Hit Your Head Hard? Concussion Symptoms and Care
Head Injuries and Concussions
When my son was assaulted and ended up with a head injury, it wasn't until a week later that he started to show the symptoms of a concussion.
I had to learn what those symptoms are and what they mean, and I am sharing here what I learned, so I can help someone else who has suffered a head injury.
At the time of the assault we were not thinking about a concussion. But a week later my son started having:
- Blurry vision
- Slurred speech
- Massive headache
- Dizziness when he got up after laying down
We took him to the doctor, where an examination showed that his blood pressure would drop upon lying down. The doctor told us he was showing classic symptoms of a concussion. They gave him a CAT scan to find out if there was any bleeding in his brain; fortunately, there wasn’t.
Signs of a Possible Concussion
If you have taken a hard fall or hit your head, you will definitely want to look out for any of the following signs of a possible concussion:
- Loss of conciousness (even if brief)
- Nausea, vomiting, or loss of appetite
- Dizziness or balance problems
- Double or fuzzy vision
- Sensitivity to light or noise
- Feeling slowed down
- Feeling "foggy," "not sharp," or confused
- Changes in sleep pattern
- Concentration or memory problems
- Feeling more emotional
- Slurred speech
When Symptoms Might Start
Symptoms might begin immediately, or they might not develop for hours, days, a week, or even a month or two. If you hit your head, be sure you take note of your body and any symptoms you might be experiencing and don't ignore them.
What to Do
If you think you might have had a concussion, get to a doctor right away. If you can, get someone else to take you since you might not be in good condition to drive.
Here's what will happen when you visit the doctor or ER:
- You will be asked about the injury, how it happened, and what kind of symptoms you've been experiencing
- The doctor might examine you physically to see if any symptoms are detectable
- If your symptoms are very serious, you might need an MRI or CT scan to "look" inside the brain and determine if there is bleeding. The cost of these vary depending on many factors, but they range from $600 - $2000 and are covered by some insurance. You can call your company to see what you will have to pay.
How It Will Be Treated
Most concussions will heal on their own with rest. Follow your doctor's advice for modifying your activities to make sure you don't re-injure yourself and give your body a chance to heal.
Your doctor might recommend:
- Taking over-the-counter pain relievers
- Getting plenty of rest
- Avoiding driving or riding a bike
- Avoiding alcohol
- Reducing workload
- Avoiding strenuous activities
- Having other people help you make important decisions (since your thinking might be impaired)
Ask your doctor how long you'll need to do these things. Rarely, concussions require surgery to treat bleeding, swelling, or serious injury in the brain.
During the first 24 hours after injury, your doctor might recommend that someone wake you up every 2-3 hours to make sure you haven't gone into a coma and that you aren't confused and don't have any abnormal behavior.
What If Symptoms Don't Go Away or They Get Worse
If you still have symptoms 2-3 weeks after your injury or they're not improving, you should talk to your doctor.
Continuing symptoms might include:
- Stiff neck
- Headache that gets worse, lasts for a long time, or doesn't get better with OTC pain relievers
- Stiff Neck
- Fluid or blood leaking from ears or nose
- Changes in your speech, behavior, or vision
- Changes in the way that you walk
- Vomiting more than 3 times
- Confused thinking
What Is a Concussion?
Concussion is moderate to mild traumatic brain injury, also called closed brain injury. It can result from a blow, from striking the head on something, or from a sudden acceleration or deceleration (as from a car crash or explosion) that affects the head. The brain has a soft, gelatin-like texture and floats in a cushion of fluid. If it bounces against the skull, the brain can be injured.
Concussion can happen even if the patient didn’t pass out when he or she got hit or injured, or didn’t have symptoms immediately after the impact. The symptoms may develop over a few weeks and then gradually decline.
Why You Should See a Doctor for a Concussion
If you have any doubt about the severity of a head injury do not hesitate to get yourself to the nearest emergency room. A concussion is traumatic brain injury. Head injuries can be life-threatening and are nothing to play around with.
One reason to get medical advice is that concussion may be associated with even more serious injury—with bleeding into the brain (hematoma), brain swelling, or injury to the bones of the skull or neck.
