Brain injury - concussion; Traumatic brain injury - concussion; Closed head injury - concussion
A concussion may occur when the head hits an object, or a moving object strikes the head. A concussion is a less severe type of brain injury. It may also be called a traumatic brain injury.
A concussion can affect how the brain works. The amount of brain injury and how long it will last depends on how severe the concussion is. A concussion may lead to headaches, changes in alertness, loss of consciousness, memory loss, and changes in thinking.
A concussion can result from a fall, sports activities, vehicular accidents, assault, or other direct injury to the skull. A big movement of the brain (called jarring) in any direction can cause a person to lose alertness (become unconscious). How long the person stays unconscious may be a sign of how bad the concussion is.
Concussions do not always lead to loss of consciousness. Most people never pass out. They may describe seeing all white, all black, or stars. A person can also have a concussion and not realize it.
Symptoms of a milder concussion can include:
The following are emergency symptoms of a more severe head injury or concussion. Seek medical care right away if there are:
Head injuries that cause a concussion often occur with injury to the neck and spine. Take special care when moving people who have had a head injury.
The health care provider will perform a physical exam. The person's nervous system will be checked. There may be changes in the person's pupil size, thinking ability, coordination, and reflexes.
Tests that may be done include:
For a mild head injury, no treatment may be needed. But be aware that the symptoms of a head injury can show up later.
Your providers will explain what to expect, how to manage any headaches, how to treat your other symptoms, when to return to sports, school, work, and other activities, and signs or symptoms to worry about.
Both adults and children must follow the provider's instructions about when it will be possible to return to sports.
You will likely need to stay in the hospital if:
Healing or recovering from a concussion takes time. It may take days to weeks, or even months. During that time you may:
These problems will probably recover slowly. You may want to get help from family or friends for making important decisions.
In a small number of people, symptoms of the concussion do not go away. The risk for these long-term changes in the brain is higher after more than one concussion.
Seizures may occur after more severe head injuries. You or your child may need to take anti-seizure medicines for a period of time.
More severe traumatic brain injuries may result in many brain and nervous system problems.
Contact the provider if:
Contact the provider right away if the following symptoms occur:
If symptoms do not go away or are not improving a lot after 2 or 3 weeks, talk to your provider.
Not all head injuries can be prevented. Increase safety for you and your child by following these steps:
Do not drink and drive. Do not allow yourself to be driven by someone who may have been drinking alcohol or is otherwise impaired.
Liebig CW, Congeni JA. Sports-related traumatic brain injury (concussion). In: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 708.
McClincy MP, Olgun ZD, Dede O. Orthopedics. In: Zitelli, BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 22.
Papa L, Goldberg SA. Head trauma. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 33.
Trofa DP, Caldwell J-M E, Li XJ. Concussion and brain injury. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 126.BACK TO TOP
Review Date: 11/13/2021
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 04/11/2023.
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