CONCUSSION GUIDELINES AND RECOMMENDATIONS
Concussion Basics
A concussion is a type of traumatic brain injury – or TBI – caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth.
This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells. These changes in the brain lead to symptoms that may affect how a child thinks, learns, feels, acts and sleeps. Symptoms are usually most severe right after the injury.
Concussions should be taken seriously because they can produce changes in your child’s brain, body and behavior. Most children with a concussion feel better within 2 – 4 weeks. However, some children have symptoms that effect their behavior, mood, memory, or emotions for months or longer. Symptoms that stay around can affect children as they grow up and even through adulthood.
Concussion symptoms can make it hard to do regular activities at home and school. Having a history of previous concussions or experiencing more severe symptoms right after the concussion increases the chance that a child will have a longer recovery. A child with multiple concussions also has a greater chance of experiencing chronic health problems later on.
Some mild TBI and concussion symptoms may appear right away, while others may not appear for hours or days after the injury. Symptoms generally improve over time, and most people with a mild TBI or concussion feel better within a couple of weeks.
Signs & Symptoms
Symptoms of mild TBI and concussion may affect how you feel, think, act or sleep.
Symptoms of mild TBI and concussion are different for each person. Symptoms may change during recovery. For example, you may have headaches and feel sick to your stomach earlier on. A week or two after your injury you may notice you feel more emotional than usual or have trouble sleeping.
Physical
- Bothered by light or noise
- Dizziness or balance problems
- Feeling tired, no energy
- Headaches
- Nausea or vomiting (early on)
- Vision problems
Thinking and Remembering
- Attention or concentration problems
- Feeling slowed down
- Foggy or groggy
- Problems with short- or long-term memory
- Trouble thinking clearly
Social or Emotional
- Anxiety or nervousness
- Irritability or easily angered
- Feeling more emotional
- Sadness
Sleep
- Sleeping less than usual
- Sleeping more than usual
- Trouble falling asleep
Complications and when to seek help
Symptoms may be difficult to sort out as they are similar to other health problems.
After a mild TBI or concussion:
- A person may not recognize or admit that they are having problems
- A person may not understand how the symptoms they are experiencing affect their daily activities
- Problems may be overlooked by the person with a mild TBI or concussion, their family members, or their healthcare provider
**Seek immediate emergency medical care if you have danger signs**
Danger signs in adults
In rare cases, a dangerous blood clot that crowds the brain against the skull can develop. The people checking on you should call 9-1-1 or take you to an emergency department right away if you:
- Have a headache that gets worse and does not go away
- Experience weakness, numbness, decreased coordination, convulsions, or seizures
- Vomit repeatedly
- Have slurred speech or unusual behavior
- Have one pupil (the black part in the middle of the eye) larger than the other
- Cannot recognize people or places, get confused, restless, or agitated
- Lose consciousness, look very drowsy or cannot be woken up
Danger signs in children
Call 9-1-1 or take your child to the emergency department right away if they received a bump, blow, or jolt to the head or body, and:
- Have any of the danger signs for adults listed above
- Will not stop crying and are inconsolable
- Will not nurse or eat
Long-term negative effects
People with a moderate or severe TBI may experience chronic health problems. Chronic health problems can lead to medical costs and challenges for people with TBI and their families. Research shows that among those still alive 5 years after a moderate to severe TBI:
- 57% are moderately or severely disabled.
- 55% do not have a job (but were employed at the same time of their injury).
- 50% return to a hospital at least once.
- 33% rely on others for help with everyday activities.
- 29% are not satisfied with life.
- 29% use illicit drugs or misuse alcohol.
- 12% reside in nursing homes or other institutions.
Having a moderate or severe TBI also increases the risk of dying from several causes. Compared to people without TBI, people with a moderate or severe TBI are more likely to die from:
Even after surviving a moderate or severe TBI and receiving inpatient rehabilitation services, a person's life expectancy is 9 years shorter.
The Risks of Playing Sports With A Concussion
Activity With a Concussion
When a concussion is suspected, some athletes and sports players may insist they’re fine and want to get back to the game, even if no symptoms are readily apparent. However, if there was a head impact and the player hasn’t been checked for a concussion, returning to play poses significant risks.
- Second Impact Syndrome: If an athlete sustains a second concussion before the first one has fully healed, it can lead to a rare but potentially fatal condition called second impact syndrome, where rapid brain swelling occurs.
- Prolonged Recovery: Continuing to play with a concussion can prolong the recovery process, causing symptoms to worsen. Ignoring symptoms and returning to play too soon can delay recovery significantly and risk life-threatening conditions.
- Increased Severity of Symptoms: Playing with a concussion can worsen symptoms such as headache, dizziness, nausea, confusion, and sensitivity to light and noise. These symptoms can interfere with performance and increase the risk of further injury elsewhere.
- Increased Risk of Additional Injuries: Concussion symptoms can impair judgment, coordination, and reaction time, increasing the risk of other injuries such as sprains, fractures, or more severe head injuries.
- Long-Term Brain Damage: Multiple concussions, especially if they occur close together, can lead to long-term cognitive impairment, mood disorders, and neurological conditions like chronic traumatic encephalopathy (CTE).
- Decreased Academic Performance: Concussion symptoms can also affect cognitive function, memory, and concentration, which can impact academic performance and daily functioning long-term.
*For further information please visit the Centers of Disease Control and Prevention website at www.cdc.gov/heads-up/