A concussion is a traumatic brain injury (TBI) where the brain moves or twists inside the skull, temporarily disrupting its normal function. While often associated with a direct head blow, this is not always necessary. Forces transmitted through the body can cause the brain to shift or jolt, resulting in a concussion.
How Concussions Occur Without Head Impact
Concussions arise from sudden movements causing the brain to rapidly accelerate, decelerate, or rotate within the skull, even without direct head contact. These forces occur during car accidents, falls, or forceful body impacts. The brain, suspended in cerebrospinal fluid, can collide with inner skull walls. This internal impact stretches and damages brain cells, altering brain function.
Whiplash is a common example of a concussion without direct head impact. In rear-end vehicle collisions, the head and neck are rapidly thrown forward and backward. This sudden motion transmits enough energy to the brain to cause a concussion. The neck acts as a conduit, transferring force to the brain.
Beyond whiplash, indirect forces through the body can also lead to concussions. A hard tackle to the torso, a fall onto the back or buttocks, or a sudden jolt can generate sufficient force to move the brain forcefully inside the skull. Activities like diving or tripping can also result in concussions.
Recognizing Concussion Symptoms
Concussion symptoms vary widely and may not appear immediately. Some signs are evident soon after injury, while others emerge hours or days later. This is important, especially when there has been no obvious head trauma.
Physical symptoms include:
- Headache
- Dizziness and balance problems
- Nausea and vomiting
- Sensitivity to light or noise
- Blurred or double vision
- Ringing in the ears
- Fatigue and feeling unsteady
Cognitive symptoms include confusion, difficulty concentrating, and memory problems. People may feel mentally “foggy” or have trouble thinking clearly. They might ask the same questions repeatedly or show a delayed response. Emotional changes are also possible, such as irritability, mood swings, or increased anxiety. Some may feel sad or depressed.
Sleep-related symptoms include sleeping more or less than usual, or trouble falling asleep. Changes in behavior or personality can also signal a concussion. A temporary loss of consciousness, though often associated with concussions, does not always occur and its absence does not rule out a concussion.
The Importance of Medical Evaluation
Seeking professional medical assessment is important following any suspected concussion, regardless of head impact. Self-diagnosis is insufficient, as the full extent of brain injury may not be immediately apparent. A healthcare provider can properly evaluate symptoms and determine the best course of action.
An undiagnosed or untreated concussion carries risks. Prolonged recovery is a concern, and serious complications can arise. One concern is second impact syndrome, a severe condition if a second concussion is sustained before recovery from an earlier one is complete. This can lead to rapid and severe brain swelling.
Another long-term issue is post-concussion syndrome, where symptoms persist for weeks, months, or even longer after the initial injury. This syndrome involves ongoing headaches, dizziness, and cognitive difficulties, significantly impacting daily life. Early and proper management helps mitigate these risks.
A medical evaluation for a suspected concussion involves a thorough assessment of symptoms, a neurological examination, and possibly other tests. Management principles include physical and cognitive rest, followed by a gradual return to normal activities as symptoms improve. Following medical guidance is important for promoting recovery and preventing further complications.