Concussions

Approximately 1.74 million people sustain a traumatic brain injury (TBI) in the United States every year. The incidence may be higher since so many injuries are unreported. Most TBI in adults are due to motor vehicle accidents and falls. Falls are more common in the elderly and motor vehicle accidents are the greatest cause in the young. Recreational accidents and sports injuries are also important causes in the younger population. In football, 10% of college players and 20% of high school athletes sustain brain injuries each year.

The hallmark symptoms of concussion are confusion and amnesia, sometimes with, but often without, preceding loss of consciousness. The amnesia almost always involves loss of memory for the traumatic event but frequently includes loss of recall for events immediately before (retrograde amnesia) and after (anterograde amnesia) the head trauma. TBI may cause a seizure disorder. Slow bleeding around the brain may lead to a space occupying blood clot.

Mild TBI and concussion may be unrecognized by both the injured and non-medically-trained observers, particularly if there is no loss of consciousness. There are standardized assessment tools to assess cognitive function. Imaging, such as CT or MRI, may be used to determine injury.

At the least, a responsible person must carefully observe a patient with TBI for 24 hours. More careful observation is possible in the hospital. The prognosis for complete recovery is good for an appropriately managed concussion. Nonetheless, there are a variety of short and long-term sequelae that have important implications. Close medical follow-up is essential.

For more information from The Mayo Clinic

A sample post-concusion worksheet