Last updated date: 03-Jun-2023
Originally Written in English
A "traumatically caused transitory disruption of brain function" is what a concussion is. TBIs (traumatic brain injuries) are a type of neurologic injury that includes concussions. Various degrees of traumatic brain injury exist, ranging from minor, temporary symptoms to prolonged periods of altered awareness.
Because the symptoms of a concussion are generally self-limited, the term mild traumatic brain injury (mTBI) is sometimes used interchangeably, even though concussions are technically a subgroup of mTBIs. The prognosis is typically favorable, and most patients receive complete symptom relief.
What is Concussion?
Concussion: Refers to a minor brain injury that occurs when your brain is disturbed by a sudden blow, shock, or blow to the head. Concussions can also be caused by a heavy blow to your body that forces your head to twitch backwards, forwards, or even sideways.
The concussion stretches and damages nerves or blood vessels in the brain. This causes chemical changes that lead to a temporary loss of brain function. Either concussion does not result in irreversible damage to the brain. However, many concussions throughout life can cause anatomical abnormalities in the brain. Fortunately, concussions are not always serious. However, it can have serious consequences that linger for days, weeks, or even months.
Brain tissue is spongy and soft. The cerebral fluid surrounding it acts as a cushion between it and the hard protective surface of the skull. concussion of the brain It develops if the brain twists or bounces inside the skull, or when it moves quickly like a whip against the inside of the skull. This movement causes chemical changes in the brain by stretching and destroying brain cells.
Injuries cause the brain to stop functioning properly for a short period of time, so this results in symptoms and concussions. Concussions are often caused by car accidents, sports injuries, and falls. Concussions can occur in any sport with physical contact.
Most concussions in children occur in playgrounds when riding bicycles or participating in sports such as basketball, soccer, ice hockey, soccer, or wrestling.
Concussion risk factors
Certain factors and activities can increase the chances of disease. concussion, namely;
- Decreased, especially in young children and the elderly
- Play high-risk sports such as soccer, soccer, hockey, boxing, rugby, or other contact sports.
- Engage in high-risk sports without the necessary equipment and safety management.
- Car accident
- Accidents involving pedestrians or cyclists
- Being a soldier in a war situation
- Being a victim of physical violence
- Had previously been concussed
Pathophysiology of concussion
The pathophysiologic mechanism of a concussion is complex. The acute symptoms of a concussion are due primarily to a "functional disturbance rather than structural injury." "Neurochemical and neurometabolic events" after an injury to the head result in an alteration of neurologic function. Acceleration, deceleration, or rotation of the head result in acute axonal injury via disruption of neurofilament organization. The release of electrolytes through ion channel depolarization leads to a release of neurotransmitters and subsequent neurologic dysfunction. Changes to glucose metabolism decreased cerebral blood flow, and mitochondrial dysfunction also occurs.
There is no commonly accepted definition of concussion, minor head injury, or mild traumatic brain damage. Concussion is a complicated pathophysiological process that affects the brain and is caused by severe biomechanical forces. It was acknowledged that concussion usually causes a transitory loss of neurological function that resolves on its own over time, and that neuroimaging usually reveals no significant structural alterations in the brain as a result of the disorder.
Although no structural brain damage occurs according to the standard definition, some studies have added injuries that have caused structural damage, and the National Institute for Health and Clinical Excellence definition includes physiological or physical disturbance in the brain's synapses.
Concussion has also traditionally been associated with a loss of consciousness. However, throughout time, the term has developed to encompass a change in consciousness, such as amnesia, however there is still debate regarding whether the definition should only include injuries that result in loss of consciousness. This issue resurfaces in some of the most well-known concussion grading measures, which rank episodes with loss of consciousness as more severe than those without.
The World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD-10) published a uniform, official classification of mild traumatic brain injury (mTBI) across disciplines in 1992. Although concussion is classified as a mild TBI, it is unclear if concussion is indicated in mild brain damage or mild head injury.
In medical literature, "mTBI" and "concussion" are sometimes used interchangeably, however additional injuries such as cerebral hemorrhages (e.g. intra-axial hematoma, epidural hematoma, and subdural hematoma) are not always excluded in mTBI or mild head injury, as they are in concussion. "Complicated mTBI" refers to mTBI that is accompanied by abnormal neuroimaging.
Although "concussion" might be thought of as a condition in which brain function is momentarily impeded and "mTBI" as a pathological state, few researchers and doctors discriminate between the two words in practice. In clinical neurology, descriptions of the disorder, such as the severity and impacted brain region, are being used more frequently than the term "concussion."
