Sports injuries, car accidents, a fall from reasonable height—no matter the cause if one sustains a blow to the head serious precautions should immediately be taken in order to rule out any type of traumatic brain injury, the most common being concussion.
Concussion when translated back to Latin literally means to shake violently and in this case refers to the brain being jarred within the skull. A variety of signs and symptoms may arise directly after the incident or may wait to present with time therefore it is necessary to be prepared with what to look for in an injured party with a potential concussion. Each person may present differently depending on what structures have been damaged. The following include signs and symptoms that suggest the diagnosis of a concussion.
First, it is essential to observe the person for any change in Physical behaviour out of the ordinary following the injury. The most commonly reported symptom in concussions is that of the headache, a constant presence with an onset that began post-injury. The headache may be accompanied with any of the following: dizziness, nausea, vomiting, and alack of motor skills, coordination or balance.
Audio/Visual Signsmay also be present and include ringing in the ears known as tinnitus or opticalsymptoms like light sensitivity, blurred or double vision, or the illusion of seeing of bright lights.
A less reported sign is that of concussive convulsions, an involuntarily contraction and relaxation of the muscles which present as uncontrolled shaking of the body.
While it is important to observe for any strange behaviour, it is just as important to engage in conversation with the injured party to identify any Cognitive or Emotional symptoms. Hallmark signs include any confusion, disorientation, trouble with focus and attention span, and difficulty engaging in coherentconversation or thought pattern. Reasoning, concentration, amnesia, and simple daily tasks may be affected.
Depending on presentation and severity of signs and symptoms, if the injured party is diagnosed with a concussion, it is assigned to a category which will help to predict the treatment and prognosis (outcome). There are several types of concussion grading systems used in the medical field but the most common include the Cantu Guidelines developed by Dr. Robert Cantu of Boston University, the Colorado Medical Society guidelines established to help determine athletes’ return to play, and the American Academy of Neurology guidelines based on loss of consciousness.
The Cantu Guidelines categorize concussions in three grades.
- Grade I: an injury occurring without loss of consciousness, and less than 30 minutes of post-traumatic amnesia
- Grade II: an injury occurring with a loss of consciousness of less than 5 minutes or post-traumatic amnesia lasting between 30 minutes and 24 hours
- Grade III: an injury occurring with a loss of consciousness greater than 5 minutes or post-traumatic amnesia lasting more than 24 hours
*The most common concussion type found by this grading criteria is Grade I.
The American Academy of Neurology Guidelines use four differentiates:
- Grade I: an injury occurring with no loss of consciousness, and symptoms of confusion that last less than 15 minutes
- Grade II: an injury occurring with no loss of consciousness, and symptoms of confusion that last more than 15 minutes
- Grade III: an injury occurring with loss of consciousness that lasts for IIIa: seconds IIIb: minutes
For interested players, coaches, trainers, and parents the Colorado Medical Society Guidelines that suggests appropriate return to play utilizes the American Academy of Neurology Grading criteria times and is as follows:
Concussion Grade|First Concussion|Subsequent Concussions
I | 15 Minutes | 1 week
II | 1 week | 2 weeks with physician approval
IIIa | 1 month | 6 months with physician approval
IIIb |6 months | 1 year with physician approval
*It is imperative to follow return to play guidelines to avoid further complications such a Post-Concussion Syndrome or Second-Impact Syndrome.
Remember that with any type of medical condition, knowledge is power and can help save lives. Using the information above and the following quick tips, you should be more prepared to make a timely and informed decision should you be in the presence of a sustained head injury. Simply Look, Listen & Take Action!
- for changes in behaviour or personality.
- for blank stare/dazed look.
- for loss of consciousness.
- disorientation in time, space, date, location.
- altered physical or spoken responses.
- trouble with memory.
- complaints of headache.
- changes in vision, hearing, or any dizziness.
- reports of nausea.
- feelings of drowsiness.
- an uneasy/unwell sensation.
- Check consciousness, if unconscious check ABCs (Airway open, Breathing normal, Circulation is the heart beating).
- If head, neck, of spine injury is suspected do not move the injured party to avoid further damage.
- Make appropriate Sports medicine services.
- When it is an athlete, follow return to play guidelines to avoid further injury.
Travis R who is a Canadian likes more in research activities. Currently he is doing his research in Health science and he likes to share all his views relating to health. You can catch him through twitter @Rtravis121.