More people get a concussion than you may think — close to 3 million U.S. Americans each year, according to the Centers for Disease Control and Prevention (CDC). A concussion is a form of mild traumatic brain injury (TBI) that can happen to anyone, from athletes sustaining a hard hit on the field to someone slipping in their bathroom.
While it may seem innocuous right when it happens, concussion effects can last and significantly disrupt your memory, balance, and even mood. Knowing the causes, symptoms, and proper treatment for a concussion, can help alleviate long-term injury and foster recovery.
What is a Concussion?
A concussion is a type of mild traumatic brain injury (TBI) that occurs when the brain rapidly moves back and forth inside the skull from a sudden impact, jolt, or blow to the head. The brain can bounce or twist in the skull, which can cause chemical changes and sometimes damage to brain cells.
Concussions can occur in cases of sports injuries, falls, car accidents, or any other instance of a head injury. Not all concussions are severe; however, they may affect how the brain functions at the moment and produce symptoms of confusion, headache, dizziness, forgetting issues, and sensitivity to light or noise.
Most people will recover from concussions with sufficient rest and medical treatment; however, once a concussion is sustained, there is an increased risk of complications from the concussion or an extended recovery time if the person does not pay attention to the symptoms or returns to regular daily activities.
Symptoms of Concussion
Concussions affect everyone differently: symptoms may develop immediately after an injury, or hours or days later. Symptoms can include a spectrum of confusion, cognitive, physical, and emotional issues, some more serious than others. Early recognition of concussion symptoms is important to facilitate proper individual care and a smooth recovery process.
Common Symptoms in Adults
Adults may notice more distinct physical and cognitive symptoms after a concussion. These may include:
Physical Symptoms:
-Headache or pressure in the head
-Nausea or vomiting
-Dizziness or balance issues
-Blurred or double vision
-Sensitivity to light or noise
-Fatigue or drowsiness
-Ringing in the ears (tinnitus)
-Slurred speech
-Loss of consciousness (sometimes, not always)
Cognitive and Emotional Symptoms:
-Confusion or feeling “foggy”
-Trouble concentrating
-Poor memory
-Slower reaction times
-Irritability, moodiness, or anxiety
-Difficulty sleeping or sleeping too much
-Depression or sadness
Common Symptoms in Children
Children and teenagers may not be able to articulate how they feel all the time, so it is important for parents or caregivers to look for changes in behavior or physical symptoms.
Physical Symptoms:
-Severe headache or pressure in the head
-Vomiting or nausea
-Difficulty walking/stumbling or poor balance
-Tired or fatigued
-Sensitivity to light, noise, or movement
Behavioral and Cognitive Symptoms:
- Appearing dazed, confused, or "out of it"
- Forgetting instructions or recent events
- Crying more easily, being irritable, or having mood changes
- Clinging or withdrawal from previously enjoyed activities
- Difficulty staying focused or completing school tasks
- Changes in sleeping behavior - too much sleep or too little
- Loss of interest in food or appetite
Causes of Concussion
A concussion happens when a blow to the head or sudden movement causes the brain to move quickly in the skull, resulting in a brief interruption of normal brain function. This movement of the brain can stretch or damage brain cells and determine the speed at which messages are passed in the brain.
Concussions can happen to anyone, but some activities and accidents are more likely to cause one.
1. Falls
Falls are the most prevalent cause of concussions, particularly in young children and older adults. That's a slip in the bathroom, a trip down the stairs, or a tumble off a bicycle; the result is a head injury.
2. Sports Injuries
Sports such as football, soccer, basketball, hockey, and boxing, especially high-impact as well as contact sports, can cause concussions. Even with protective headgear, an athlete can suffer a concussion from a sudden hit or collision with a person or object to the head, causing the brain to suddenly move violently.
3. Motor Vehicle Accidents
Whiplash or a direct impact with a hard surface inside a car from a car, motorcycle, or bicycle accident is another common cause of a concussion. Many concussions result from the sudden deceleration of the head, which can cause the brain tissue to impact the inside of the skull.
4. Physical Assault or Violence
Sustaining a blow to the head during a fight, domestic violence, or another form of physical violence may lead to a concussion, a type of injury that can often be dismissed as less serious than other traumas.
5. Blasts or Explosions (Military or Industrial)
Military personnel and workers in the industrial field may be at risk for blast exposure-related concussions, in which pressure waves from blasts affect the brain without any actual mechanical impact to the head.
