What is a concussion?
Whether it happens on the field, on the highway, or in battle, a concussion is a mild form of traumatic brain injury caused by a blow or jolt to the head or body that causes the brain to move back and forth inside the skull. This sudden movement can result in the brain hitting the front and back of the skull or twisting within the skull. That movement can damage the brain tissue on a molecular level and disrupt normal cognitive function.
Concussion symptoms usually fall into four categories:
- Physical: Headache, dizziness, fatigue, impaired balance
- Cognitive: Difficulty with memory, concentration, focus
- Emotional: Anxiety, irritability, mood changes
- Sleep: Difficulty falling asleep/staying asleep, disturbed sleep patterns
When to go to the Emergency Department
If you observe any of the following red-flag concussion symptoms, please go to an Emergency Department immediately for a medical evaluation:
- Loss of consciousness
- Seizures or convulsions
- Repeated vomiting or nausea
- Increasing confusion or dizziness
- Drowsiness or inability to waken from sleep
- Pupils that are unequal in size
- Slurred speech
- Weakness or numbness in arms or legs
- Clear, watery discharge from the nose or ears, or bloody discharge from the ears
- Severe or worsening neck pain
When and why to see a specialist
Generally, the symptoms of a concussion largely resolve within two weeks. When symptoms are still present after two weeks, it may be helpful to consult with a neurologist who specializes in the assessment and care of concussions.
The first step in determining why symptoms aren’t going away is to review a patient’s background. Prior concussion, depression, anxiety, medication use, sleep disturbance or other chronic health conditions can slow recovery or even masquerade as concussion symptoms.
What is neuropsychological assessment and when is it helpful?
A neuropsychological evaluation will assess memory, attention, problem solving and other cognitive skills to see how the brain is functioning after the injury. Personality and mood measures can also illuminate any psychological factors that may be influencing recovery. Results of this evaluation will help identify ongoing cognitive impairments and specify what abilities have been most affected. Repeat testing can be useful to document improvement over time. A neuropsychological assessment can help determine when it’s safe for an individual to return to their normal routines (e.g., school, sports).