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Texas Emergency Management ONLINE 2018 Vol. 65 No. 3

Heads Up: Concussions

Concussion Overview

A concussion is a traumatic brain injury that affects your brain function. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. Concussions are usually caused by a blow to the head. Violently shaking the head and upper body also can cause concussions. Some concussions cause you to lose consciousness, but most do not, so it's possible to have a concussion and not realize it. Concussions are particularly common if you play a contact sport, such as football. Most people usually recover fully after a concussion.

Causes of Concussions

Your brain has the consistency of gelatin. It's cushioned from everyday jolts and bumps by cerebrospinal fluid inside your skull. A violent blow to your head and neck or upper body can cause your brain to slide back and forth forcefully against the inner walls of your skull. Sudden acceleration or deceleration of the head, caused by events such as a car crash or being violently shaken, also can cause brain injury.

These injuries affect brain function, usually for a brief period, resulting in signs and symptoms of concussion. This type of brain injury may lead to bleeding in or around your brain, causing symptoms such as prolonged drowsiness and confusion. These symptoms may develop immediately or later.

Such bleeding in your brain can be fatal – that's why anyone who experiences a brain injury needs monitoring in the hours afterward and emergency care if symptoms worsen.


The signs and symptoms of a concussion can be subtle and may not show up immediately. Symptoms can last for days, weeks or even longer. Common symptoms after a concussive traumatic brain injury are headache, loss of memory (amnesia) and confusion. The amnesia usually involves forgetting the event that caused the concussion.

Signs and symptoms of a concussion may include:

  • Headache or a feeling of pressure in the head
  • Temporary loss of consciousness
  • Confusion or feeling as if in a fog
  • Amnesia surrounding the traumatic event
  • Dizziness or "seeing stars"
  • Ringing in the ears
  • Nausea
  • Vomiting
  • Slurred speech
  • Delayed response to questions
  • Appearing dazed
  • Fatigue

You may have some symptoms of concussions immediately. Others may be delayed for hours or days after injury, such as:

  • Concentration and memory complaints
  • Irritability and other personality changes
  • Sensitivity to light and noise
  • Sleep disturbances
  • Psychological adjustment problems and depression
  • Disorders of taste and smell
  • Symptoms in children

Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they can't describe how they feel. Concussion clues may include:

  • Appearing dazed
  • Listlessness and tiring easily
  • Irritability and crankiness
  • Loss of balance and unsteady walking
  • Crying excessively
  • Change in eating or sleeping patterns
  • Lack of interest in favorite toys

Seek emergency care for an adult or child who experiences a head injury and symptoms such as:

  • Repeated vomiting
  • A loss of consciousness lasting longer than 30 seconds
  • A headache that gets worse over time
  • Changes in his or her behavior, such as irritability
  • Changes in physical coordination, such as stumbling or clumsiness
  • Confusion or disorientation, such as difficulty recognizing people or places
  • Slurred speech or other changes in speech
  • Other symptoms include:
    • Seizures
    • Vision or eye disturbances, such as pupils that are bigger than normal (dilated pupils) or pupils of unequal sizes
    • Lasting or recurrent dizziness
    • Obvious difficulty with mental function or physical coordination
    • Symptoms that worsen over time
    • Large head bumps or bruises on areas other than the forehead in children, especially in infants under 12 months of age


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