Not all that long ago, an athlete with a bad bump on the head might have been treated with some time out and a bag of ice. But today, everyone is aware that a concussion is a serious matter: It’s an injury to the brain that can temporarily disrupt normal brain function and lead to permanent damage. Yale Medicine physicians use advanced technology to test for and identify concussions in people of all ages. Also, we offer specialized expertise in treating children with concussions.
What is a concussion?
Usually caused by a bump to the head, a concussion is a type of traumatic brain injury. Violent shaking can also damage brain tissue and cause a concussion. While often associated with contact sports such as football and rugby, concussions can also happen after a fall, a car accident, or another injury.
Symptoms of concussion can be subtle. Many strongly-held beliefs about the condition can be misleading, so accurate diagnosis and treatment of concussions is crucial. The earlier a concussion is diagnosed, the earlier doctors can take steps to prevent long-term disability.
What are the symptoms of a concussion?
Symptoms of a concussion vary and can appear in different ways. There are three broad categories of symptoms: physical, cognitive, and emotional. After an accident or a blow to the head, a person may experience any combination of the symptoms listed below. It's important to get medical help immediately to start treatment.
- Cognitive symptoms usually include difficulty reading, concentrating, or loss of memory.
- Emotional response to a concussion might include mood changes, depression, or anxiety.
- Physical complaints usually include headache—a very common symptom. People might also suffer from weakness, changes in their vision, balance difficulties, neck pain, dizziness, or have trouble sleeping.
It can be difficult to pinpoint the exact symptoms of a concussion. For many people, it just comes down to a funny feeling or a sense that something is not quite right. If you suspect that someone has a concussion, ask broad, inclusive questions such as “Are you feeling off?” to determine if the person needs to see a doctor.
How are concussions diagnosed?
A physician diagnoses a concussion based on symptoms, a physical exam and taking a patient’s medical history. and performing a physical exam. Though brain scans such as magnetic resonance imaging (MRI) aren't necessary to diagnose a concussion, a doctor might order an MRI to look for other types of brain injury, such as bleeding in the brain, which can cause similar symptoms.
Concussion patients usually spend time under observation, either in the hospital or doctor’s office, according to Yale Medicine neurologist Deena Kuruvilla, MD. Close observation is needed to determine whether patients diagnosed with a concussion have a mild traumatic brain injury, Dr. Kuruvilla says, noting that this is the case for more than 80 percent of cases. Depending on the severity of the injury, you may need to stay at the hospital for an extended amount of time.
What are the treatment options for concussions?
Concussion symptoms can last for days, weeks or even months. There is no cure. Brain rest is considered the standard of care for people who suffer a concussion. Brain rest means limiting physical activity that could aggravate a concussion, as well as mental activity, such as schoolwork or office work. People thought to have a concussion are also advised to avoid reading, watching television or looking at computer screens for long periods of time. Brain rest is thought to help tissue heal, whereas strenuous physical or mental activity increases the chances of permanent damage. Your doctor will give specific instructions on how long brain rest should last, depending on the severity of your injury.
The second line of treatment focuses on the common symptoms of a concussion, which are headaches, says Dr. Kuruvilla. Medications, such as antidepressants, anti-seizure medications, and blood-pressure drugs, may be prescribed to help control the headache, but they do not correct damage caused by concussion.
What is the connection between concussion and sports?
Concussions are often caused by the type of high-impact collisions common in contact sports, such as boxing, lacrosse, soccer, football, and rugby.
Doctors, including those at Yale Medicine, now know that multiple concussions without proper treatment can lead to a progressive neurodegenerative disease called Chronic Traumatic Encephalopathy (CTE). Many prominent athletes have suffered from dementia and depression because of CTE. There is now greater awareness and media coverage of concussion—and growing willingness among athletes to talk about the effects of extreme impacts to the head.
Professional athletic associations have amended rules and guidelines to make sports safer for players. For example, the National Football League (NFL) developed concussion management guidelines that include a “sideline assessment” for any player suspected of having suffered a concussion during a game.
What makes Yale Medicine's approach to treating a concussion unique?
Yale Medicine has specialized expertise in helping patients with concussion heal quickly and completely, while also mitigating the long-term damage caused by one or more concussions.
Yale New Haven Children’s Hospital is home to a specialized Pediatric Concussion Clinic, staffed with Yale Medicine specialists. These doctors are focused on helping children with concussion heal and return to school and sports, while also mitigating long-term effects of the injury.
Adults receive the same level of expert care, focused on their unique needs, at Yale Medicine’s Department of Neurology. Patients there are treated by a multidisciplinary team of specialists—including neurologists, psychiatrists, cognition specialists, and pain experts—who monitor the range of concussion symptoms and address all aspects of treatment.