Avoid physical activity and sport
• Avoid watching TV, working at a computer or reading for long periods
• If necessary, on medical advice, patients can also take medication for headaches and/or nausea 

Aspirin or other non-steroidal painkillers (NSAIDs) should be avoided, as they can impair blood clotting and therefore encourage bleeding from damaged blood vessels. Mild concussion usually does not require further treatment. Depending on the symptoms, however, it may be advisable to take sick leave for a few days and use the time to take care of yourself.

Treatment of post-traumatic syndrome

The treatment of post-traumatic syndrome depends primarily on the severity of the symptoms. Regular observation and rest are recommended. If symptoms worsen, patients should seek medical advice.

After concussion, those affected should not resume sporting activities until the medical treatment has been completed and health risks have been ruled out.

Patients with mental health problems can benefit from psychotherapeutic support. 

Prevention

In order to prevent concussions, people should exercise appropriate caution in their daily lives and avoid unnecessary risks: wearing a helmet while cycling, skiing or playing hockey, for example, can make a significant contribution to preventing concussions or severe traumatic brain injury. Compliance with traffic and safety rules is another effective preventive measure. In summary, many falls and accidents can be prevented by a safe environment and attentive behaviour.

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