A concussion is a brain injury caused either by a direct impact to the head, or an impact to the body which transmits a force to the head and results in the brain moving abnormally inside the skull. Signs and symptoms of concussion are a result of the above forces on the brain causing a temporary impairment to normal brain cell function. These changes are at a cellular or microscopic level which is why they do not show up on a CT or MRI brain scan.
The management of concussion is critical to ensure both the short and long term health of the athlete. This is because the brain is more susceptible to further injury when in a concussed state. Premature return to sport leads to a higher risk of repeat or prolonged concussions which can occur at lower impacts than the original one. Such repeated concussions can shorten an athlete’s playing career, and may lead to longer-term neurological impairment.
No two concussions are the same: different concussions will have a different combination of a number of symptoms. Some concussions may have just one or two symptoms while others may have several more. Severity of each symptom can also vary from mild to severe. The combination and timing of symptoms also directs what type of treatment is most appropriate.
About 10% of concussions will lead to a loss of consciousness (i.e. getting ‘knocked out’), but the other 90% don’t. Symptoms of concussion can include lying motionless on the ground or being slow to get up, being unsteady on your feet once up, feeling dazed, ‘seeing stars’, having a blank or confused look, difficulty remembering, sensitivity to light or sound, headache, nausea, dizziness, blurred vision, feeling slowed down, difficulty concentrating , drowsiness, irritability, sadness, anxiousness and sleep disturbance among others.
Not all concussions are easy to detect, and therefore a proper assessment by a suitably experienced medical practitioner is essential. Sometimes symptoms may only start after 24-48 hours, and some symptoms that occur early on can be confused with associated injuries such as neck muscle strain.
Likewise, being guided through the recovery process by a qualified professional is important, due to concussion symptoms often resolving before the brain has fully recovered. A comprehensive return to play protocol ensures you have allowed your brain to recover fully and will significantly reduce the risk of repeated concussions when compared to a premature return.
Trying to assess for the presence of a concussion, and recovering from a confirmed one, can be a tricky and frustrating process for family, teammates, coaches, and most importantly the athlete themselves. With that in mind, as part of the world-renowned UPMC Concussion Network, we have created a service in our city-centre Concussion Clinic to make the entire process from diagnosis to management to return to play as quick and safe as possible.
This is a guide only, as a programme will be created specifically for your needs. Your expected return to play timeframe will be discussed with you at your initial assessment, and will be closely monitored throughout your rehabilitation, with you being kept fully informed throughout.