Several years ago my father fell off a ladder. Within days he had a very bad headache. My mother took him to the emergency room. They sent him home twice without X-rays, and said he was just suffering from one of his "normal" headaches.
On the third trip there my mother insisted that they do an X-ray. Thank God she did, because the X-ray showed that my dad had a subdural hematoma (bleeding in the brain) which eventually required two brain surgeries.
Had my father gone home after that third trip, he might well have lain down and not woken up. Mostly likely my mother would not have gotten him back to the hospital in time and he would have died.
If there is any indication that you may have injured your brain, get to an emergency room right away. Depending on the severity of your symptoms, you might need a CAT scan (an X-ray in stages) or an MRI to find out if you have bleeding in the brain or other detectable injury. Better safe than sorry.
A Concussion Is Traumatic Brain Injury
If all you have is a concussion, doctors are unlikely to find visible evidence of it, or prescribe anything that will heal it faster. Nevertheless, even if you don’t have a hematoma or another complicating issue, concussion is, in fact, brain trauma, and you should see a doctor.
A doctor can confirm that your brain has been injured, that you are going to feel sick for a few days or weeks, and that there’s not much you can do about it except take it easy until your brain heals itself.
Also, a doctor can give you permission to skip work activities that might be difficult for you—for example if they require balance or concentration you don’t have—and most importantly, support your decision to take a break from activities that might put you at risk of another concussion.
Recovery From Concussion: Prevent Lasting Injury
It is clear that the brain can repair a single concussion, or several, but the recovery process is not well understood. It can take weeks, it can be uneven in pace, and it involves changes in the brain’s blood flow, ion balance, glucose (energy) supply, and the shape of the neurons.
There are at least two reasons why it's critical to let the brain repair itself before exposing it to risk of further injury.
- A second concussion while the brain is healing from the first one can lead to permanent, even fatal injury; this is called Second-Impact Syndrome.
- Repeated concussions can lead to progressive brain deterioration (chronic traumatic encephalopathy, CTE) which can be diagnosed through an autopsy finding of abnormal accumulations of tau protein in brain tissue.
The Frontline documentary League of Denial offers shocking evidence that hundreds of retired football players have permanently lost mental and emotional abilities because of the repeated brain trauma they suffered.
Other athletes—wrestlers, hockey players, soccer players—are also at risk for CTE, as are soldiers subjected to bombs and explosive devices. If you watch the documentary below, you may not want to watch American football any more, or let your kids play it.
Athletes and the Symptoms of Concussion
There is a lot of pressure on even young athletes to pull themselves together from an injury and get back into the game. If an athlete has had a concussion, though, getting back into the game is NOT an option. The risk of permanent brain injury from a second concussion before the first one is healed is far too serious.
The Centers for Disease Control say, “An individual should never return to competitive sporting or recreational activities while experiencing any lingering or persisting MTBI symptoms.”
Here are some signs that may indicate an athlete has gotten a concussion while playing sports:
- Appears dazed
- Has vacant facial expression
- Forgets his or her assignment
- Forgets plays
- Disoriented about the game or the score
- Has an inappropriate emotional reaction
- Displays clumsiness
- Answers questions slowly
- Loses consciousness
- Can’t remember facts like the date, their birthplace, who is President
- Displays any kind of atypical behavior
Receiving Proper Care for a Head Injury
The brain is a vital organ. If it’s injured, it can cause repercussions for life. Although concussion symptoms do not necessarily mean lasting disability, they do indicate that there is a risk of a disabling condition, and they need to be investigated.
If you are diagnosed with the symptoms of a concussion, make sure you receive proper treatment and do proper follow-up with your physician. The good news is that our brains and bodies have amazing powers of healing. Sometimes all that is needed is time.
- Brain Injury Association of America. “Mild Brain Injury and Concussion.”
- Kaiser Permanente. “Concussion.”
- Mayo Clinic. “Diseases and Conditions: Concussion.”
- US Department of Health and Human Services, Centers for Disease Control and Prevention. “What to Expect After a Concussion: Patient Take-Home Instructions.”
- WebMD. “Concussion (Traumatic Brain Injury).”
- Healthline. "Concussion."
- MedlinePlus. "Concussion - adults - discharge."
- MedlinePlus. "Head injury - first aid."
- Brainline.org. "When to go to the hospital."