When concussion is serious and what to do if you think you or someone is concussed.
Reviewed by Jeni Worden
If you or someone else sustains a head injury it can be pretty scary. While not all head injuries are serious, sometimes it results in concussion. This can vary from mild concussion to severe, so it’s important to be aware of the signs and symptoms of concussion and when to visit A&E.
We look at the causes, symptoms and treatment of concussion, and establish when it’s a cause for concern:
What is concussion?
Concussion is a disturbance of function of the nerve cells in the brain as a result of a blow to the skull. This means that parts of the brain’s functions are temporarily ‘on hold’. It is common after a blow to the head – perhaps during a fall or sports injury – and the least dangerous type of brain injury.
What are the symptoms of concussion?
Signs of concussion usually appear shortly after a head injury but delayed symptoms can occur, so if you or someone you know does experience a head injury, keep an eye out for a few days. The signs and symptoms of concussion can include the following:
- Loss of consciousness
- Feeling dizzy
- Memory lossor confusion
- Trouble with balance
- Sudden mood swings
- Struggling to stay awake
- Blurred vision Nausea and vomiting
If you experience any of the above symptoms or you’re not sure if you need medical assistance, call NHS 111 for advice.
Is concussion serious?
An uncomplicated concussion is not dangerous and there is no specific treatment. Rest and avoiding exertion is all that is usually needed. Complications can arise in severe cases of injury to the head.
An uncomplicated concussion is not dangerous and there is no specific treatment.
A blow to the head can cause a tear of a blood vessel under the skull and thereby cause a growing accumulation of blood that will gradually cause the brain to become displaced. This condition is life threatening if the blood accumulation is not drained by drilling a hole in the skull.
A very serious concussion, with several days of unconsciousness, is also dangerous owing to the risk of the brain swelling.
What to do if someone is concussed
If the patient only has mild symptoms, it’s most likely not a severe case and rest is all that is needed. However, the doctor should be contacted in the following circumstances:
- If the patient is unconscious for more than a couple of minutes.
- If the patient, after having regained consciousness, becomes sleepy and hard to converse with.
- If the patient’s condition worsens after improvement.
- If the patient vomits – although this is common in children under 12 years old.
- If the patient has a fit or seizure.
- If there is amnesia (memory loss for events either before or after the injury).
- If they experience loss of balance or weakness in an arm or leg.
- Slurred speech.
- Clear fluid leaking from the ears or nose.
- If the patient has been taking recreational drugs or alcohol.
- If the patient has a wound to their face or head.
How a doctor treats concussion
The doctor will admit the patient to hospital for observation and tests, including a CT scan if they have any of the above symptoms. If the head injury does not cause the more serious symptoms outlined above, or the CT scan is normal, then a minor head injury or concussion will be diagnosed and the patient can usually go home with supervision from an adult for 48 hours plus written and verbal head injury instructions.
The doctor will admit the patient to hospital for observation and tests, including a CT scan.
The exceptions to this would be an older person over 65 years old, someone who has had previous brain injury or surgery and patients with a blood clotting problem, such as haemophilia, or on blood thinning medication, such as warfarin. These patients are more at risk of developing complications from their head injury, such as bleeding in to the brain, and might need a longer period of observation in hospital.
Treatment for concussion at home
Usually concussion symptoms disappear gradually after a few days or a few weeks. Some points to remember to get plenty of physical rest and hard physical activity should be avoided in the first week and there should be a gradual return to sporting activities.
In general, the patient should be looked after by an adult for 12 to 24 hours after the incident. Initially every half an hour, then at longer intervals, the patient should be asked to repeat something simple like their name and address, and also checked at night to make sure they can be roused, without having to be fully woken.
Concussion and risk of permanent injury
By its nature, concussion is a minor injury of the brain and a full recovery should be made. There is a small risk of developing epilepsy after a concussion. The risks are particularly high when the concussions occur repeatedly, ie in boxers.
By its nature, concussion is a minor injury of the brain and a full recovery should be made.
‘Post concussion’ syndrome more commonly follows a mild head injury and includes: headaches, dizziness, difficulty in breathing, depression and anxiety. This syndrome can develop even if brain damage is minimal or absent on investigation. All head injury patients require adequate medical assessment and for any other than minor injuries, this should be by a consultant in trauma medicine or a neurologist.