Concussions

Your brain has the consistency of gelatin. It's cushioned from everyday jolts and bumps by cerebrospinal fluid inside your skull.

A violent blow to your head and neck or upper body can cause your brain to slide back and forth forcefully against the inner walls of your skull.

Sudden acceleration or deceleration of the head, caused by events such as a car crash or being violently shaken, also can cause brain injury.

These injuries affect brain function, usually for a brief period, resulting in signs and symptoms of concussion.

This type of brain injury may lead to bleeding in or around your brain, causing symptoms such as prolonged drowsiness and confusion. These symptoms may develop immediately or later.

Such bleeding in your brain can be fatal. That's why anyone who experiences a brain injury needs monitoring in the hours afterward and emergency care if symptoms worsen.

A concussion is a traumatic brain injury that affects your brain function. Effects are usually temporary but can include headaches and problems with concentration, memory, balance, and coordination.

Concussions are particularly common if you play a contact sport, such as football. Most people usually recover fully after a concussion. Older people or those who have balance or falling issues may be susceptible to concussions.

Semmes Murphey physicians are particularly skilled and experienced in diagnosing and treating concussions.

In fact, we have a multi-disciplinary Concussion Management Team, which includes specialists in the areas of clinical neurology, neuropsychology, neuroradiology, neurosurgery, physiatry, and physical therapy.

To ensure optimum treatment for concussed patients, the team works closely to assess the possible concussion, amount of damage, if any, and determine an appropriate plan for treatment.

We also work closely with parents, coaches, athletic trainers, employers, and/or school officials to develop an appropriate return-to-work, return-to-school, or return-to-play plan.

Currently, our clinical staff consults with various local high schools (including Memphis University School, Hutchison School, St. George’s Independent School, St. Agnes Academy, and Christian Brothers High School), universities (including University of Memphis and Rhodes College), semi-pro leagues (Mississippi River Kings), and pro teams (Memphis Grizzlies), in the assessment and treatment of possible sports concussions.

The signs and symptoms of a concussion can be subtle and may not show up immediately. Symptoms can last for days, weeks or even longer.

Common symptoms after a concussive traumatic brain injury are headache, loss of memory (amnesia) and confusion. The amnesia usually involves forgetting the event that caused the concussion.

Symptoms may include:

• Headache or a feeling of pressure in the head
• Temporary loss of consciousness
• Confusion or feeling as if in a fog
• Amnesia surrounding the traumatic event
• Dizziness or "seeing stars"
• Ringing in the ears
• Nausea
• Vomiting
• Slurred speech
• Delayed response to questions
• Appearing dazed
• Fatigue

You may have some symptoms of concussions immediately. Others may be delayed for hours or days after injury, such as:

• Concentration and memory complaints
• Irritability and other personality changes
• Sensitivity to light and noise
• Sleep disturbances
• Psychological adjustment problems and depression
• Disorders of taste and smell
• Symptoms in children

Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they can't describe how they feel.

Concussion clues may include:

• Appearing dazed
• Listlessness and tiring easily
• Irritability and crankiness
• Loss of balance and unsteady walking
• Crying excessively
• Change in eating or sleeping patterns
• Lack of interest in favorite toys

The American Academy of Pediatrics recommends that you call your child's doctor for anything more than a light bump on your child's head.

See a doctor within 1 to 2 days if you or your child experiences a head injury, even if emergency care isn't required.

If your child doesn't have signs of a serious head injury, remains alert, moves normally and responds to you, the injury is probably mild and usually doesn't need further testing.

In this case, if your child wants to nap, it's OK to let him or her sleep. If worrisome signs develop later, seek emergency care.

Seek emergency care for an adult or child who experiences a head injury and symptoms such as:

• Repeated vomiting
• A loss of consciousness lasting longer than 30 seconds
• A headache that gets worse over time
• Changes in his or her behavior, such as irritability
• Changes in physical coordination, such as stumbling or clumsiness
• Confusion or disorientation, such as difficulty recognizing people or places
• Slurred speech or other changes in speech

Other symptoms include:

• Seizures
• Vision or eye disturbances, such as pupils that are bigger than normal (dilated pupils) or pupils of unequal sizes
• Lasting or recurrent dizziness
• Obvious difficulty with mental function or physical coordination
• Symptoms that worsen over time
• Large head bumps or bruises on areas other than the forehead in children, especially in infants under 12 months of age

Athletes should never return to play or vigorous activity while signs or symptoms of a concussion are present.

If a concussion is suspected the athlete should not return to play until he or she has been medically evaluated by a health care professional trained in evaluating and managing concussions.

Children and adolescents should be evaluated by a health care professional trained in evaluating and managing pediatric concussions.

Adult, child and adolescent athletes with a concussion also should not return to play on the same day as the injury.

You can help prevent or minimize the risk of head injury by:

• Wearing protective gear during sports and recreational activities. Make sure the equipment fits properly, is well-maintained and worn correctly. Follow the rules of the game and practice good sportsmanship.
• Buckling your seat belt: Wearing a seat belt may prevent serious injury, including head injury, during a traffic accident.
• Making your home safe: Keep your home well-lit and your floors free of anything that might cause you to trip and fall. Falls around the home are a leading cause of head injury.
• Protecting your children: To help lessen the risk of head injuries to your children, block off stairways and install window guards.
• Exercising regularly: Exercise regularly to strengthen your leg muscles and improve your balance.

Semmes Murphey has a multi-disciplinary Concussion Management Team, represented by specialists in the areas of clinical neurology, neuropsychology, neuroradiology, neurosurgery, physiatry, and physical therapy. To ensure optimum treatment for concussed patients, the team works closely to assess possible concussions and determine an appropriate plan for treatment.

Our process may include, but are not limited to:

• Outpatient neurologic examination
• Vestibular assessment/intervention
• Neurocognitive testing
• Neuroimaging (MRI)
• Neurophysiologic assessment (EEG, EMG)

If you are a sports educator, coach or trainer and would like further information and training, please contact the Concussion Management Team at Semmes Murphey Clinic.

This information was created and provided by the specialists at Semmes Murphey Clinic. Readers are encouraged to research trustworthy organizations for information. Please talk with your physician for websites and sources that will enhance your knowledge and understanding of this issue and its treatment.