Signs and symptoms of concussion
The signs and symptoms of a concussion can be subtle and may not appear immediately. On the other hand, signs and symptoms may linger for days, weeks, or months.
headaches, confusion, and memory loss (amnesia) is common following a traumatic brain injury. The most popular symptom of amnesia is forgetting about the events that led to the concussion.
Here are some physical indications and symptoms of a concussion:
- Have a headache
- Nausea and vomiting
- The phone rang in my ear.
- Blurred vision
- Tiredness or drowsiness
These symptoms are also characteristic of a brain aneurysm.
Other possible concussion signs and symptoms may include;
- Amnesia in a tragic event
- Confusion and the feeling of being in the fog
- Dizziness (seeing stars)
Signs and symptoms of a concussion that you can notice in other people include:
- Loss of coordination
- Balance issue
- Mocking speech
- Delay in answering questions
- Difficulty walking
- Confusion for a long time
- Abnormal eye movements
These symptoms are also characteristic of a Brain Tumour.
For more information see: Brain tumor facts view points from expert doctors
If you notice a friend, loved one, or anyone else experiencing these symptoms after your injury, seek medical attention as soon as possible.
Symptoms of concussion in children
Signs and symptoms of concussion in infants tend to be different Since babies do not find snobby speech, difficulty walking, or other tell-tale signs that older children and adults exhibit, it may not be obvious at first.
Here are the most common indicators of concussion for children:
- Drops from the ears, mouth and nose
These symptoms are also characteristic of a Meningitis.
For more information see: How could meningitis change your life forever
Concussions can result in lifelong brain damage in some cases. Although most babies recover from concussion but it's always a good idea to have it checked by a doctor. If your child is unconscious, get medical help right away.
The diagnosis of a concussion is still solely dependent on history and examination findings. For diagnosing a concussion, however, there is no one pathognomonic finding or a minimal number of symptoms. Following an acute head injury, many standardized diagnostic techniques may be used in the pre-hospital environment to help determine the existence of a concussion.
Because symptoms and objective results may show later than expected, it is crucial to monitor for the development of symptoms or any indicators of neurologic impairment following the initial post-injury examination. Severe headaches, seizures, focal neurologic deficits, loss of consciousness, deterioration of mental status, and increasing symptoms are all signs and symptoms of a more serious head injury that should be referred to an emergency room for additional assessment.
Some of the tests and procedures your doctor can perform or prescribe include;
- Neurological examination:
A doctor can perform a neurological exam after a thorough inquiry about your accident. This assessment includes looking at your hearing, vision, feeling, strength, coordination, balance, and reflexes.
- Cognitive Tests:
During a neurological exam, your doctor can perform a number of tests to assess your cognitive or cognitive abilities. Your doctor can assess various factors during the test. They may include concentration, memory and the ability to remember facts.
- Imaging test:
Individuals with signs and symptoms such as seizures, severe headaches, frequent vomiting, or any worsening of symptoms may benefit from brain imaging. If the damage is severe and results in bleeding or intracranial edema, brain imaging may be helpful in determining the severity of the injury.
In adults, a cranial computed tomography (CT) scan is a standard procedure for assessing the brain after injury. A CT scan is a procedure that involves X-rays to create cross-sectional images of the brain and skull.
CT scans are reserved for minors with suspected concussion only if certain criteria are met. This includes the type of damage or symptoms of a skull fracture. It also protects young children from radiation exposure.
Magnetic resonance imaging (MRI) is useful in detecting abnormalities in the brain or diagnosing problems related to concussion. MRI creates comprehensive images of the brain using strong magnets and radio waves.
Following a concussion diagnosis, an outpatient monitoring by a responsible individual trained in warning indications that require additional investigation is usually recommended. Patients who have indications or symptoms of a more serious head injury may need to stay in the hospital longer. When a concussion is diagnosed, the patient should be removed from any situation that might result in another hit to the head.
Concussion treatment is mostly supportive. Concussion supportive treatment focuses on limiting physical and cognitive activity at first, then gradually returning to prior activity levels. Extended, severe cognitive and physical rest has lost its utility. While rest is recommended during the acute post-injury period (the first 24 to 48 hours), the patient should gradually return to activities after that. However, no one knows how long the initial rest period should last.
