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Head

Concussion

What is a Concussion?

A concussion is a traumatic head injury resulting in a temporary disturbance of brain function. It is caused by a direct bump or blow, or an indirect jolt to the head from a knock to another part of the body. In other words, you don't have to be hit on the head to become concussed!

You don't have to be playing a sport to get a diagnosis of concussion.

Who is most at risk of concussion?

Although it may seem to be synonymous with partaking in some sports anyone can get a concussion. Specifically, children, adolescents and females - 

  • appear to be more susceptible
  • take longer to recover
  • report more symptoms
  • and, in the case of the young, are more susceptible to rare complications like death from a single or second impact whilst suffering from symptoms of concussion.
Less than 10% of concussion cases involves loss of concsiousness.

How do I know it's a concussion?

Diagnosing a concussion is not always straight forward and I don't expect the majority of you out there who are not medically trained to make such a call. It is important though that if you see your friend, student, child, teammate present with any of the following you should be able to recognise that something is wrong and either remove them or tell someone who can remove them from further harm's way: RECOGNISE AND REMOVE

I think it is now common knowledge but it is always worth repeating the fact you don't have to have lost consciousness to be diagnosed with a concussion, so if you see a mechanism that you think may cause the injury, like two heads colliding in a header (soccer), or a person getting up slowly having fallen headfirst off the top of a climbing frame, have an index of suspicion. A concussion can affect your memory, judgement, speech, balance and coordination. Common symptoms include:

  • Headache
  • Dizziness and/or trouble with balance
  • Feeling sick or vomiting (early on)
  • Difficulty concentrating
  • Problem with your memory - forgetful or difficulty remembering
  • Easily irritated by bright lights or noise
  • Feeling more tired than usual
  •  Very commonly you may simply not feel right or feel like you're in a fog.

When should you seek urgent medical care?

A concussion is regarded as a mild traumatic brain injury that most people recover quickly and completely from. Unfortunately, during the early stages, it can be difficult to tell a concussion apart from a more severe brain injury.

You should go to your nearest Emergency Department or call 999 if you have any of the following, or are caring for someone, following a head injury:

  • A severe or worsening headache
  • Slurred speech
  • Weakness, tingling, numbness or decreased coordination in the arms or legs
  • Seizures or convulsions
  • Loss of consciousness - after the initial injury
  • Difficulty waking up
  • Double vision
  • Continuous vomiting

The HEADCASE  (England Rugby) animation provides an overview of what concussion is and how it should be managed. It provides useful information for young people and adults (coaches, parents, teachers etc ) on how they can support a person with a suspected concussion.

What is Post-Concussion Syndrome?

You are said to be suffering from prolonged recovery or post-concussion syndrome if your symptoms have not settled by 3-4 weeks. Over 95% of patients would have recovered by this time.

Post-concussion syndrome is a bit of a misnomer because it assumes it is one diagnosis. Unfortunately, there are a number of things that can be disrupted by mechanical forces that may prolong your recovery:

  • You can have a post-traumatic headache/migraine
  • Vestibular/neuro-ophthalmic (balance controller) disturbance
  • an autonomic nervous system disturbance. This may present as symptoms coming on when you raise your heart rate 
  • or, if it goes on long enough it can result in you developing a mood disorder.

It is important that you are seen by a specialist or multi-disciplinary team experienced at managing complex/prolonged concussions early as each one of these problems can be treated aggressively.

Frequently asked questions:

If you have sustained a head injury it is recommended you seek medical care to confirm a diagnosis and get guidance on how to safely return to school, work or sports. Click here to schedule an appointment with Dr Ade.

I can meet you in Central London or Hertfordshire or via a Zoom video consultation

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