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A concussion, also referred to as a mild traumatic brain injury, is an injury to the brain caused by a bump or blow to the head. It can also result from a blow to the body that causes a whiplash effect. Concussions change the way the brain works and how a person thinks, acts, and feels. Most people do not lose consciousness. Even a "ding" or "bell ringer" can be serious.
Symptoms fall into three main categories: cognitive or thinking abilities, physical, and mood and behavior. A person may have many symptoms or only a couple of symptoms. Typical concussion symptoms are:
PHYSICAL
Dizziness
Confusion
Headache
Fatigue
Changes in vision or hearing
Sensitivity to light and/or noise
Nausea or vomiting
Sleep problems
COGNITIVE:
Forgetfulness
Trouble remembering what happened
right before and/or right after the injury
Slower thinking
Difficulty concentrating or staying focused
Trouble remembering recent information
Trouble understanding language
MOOD and BEHAVIOR:
Irritability
Depression
Anxiety
Mood swing
Impulsivity
Defiance
Low frustration tolerance
Changes in friendships
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Most concussions resolve fully within a few weeks but sometimes it can take months or longer. Getting plenty of rest, both mental and physical, and maintaining a good nighttime sleep pattern, are important after a concussion. Exertion can make symptoms worse. Immediately after a concussion, you should avoid activities such as physical education (PE), sports practices, weight-training, riding a bike, skateboarding, running, exercising, heavy lifting, and amusement park rides. Tasks that involve deep concentration should also be avoided such as video games, computer use, texting, television, reading, writing, and schoolwork. Your doctor will advise you as to when you can resume these activities.
Gradual return to activities
For both mental and physical activities, gradually reintroducing them back into your life will help you avoid making symptoms worse or prolonging your recovery. Depending on one’s progress, a gradual return to school may be necessary. This may mean no school at all, a shorter school day, or frequent breaks throughout the day. There should also be a gradual increase in time spent on activities like texting, playing video games, using the computer, and completing homework. Ask your doctor about a gradual return to mental activity program.
Gradual return to play
Your doctor will probably also recommend a gradual return to play/physical activity. The Consensus Statement on Concussion in Sport (Clinical Journal of Sport Medicine 2009; 19:185-200) provides guidelines for a graduated return to play. You should not participate in any physical activity until you have been cleared by your doctor.
We understand that it can be very difficult for a student to miss school, especially in high school. However, trying to do too much too soon can slow recovery, make symptoms worse, and have a negative effect on grades and performance. Slowed processing speed, fatigue, trouble concentrating, and short-term memory problems are the most common cognitive complaints following a concussion. These cognitive symptoms can be made worse by physical symptoms like headaches, fatigue, sensitivity to noise and light, and changes in sleep patterns. It is important that family members, school personnel, and others who interact with the concussed youth understand that he or she may have difficulty:
Paying attention or concentrating on one thing for long
Understanding what is said to them or what they have read
Quickly transitioning between tasks or activities
Working on more than one thing at a time
Staying alert and energized throughout the day
Remembering things that he or she recently heard, saw, or learned
Remembering things from the past without a cue or reminder
Staying organized and keeping track of activities, assignments, and appointments
Taking notes while listening
Thinking quickly, following conversations, and responding to questions
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