The patient should gradually return to activities while being closely monitored for the recurrence or exacerbation of symptoms. If symptoms recur, you should reduce your activity level until they improve. Each increase in activity should take at least 24 hours, but there is no conclusive evidence regarding the best time to begin a return-to-activity strategy. Athletes who have had a concussion should not be allowed to return to play unless they have been cleared by a medical professional.
The following steps can help in concussion as well as improve brain healing and accelerate recovery;
Headaches are common for days and weeks after the impact. Ask your doctor if using over-the-counter pain relievers, such as Is acetaminophen (Tylenol) safe? Other pain relievers, including ibuprofen (Advil, Motrin IB, and others), as well as aspirin, should be avoided because they can cause bleeding.
Physical and emotional (mental) rest:
Relative rest is the best way to allow the brain to recuperate during the first few days after a concussion. To successfully treat a concussion, your doctor will advise you to rest physically and mentally. Within the first two days after the concussion it is recommended to rest relatives. This includes reducing activities that require mental thoughts and attention.
Complete rest, which includes sleeping in a dark room and ignoring all stimuli, on the other hand does not help recuperate and is not recommended. If symptoms worsen within the first 48 hours, you should reduce activities that require high concentration of attention. This includes playing video games, working at school, watching TV, texting, reading or using a computer.
You should also avoid any physical activity that can worsen your symptoms. For example, sports, general physical exertion, and any intense movement until your symptoms subside.
If you are able to tolerate daily activities such as screen time without causing symptoms after a period of relative rest, it is recommended that you continue increasing it.
You can consider starting a minimal level of physical and mental exercise where the symptoms are not significantly aggravated. Start with light exercises and exercises you can withstand a few days after the accident found that your recovery has accelerated. However, you must avoid any action that puts you in danger of re-injuring the head until you have fully recovered.
Chinese medicine and acupuncture for Concussion treatment
Traditional Chinese medicine (TCM) is a potential alternative therapy that is performed globally, in addition to conventional therapies such as surgery, medication, and rehabilitation.
Traditional Chinese medicine (TCM), which has been practiced for thousands of years in China, has gained popularity in recent years. There is substantial evidence to support the therapeutic advantages of TCM, including Chinese herbal medicine components, acupuncture, and electroacupuncture, in the treatment of concussion.
Some people suffer a variety of symptoms after a concussion. Many typical concussion symptoms can be treated by certified acupuncturists utilizing a range of acupuncture treatments. Many patients suffer from persistent headaches after a concussion, and acupuncture can help alleviate this long-term suffering.
Chinese herbal medicine is available in a variety of forms, including decoctions, tablets, and powders. Numerous researches have demonstrated that Chinese medicine offers a variety of neuroprotective properties, such as improved brain edema, anti-inflammatory responses, and anti-oxidative effects. Several studies have established that TCM plays a significant role in the prevention and treatment of neurological disorders, and that it has the potential to be beneficial in neural regeneration and CNS functional recovery.
It is worth noting that Dr. Kangill Lee is one of the most well-known experts working in the field of Traditional Korean Medicine for concussion treatment.
Continued activities after concussion
Over time, as symptoms improve, you can incorporate more thoughtful tasks into your daily routine. This may include accomplishing more studies or assignments and increasing the time you spend at work or school.
When it's safe for you to return to light exercise, your doctor will let you know. Before the symptoms are completely gone, you can do some light physical training like riding a stationary bike and running lightly. This is as long as it doesn't exacerbate your symptoms.
- Return to school
After the youngster feels ready and has finished an initial period of cognitive rest of no more than 24–48 hours following the acute injury, low-risk school activities should be resumed. Long absences from school are not advised; nevertheless, a progressive and step-by-step return to school is recommended. Longer periods of full mental or physical rest (more than 24–48 hours after the concussion) have been linked to worsening results; however, returning to school before the person is ready has also been linked to longer-lasting symptoms and a longer recovery time.
Students with a suspected concussion must see a doctor for an initial medical examination and rehabilitation recommendations, but medical clearance is not necessary for them to return to school. Because kids may look 'normal,' relevant school workers may require continued education to ensure that necessary modifications, such as part-days and extended deadlines, are made.
Accommodations should be based on the monitoring of symptoms such as headaches, dizziness, visual issues, memory loss, trouble concentrating, and atypical behavior that occur during the return-to-school transition. Before returning to full-contact sports, students must have completed all of their schoolwork.