6. Recreational Accidents
Anything from skateboarding to horseback riding, skiing, or cycling may place someone at risk for a concussion if there is a potential of falling or colliding, especially if proper precautions are not taken for protective equipment.
How Does a Concussion Affect Your Sleep?
Sleep issues are among the most frequent - and most underrated - problems associated with a concussion. The injury affects normal brain function, meaning it can affect the brain’s ability to regulate sleep-wake cycles (or circadian rhythm). As a result, an individual may either oversleep or undersleep their usual amount due to the injury.
1. Trouble Falling or Staying Asleep
Insomnia is common after a concussion, as the brain may now have difficulty "shutting down," resulting in restlessness, racing thoughts, or waking early or frequently at night.
2. Too Much Sleep or Fatigue
Some people, however, report constant fatigue and a tendency to sleep more than usual. This is because the brain is trying to heal, and additional sleep allows the body to conserve energy and recover from the concussion.
3. Disturbed Sleep Schedules
A concussion can disrupt the body’s internal biological clock, leading to inconsistent sleep patterns, increased napping, or difficulty adhering to a regular sleep schedule.
4. Nightmares or Intense Dreams
Post-concussion changes in brain chemistry can lead to heightened dream intensity or nightmares, leading to decreased quality of sleep and increased fatigue or worry during the day.
5. Daytime Fatigue and Lack of Attention
You may feel the effects of not sleeping enough, even if you are getting enough hours of sleep, based on its quality. Individuals report feeling fuzzy or an inability to concentrate or having blackouts, etc., which suggests the brain is not receiving deep restorative sleep.
Why Sleep Is Important Following a Concussion?
The brain's recovery depends on the quality of sleep. During deep sleep periods, the brain removes toxins, repairs cells, and balances neurotransmitters. If sleep is impaired, recovery may slow down, symptoms like headache and mood changes may amplify, and recovery may take longer.
Tips for Better Sleep After a Concussion
- Establish a regular sleep schedule — waking up and going to bed at the same time each day.
- Limit electronic devices (phones, computers, televisions) for at least one hour before bed.
- Make your bedroom dark, cool, and quiet.
- Do not consume caffeine or alcohol, particularly in the evening.
- Consider engaging in relaxation exercises (e.g., deep breathing or meditation) just before sleep.
- If you continue to have difficulties with sleep, discuss with your doctor or neurologist, who may give you a short-term medication or cognitive therapy to re-establish a better sleep cycle.
When To See A Doctor?
While most never cause long-term issues, concussions can seem deceptively mild and still require medical attention. Here are some symptoms that indicate the possibility of brain swelling, internal bleeding, or post-concussion syndrome (PCS), which should result in immediate medical evaluation.
If you see any of the following, seek emergency medical assistance:
- Recurring vomiting or nausea
- A serious or worsening headache
- Loss of consciousness, even briefly
- Difficulty speaking or slurred speech
- Unequal pupil sizes or unusual or jerky eye movements
- Convulsions or seizures
- Weakness, tingling, or difficulty coordinating their movements
- Extreme levels of drowsiness or cannot be woken
- Worsening confusion or unusual behavior
- Fluids or blood draining from the nose or ears
Consult a Physician Promptly If You Have:
- Persistent migraines or dizziness for several days or longer
- Ongoing problems with memory or concentration
- Vision difficulties or sensitivity to light/noise
- Sleep disturbances or extreme fatigue
- Emotional changes, such as irritability, sadness, or anxiety
- Symptoms that are aggravated by physical or mental exertion
For Children and Teens:
Whenever a child sustains a head injury, always go for an evaluation by a physician, even if the symptoms appear mild. Children do not always convey how they are feeling in a clear manner, and more subtle signs such as irritability, sleepiness, or loss of the ability to pay attention may be present.
Final Thoughts
Although a concussion may be labeled a "mild" brain injury, its impact can be far from mild. Symptoms can include headaches and confusion, but they can also affect your sleep, mood, and interfere with daily life; recovery takes time and patience.
If you notice the warning signs early on, seek medical attention, and allow your brain the time it needs to heal, this will help you to safely recover.
Whether the concussion injury happens on the field, on the road, or at home, taking a concussion injury seriously and following the proper treatment can help minimize the risk for long-term complications and ensure that your brain gets the care it needs.
