How is a concussion diagnosed?
There isn't a "test" for concussions, but typically an evaluation at an emergency room will include basic neurological tests and may include neuroimaging tests such as an MRI or CT scan. A concussion does not cause structural injury to the brain, so these scans are used primarily to rule out a more serious injury, especially bleeding inside the skull. An evaluation done immediately following a potential concussion would include an interview of the athlete to check for loss of memory or consciousness, an evaluation using a SCAT (Sideline Concussion Assessment Tool) to check symptoms, attention, memory, balance and coordination. Finally there may be an examination to test strength, reflexes, coordination, mental status and other neurological functions.
There is a lot of information about concussions that some claim to be myths. Can you tell us if this information is true?
- A concussion only occurs when a person is knocked unconscious.
False. The American Academy of Neurology defines concussion as a "trauma- induced alteration in mental status that may or may not involve a loss of consciousness". Only about 10% of concussions involve loss of consciousness.
- If someone has a concussion, do not let them sleep.
False. If the person is tired, let them rest! Their brain needs to heal. The exception to this rule is if the person is showing other signs- extreme fatigue, vomiting, not acting like themselves. In that case, it is best to seek emergency care to ensure there are no other internal injuries.
- A concussion takes two weeks to heal.
True and False. All concussions are different so there is not one time frame to know you have healed properly. Most concussions do resolve in 7-10 days with proper treatment. When symptoms do not resolve within 30 days, post concussive syndrome is usually diagnosed, and in most cases a specialty concussion clinic like NDBC is needed to properly evaluate and design an appropriate treatment plan. Untreated post concussive syndrome can affect memory, physical and emotional functioning for many months to years post injury. Children and teenagers actually recover more slowly due to their developing brain. They are also more prone to complications from concussion.
- It is not safe to give a person that may have a concussion over the counter headache medicine.
True and False. After a concussion is sustained, you do not want to give your athlete any OTC medication that is a blood thinner, such as Advil or Ibuprofen. Parents ask “Can I just give him Advil to make his headache go away?” The answer is NO. These medications will restrict the blood flow to the brain and hide the true symptoms of the concussion. There are a few OTC medications that are acceptable to give your athlete after 24-48 hours of sustained concussion if his/her headache is intolerable. In this case, taking your athlete in for an evaluation is highly recommended. It is very important to consult your physician on proper recommendations before administering any medication.
- An athlete who has had one concussion is more likely to have another than an athlete who hasn't been concussed.
True. Once a person has had one concussion, the threshold for sustaining another concussion is lowered. Also, if a player sustains another blow before he or she is fully recovered the symptoms can be worse and it may take longer to recover.