- Return to sport
For persons participating in athletics, it is suggested that participants progress through a series of graded steps. These steps include:
- Immediately after injury: 24-48 hours (maximum) of relative physical and cognitive rest.
- Stage 1: Gentle everyday activities that do not aggravate symptoms include wandering about the home, light cleaning, and light schoolwork. There will be no sporting activity.
- Stage 2: Light aerobic activity such as walking or stationary cycling
- Stage 3: Sport-specific activities such as running drills and skating drills
- Stage 4: Non-contact training drills (exercise, coordination, and cognitive load)
- Stage 5: Full-contact practice (requires medical clearance)
- Stage 6: Return to full-contact sport or high-risk activities (requires medical clearance)
The person should not have any worsening or new symptoms for at least 24 hours before going on to the next step. If symptoms worsen or new difficulties emerge, athletes should return to the previous dose for at least another 24 hours.
Intercollegiate or professional athletes, are typically followed closely by team athletic trainers during this period but others may not have access to this level of health care and may be sent home with minimal monitoring.
Complications of concussion
A concussion's most prevalent consequence is post-concussion syndrome (PCS), which is defined by persistent symptoms that extend weeks to months after the initial injury. In one investigation, the median duration of symptoms was seven months. "Ill-defined and poorly understood" is the transition from a concussion to post-concussion syndrome.
Post-concussion syndrome can manifest with any of the various concussion symptoms, although it is most commonly associated with several "somatic, emotional, and cognitive deficits." The severity of the initial injury does not appear to be linked to the development of post-concussion syndrome. Nonetheless, a history of previous concussions appears to be linked to the development of PCS.
Second-impact syndrome is one of the most feared and frightening sequelae of a concussion, despite its rarity. Second-impact syndrome (SIS) is caused by a second blow or damage to the head before the previous concussion has fully healed, resulting in fast and severe brain swelling. Though much of the known data and study on the syndrome is anecdotal, SIS has the potential for catastrophic neurologic consequences, including brain herniation and death.
The amount of research on the long-term effects of a concussion is currently minimal. The risk of developing chronic traumatic encephalopathy (CTE) is the most serious issue. Due to recurrent head trauma and tau protein accumulation, this syndrome is characterized by gradual, progressive neurodegeneration.
Memory problems, behavioral or personality changes, and speech or gait issues are also possible symptoms. CTE's total incidence and prevalence are unclear, and it can currently only be identified definitely with a neuropathologic study. Finally, no cause-and-effect link between concussions and CTE has been established.
When should I see a doctor?
If you think you or someone else has symptoms affect consult a doctor immediately If you get a concussion during a sports activity or game, notify your sports coach and see your doctor ASAP.
Concussions can be accompanied by spinal damage. If you suspect someone has injured their back or neck, don't move them. But immediately ask for help. If you must transfer a patient, do so with extreme caution. It's best if you can keep the patient's neck and back as still as possible. This will protect the spine from further harm.
Immediately following a head injury, the differential diagnosis should include potentially serious injuries such as cervical spine damage, cerebral bleeding, or skull fracture. Once the initial injury has passed, the differential diagnosis for post-concussive symptoms alters. The symptoms of a concussion might be confused with those of other chronic diseases, such as:
- Headache disorders or migraines
- Mental health diagnoses such as anxiety, depression, or post-traumatic stress disorder
- Problems with attention such as attention deficit hyperactivity disorder
- Sleep dysfunction
The doctor must determine if a patient's symptoms are caused by a concussion, are the outcome of other pre-existing disorders, or are caused by something else entirely.
The prognosis for a concussion patient is typically positive, with symptoms improving within one to two weeks of the incident. According to previous study, it takes roughly 10 days to recover from a concussion. The 5th International Conference on Concussion in Sports has lowered the projected recovery timescale for sports-related concussions, claiming that most injured athletes recover clinically within a month.
A 2013 expert consensus statement emphasized the need of acknowledging a more varied concussion recovery timetable. The most reliable prognostic indication is the intensity of symptoms in the first few days following a head injury. There is no proven predictor of concussion recovery time at this time, and each patient's expected recovery period should be personalized.
Concussions can occur as a result of a blow to the head, a blow, or a severe blow. It can affect anyone from infants to teenagers to the elderly. The most common symptom is a headache.
Most people recover from all concussions. But symptoms can take months to go away. Others sometimes experience more permanent emotional, mental, or physical changes. Avoiding recurrent concussions is essential because while they are rarely life-threatening, they can increase the risk of irreversible brain damage.