Concussions—Warning signs and prevention

September 2016 View more

woman holding her head, suffering from headache (soft focus)

It’s not just a concern for athletes in football, hockey, or lacrosse. Any strenuous physical activity that increases the risk of collisions and falls can sometimes cause a concussion—a mild traumatic brain injury. This can happen to a soccer player incorrectly heading the ball, a cyclist taking a bad fall off a bike, a skateboarder losing their balance, or even snow skiers colliding on the slopes.

The human brain is soft, and the body protects it by cushioning the brain in cerebrospinal fluid within the skull. So the brain can move around and sometimes bang against the skull, causing bruising to the brain. Blood vessels can tear and nerves can become damaged. The end result is a concussion. It often happens after sudden impact to the head that causes the brain to shake quickly back and forth. In extreme cases, the person may lose consciousness.


Symptoms of a concussion can occur right away or take hours, days, or even months after the impact to appear. “Immediate 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 and fatigue,” said Dr. Mohammad Sajed, neurologist and Medical Director of Neurocritical Care, Edward Hospital.

The recovery time can be a frustrating time for someone healing from a concussion. “Concentration and memory complaints, irritability and other personality changes, sensitivity to light and noise, sleep disturbances, psychological adjustment problems and depression, and disorders of taste and smell, are all symptoms that can last throughout the recovery process,” said Dr. Sajed.

Symptoms of a concussion can occur right away or take hours, days, or even months after the impact to appear.


It’s best to call the doctor following a major fall or collision involving the head. Especially if any severe symptoms occur such as losing consciousness, a seizure, unusual eye movement, extreme confusion, fluid draining from the ears or nose, problems speaking, or vomiting. In these cases, doctors recommend you immediately call 911.


Doctors will perform an examination and ask a number of questions to diagnose the severity of the concussion before starting treatment. Surgery is possible if there is swelling and/or bleeding in the brain. For more routine cases, the doctor may want the patient to wake up every couple of hours to confirm that there’s no severe confusion or coma for the first day or two. Headaches following head trauma are common, so the doctor will suggest over-the-counter medicine and urge the patient to rest without doing strenuous activities or driving. Getting a second concussion can cause SIS or Second Impact Syndrome. This can increase chances for the brain to swell. In these cases, the patient is urged to take it slow. “Rest, rest, rest. Avoid any stimulation to the brain, like watching TV for prolonged time or playing video games,” said Dr. Sajed.


It may take months for all symptoms to dissipate. Some patients may experience mental or emotional changes that last even longer. Repeat concussions can increase chances of permanent brain damage. So it’s important to prevent concussions before they happen. Experts recommend that athletes wear safety gear and a proper fitting helmet when participating in strenuous sports – especially when returning to the activity after having a concussion.

The American Academy of Neurology (AAN) recommends athletes with suspected concussion should be immediately taken out of the game and not returned until they’re assessed by a licensed health care professional trained in concussions, return to play slowly and only after all acute symptoms are gone. Athletes of high school age and younger with a concussion should be managed more conservatively in regard to return to play, as evidence shows that they take longer to recover than older athletes.