A hard hit, sudden fall or sharp jolt might not always seem serious. But when the brain gets shaken, it can result in a concussion -- an injury that often goes unnoticed or underestimated.
“A concussion is a type of traumatic brain injury (TBI) that occurs when a sudden impact or jolt to the head or body causes the brain to move rapidly within the skull,” said Dr. Justin Williams, Emergency Medicine Physician and Chief of Staff at Methodist Hospital | Stone Oak.
This movement can disrupt normal brain function, leading to various symptoms.
Concussions can result from various incidents. Williams said some of the most common causes doctors see include sports injuries, falls -- particularly in older adults and children, car wrecks, physical assault and explosive blasts -- especially in the military.
Potential dangers and symptoms
While some might view concussions as a minor injury, Williams emphasized their seriousness.
“They can have significant effects on physical, cognitive and emotional health. Symptoms can appear immediately or develop over hours or days after the injury.”
Common symptoms include:
- Physical: Headaches, dizziness, nausea or vomiting, sensitivity to light or noise, blurred or double vision and fatigue.
- Cognitive: Confusion or feeling “foggy,” difficulty concentrating or remembering, and slowed thinking or response time.
- Emotional and behavioral: Mood swings, irritability, anxiety or depression.
- Sleep-related: Trouble falling or staying asleep, or changes in sleep patterns.
Risk factors
Certain factors can increase the likelihood of developing symptoms or experiencing prolonged recovery from a concussion. These include:
- Age: Children and adolescents have developing brains that are more susceptible to the effects of a concussion and may take longer to recover. Older adults may have pre-existing conditions or slower healing processes that contribute to prolonged symptoms.
- Previous concussions: Having a history of one or more concussions increases the risk of more severe symptoms or prolonged recovery in subsequent concussions.
- Gender: Some studies suggest that females may experience more severe symptoms and longer recovery times in subsequent concussions.
- Type and severity of injury: High-impact or repetitive injuries, such as in contact sports or motor vehicle accidents, can lead to more severe symptoms.
- Pre-existing medical conditions: Conditions like migraines, depression, anxiety or ADHD can exacerbate symptoms or prolong recovery. Sleep disorders can also affect recovery.
- Genetic factors: Some genetic predispositions may influence susceptibility to concussion symptoms and recovery time.
- Lifestyle factors: Lack of proper rest or returning to activities too soon can worsen symptoms or prolong recovery. Poor nutrition or hydration can also negatively affect healing.
- Substance use: Alcohol or drug use around the time of injury may worsen outcomes.
- Psychosocial factors: High levels of stress, lack of social support or certain personality traits may influence symptom severity or duration.
- Mechanism of injury: Injuries involving rotational forces or direct blows to the head are often associated with more severe symptoms.
- Diagnosis and management: Delayed diagnosis or inadequate management of the concussion can lead to worsened outcomes or prolonged symptoms.
When to seek emergency care
“It’s crucial to know when to seek emergency medical care for a suspected concussion, as some symptoms may indicate a more serious brain injury, such as a skull fracture or brain bleed,” Williams said.
You should go to the ER immediately if any of the following symptoms occur:
- Severe or worsening symptoms: Persistent or worsening headache, repeated vomiting, loss of consciousness (even briefly), or increasing confusion or ability to stay awake.
- Neurological signs: Difficulty speaking, slurred speech, trouble understanding speech; weakness, numbness or tingling in the arms or legs; difficulty walking or clumsiness; seizures or convulsions; vision or sensory changes; unequal pupil sizes or pupils that don’t react to light.
- Behavioral or emotional changes: Unusual behavior, extreme irritability or restlessness.
- Signs of skull fracture or brain bleed: Clear fluid or blood draining from the nose or ears, bruising behind the ears or around the eyes, or a soft spot on the skull.
Williams said early intervention can make all the difference in managing a concussion or other serious brain injuries.
“If you’re unsure whether symptoms are serious, it’s always better to be on the safe side and seek medical attention. Prompt evaluation by a health care provider can rule out severe injuries and guide proper treatment.”
Methodist Healthcare offers hospital-based and neighborhood ERs throughout San Antonio. Visit SAHealth.com/ER to find the location nearest you.
What to do and what not to do while waiting for medical help
Williams said during the time between the injury and getting an injured person to an ER, you should monitor the injured person closely, keep them calm, support their head and neck, ensure they stay awake and prepare for the ER visit.
“Keep an eye on the person’s symptoms, check regularly to ensure they can be roused easily, and make a list of symptoms, medications and details about the injury to share with the health care providers,” Williams directed.
Conversely, there are a few things Williams recommended avoiding before getting to an ER.
“Avoid giving ibuprofen or aspirin, as they could increase bleeding risk,” he said. “And do not allow the person to engage in any physical exertion.”
He also advised to avoid alcohol or drugs, and the person should avoid food or drink to reduce the risk of choking.
Treatment and recovery
“The treatment for a concussion primarily involves rest and symptom management to allow the brain to heal,” Williams said
Though each case is unique, typical concussion treatment strategies include:
- Initial rest (24–48 hours): Avoid physical and cognitive activities to support recovery and prioritize good sleep hygiene.
- Gradual return to activities: After the initial rest period, gradually reintroduce activities under the guidance of a health care provider.
- Symptom management: Use acetaminophen for headaches and stay hydrated to manage nausea. Patients should also establish a regular sleep schedule, avoid caffeine and screens before bedtime, and break tasks into smaller steps to allow more time to complete them.
- Monitor symptoms: Track progression. “While mild symptoms often improve within a few days to weeks, seek medical attention if symptoms worsen or persist beyond expected recovery times,” Williams said.
- Avoid risk factors for re-injury: Avoid activities with an elevated risk of falls or impacts until fully recovered. The person should not return to sports or physically demanding activities until after they have medical clearance.
Patients should also avoid alcohol, drugs, excessive screen time and driving until a doctor clears them.
Williams said medical follow ups are necessary post-concussion.
“They are essential to monitor recovery and adjust treatment as needed.”
Concussion recovery varies by individual. However, most people recover fully within a few weeks to months with appropriate care.
Consequences of untreated concussions
If a concussion is left untreated, it can lead to several potential complications and long-term effects, especially if the patient does not take the necessary precautions during recovery.
Williams warned there could be symptoms like headaches, dizziness, fatigue and mood changes that can persist for weeks or months.
There is also a risk of second impact syndrome, a rare but serious condition where a second concussion occurs before the first has healed.
Other potential complications include memory and concentration problems, as well as emotional instability, all of which can affect work, school and daily life.
A person could also experience chronic headaches or migraines and balance issues.
“They also face a risk of chronic traumatic encephalopathy (CTE), a progressive neurodegenerative condition linked to repetitive head injuries,” Williams warned. “This can come with memory loss, impaired judgment, depression, aggression and, eventually, dementia.”
All of these can ultimately lead to a reduced quality of life.
“These can interfere with daily activities, relationships and the ability to work or study effectively, leading to social isolation and decreased overall well-being,” Williams said.
Understanding concussions is crucial for prevention, timely intervention and effective management. If you suspect a concussion, prioritize safety and seek medical attention promptly to ensure the best possible outcome. Early intervention can make all the difference in managing a concussion or other serious brain injuries.
Click or tap here to learn more about emergency care at Methodist Hospital | Stone Oak.