by MARK SHALAUTA, MD; Scripps Clinic, Rancho Bernardo

Wrapping Your Head Around Concussions

1. No two concussions are the same.
A concussion, usually caused by a blow to the head or violent shaking, is a head injury that can cause physical symptoms and neurological damage. Symptoms may include headache, nausea, vomiting, sleep changes, balance or visual issues, memory or cognitive problems, and emotional changes. Concussions do not always lead to loss of consciousness – in fact, most people never pass out. This is commonly referred to as “getting your bell rung.” That’s why some people can suffer a concussion and not realize it. Others may describe seeing all white, all black, or “stars” upon impact. Younger children may have delayed symptoms.

2. Concussion can happen many ways, in many places.
Although contact sports such as boxing and football have received a lot of attention due to their risk of head injuries, concussions can occur on and off the playing field, among children and adults. Common causes include falls, playground injuries, car accidents, and bike accidents. An indirect “jarring” of the head can also cause concussions. Other high-risk activities include cheerleading, hockey, soccer, skiing, and snowboarding. Warning signs and symptoms that need medical attention include worsening headaches, seizures, persistent vomiting, drowsiness, slurred speech, and severe confusion.

3. One concussion can lead to another.
Those diagnosed with one concussion are far more likely to be diagnosed with another concussion in the future. In fact, a previous incidence of concussion is the number one predictor for future concussions. In particular, sustaining a second concussion during the healing period of a previous concussion may cause serious long-term problems, including chronic difficulty with concentration, memory trouble, headache, and physical impairment, such as problems maintaining balance.

4. When in doubt, sit it out.
The American Academy of Neurology recommends that every athlete suspected of having a concussion should immediately be removed from play and not allowed to return until free of symptoms and cleared by a health care professional trained in concussion management. In the past, athletes were often mistakenly allowed to return to the game after a “mild” head injury that didn’t cause loss of consciousness, but today experts agree there is no such thing as a “small” concussion. Every blow to the head is potentially serious and should be treated conservatively.

5. Rest and let your brain heal.
Physical and mental rest is very important following a concussion because it helps the brain heal. You’ll need to be patient because healing takes time. This can take days, weeks, or sometimes even months. Only when your symptoms have reduced significantly should you slowly return to your daily activities such as work or school. If your symptoms return or you experience new symptoms as you become more active, this is a sign that you are pushing yourself too hard. Stop these activities and take more time to rest and recover. With time and proper medical management, you can expect to gradually feel better.

scripps02Mark Shalauta, MD, is a family medicine physician at Scripps Clinic in Rancho Bernardo. Dr. Shalauta treats patients of all ages with a variety of medical needs.

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