A traumatic injury to the brain that alters mental status or causes other symptoms is called a concussion. If they have not lost consciousness many people assume they do not have a concussion. The fact is that significant injury can occur without losing consciousness in many cases. Boxers, wrestlers and football players often say "I just got my bell rung" when a blow to the head causes ringing in the ears. However, those symptoms are often consistent with concussion. A concussion may, if left undiagnosed, place an athlete at risk of developing second impact syndrome. This is a potentially fatal injury that occurs when an athlete sustains a second head injury before a previous head injury has completely healed.
At such time when the athlete is symptom free, not taking any medication for symptom control, and has normal cognitive levels evidenced by computer neurocognitive testing can the athlete be placed on a return-to-activity protocol as concussion is treated symptomatically. Treatment goals are to control symptoms, prevent the cumulative effects of concussion, prevent Second Impact Syndrome, and prevent Post-Concussion Syndrome. The primary care of first line treatment is mental and physical rest that includes refraining from things that can challenge the vestibular and cognitive system such as texting, video games or long periods of reading. Every individual patient will have a treatment plan tailored to their needs.
A health care physician may conduct several tests to evaluate your thinking (cognitive) skills during a neurological examination. Testing may evaluate several factors, including your concentration, memory and ability to recall information. People with symptoms such as severe headaches, seizures, repeated vomiting or symptoms that are becoming worse may be recommended for brain imaging. A brain imaging scan may discover whether the injury is severe and has caused bleeding or swelling in your skull.
The standard test to assess the brain right after injury is a cranial computerized tomography (CT) scan. The CT scan uses a series of X-rays to obtain cross-sectional images of your skull and brain. To identify changes in your brain or to diagnose complications that may occur after a concussion magnetic resonance imaging (MRI) may be used. The MRI uses powerful magnets and radio waves to produce detailed images of your brain.
The increasing awareness of concussions in sport are an area of much discussion. Without doubt it is imperative that individuals with a suspected concussion are removed from play until they can be medically evaluated and do not return until they are cleared to do so. Thankfully the good news is that most people recover well following a concussion when managed appropriately. Full awareness of the signs and symptoms of concussion, and the appropriate initial management when a concussion may have occurred, are of utmost importance for each patient.