“After enough concussions the head injuries blur together.” - James Nicoll
Traumatic brain injuries are a significant public health problem, with an estimate of 1.6 to 3.8 million injuries each year in the United States. In just the recent decade, more information and discussion has begun to evolve surrounding concussions, symptoms of concussions, and short and long term impacts of concussions. The public became more aware of concussions in the context of football after Will Smith’s brilliant portrayal of Dr. Bennet Omalu in the 2015 movie, “Concussion.”
Unfortunately, and despite Hollywood’s depiction of concussions, many people are still unaware of the most common symptoms and treatment options for concussions. In this blog entry, we will take a look at concussions, the most common symptoms to watch out for that are associated with concussions, and some helpful tips to follow after receiving a concussion diagnosis.
What is a concussion?
Concussion is the word used to describe traumatic brain injuries (TBI) that result from trauma to the head. Concussions can also occur with violent shaking and movement of the head or body. A person does not have to lose consciousness to get a concussion or experience persistent post-concussive symptoms. In fact, the risk of developing persistent post-concussive symptoms doesn't appear to be associated with the severity of the initial injury. Symptoms can range from minimal and non-existent to severe and debilitating.
What is post-concussion syndrome?
Post-concussion syndrome (PCS) is a collection of symptoms that some people develop after they have had a concussion and may last weeks, months, or years.
10 common symptoms associated with concussions:
Headaches: Persistent headaches following a concussion are called “post-concussion headaches.” Post-concussion headaches can vary and may feel like tension-type headaches or migraines. Most often, they take the form or resemble tension-type headaches. These may be associated with a neck injury that happened at the same time as the head injury. A 2017 study found that 51 percent of people with a TBI experience headaches within the following 2 weeks. After 3 months, 23 percent had persistent headaches. Persistent headaches were more common in women and in people who visited the emergency department for headaches.
Sleep Disturbance: People with concussions often report that they are excessively sleepy in the first week following injury and may report taking daytime naps. However, 2 to 3 weeks after their injury, they may report difficulty falling asleep or early morning awakenings, which in turn may be fueling daytime fatigue.
Difficulty Concentrating: People, particularly student athletes, who have sustained a concussion may not immediately recognize their ability to concentrate has changed. There are often no physical signs to suggest a problem exists. This can lead to misunderstandings when others perceive an inability to concentrate as a lack of interest or motivation. This problem is of particular concern with children who return to the classroom after a concussion. Concentration problems can inhibit the ability to learn, remember, and recall information, causing people to feel frustrated with themselves and others. They may be easily overwhelmed and confused, which can exacerbate problems related to fatigue, headaches and dizziness.
Appetite Changes: It is not uncommon after a concussion for people to have a change in their appetite, food sensitivity, or to experience other gastrointestinal issues.
Fatigue: Following a concussion, many people complain of feelings of exhaustion or fatigue that they just can’t shake. This fatigue is often categorized as both physical and mental. Some have compared their fatigue to a feeling of being drained after staying up too late while others have said it’s like waking up the next day after running a marathon. Mentally, many people say they become exhausted quickly, even with previously simple tasks like having conversations with others.
Depression: It is not uncommon for people to suffer from depression days, weeks, or several months after suffering a concussion. Depression is a common problem after TBI. About half of all people with TBI are affected by depression within the first year after injury. Even more (nearly two-thirds) are affected within seven years after injury. In the general population, the rate of depression is much lower, affecting fewer than one person in 10 over a one-year period.
Anxiety: Following a concussion, it is normal to feel intense stress. But sometimes stress can build up and lead to anxiety. The main symptoms of anxiety are fear and worry. Anxiety can impact a person’s daily life and may obstruct their rehabilitation. During the early stages of recovery after a concussion, people may experience feelings of anxiety as the person comes to terms with changes to their cognitive abilities and personality. As time goes on, people with a more severe injury may become anxious as they begin to appreciate the extent of their long-term disability and feel apprehensive about the future.
Light and Sound Sensitivity: Light and sound sensitivity are common after a concussion and typically a result of dysfunction to the cerebellum, frontal lobe or a result of inflammation. Some experts have suggested that as many as 43% of individuals experience ongoing light sensitivity after a concussion, although that number could be even higher depending on other risk factors. Many people find that it can be difficult to go out in public following a concussion due to the loud sounds, such as city streets and sirens, malls, and school hallways.
Dizziness: Acute dizziness is a commonly-reported problem following concussion, so much so that there are multiple clinical definitions that include it as an identifying sign of post-concussion syndrome. Evidence has suggested that up to 80% of those who sustain a concussion frequently report vertigo in the first few days after a head injury, and it can often last up to a week or more. On the other hand, post-concussive dizziness can persist for weeks or months after the trauma, and even become a chronic problem in one out of five patients—with some reporting symptoms for 2 to 5 years or even longer.
Memory Problems: According to the brain injury information organization Model Systems Knowledge Translation Center (MSKTC), the common perceived notion of amnesia rarely happens following a concussion. More commonly, people exhibit short term memory (trouble learning and remembering new information, recent events, or what’s happening from day to day) and prospective memory (remembering to remember) following a concussion.
What are some easy and helpful tips to remember after suffering from a concussion?
Don’t rush back - it is generally advised that anyone who has had a head injury should take things slowly. If possible, try to return to your usual activities gradually after a head injury.
Sleep hygiene - if you are having problems sleeping and are feeling very tired, try to stick to a regular schedule.
Medication to help symptoms - your doctor may suggest some medication to help some of the symptoms of post-concussion syndrome, such as: Amitriptyline, Zofran, Tylenol PM, or similar.
Keep your stress levels down.
Avoid alcohol and recreational drugs.
Avoiding activities that worsen symptoms such as: screens and television, loud sounds or music, and similar.
Activities such as driving should be reviewed with your doctor.
As always, our concussion specialists and sports medicine team are happy to see and treat patients of all ages who have been diagnosed with a concussion or who may suspect a concussion following a head injury. Give us a call today for your concussion evaluation to get you back on the road to recovery as quickly and safely as possible! 1-844-999-3627.