That Concussion Can Have Lasting and Serious Effects

Hi, it’s Anna in Virginia. Recently, a friend of mine landed in the hospital with a concussion and I had a lot of questions, but first...

Last week, a friend of mine was in a head-on collision and he was hospitalized with seemingly a pretty serious concussion, among other things.

The scare got me thinking about brain trauma. When I was a kid playing soccer long ago, it seemed like concussions weren’t taken very seriously. I had a feeling times have changed, but I didn’t really know what that meant. So I talked to Conor Gormally, who co-founded the Concussion Alliance, and Elizabeth Sandel, a clinical professor in the Physical Medicine and Rehabilitation department at University of California Davis School of Medicine. Sandel also wrote Shaken Brain: The Science, Care, and Treatment of Concussion.

Their first piece of advice was that trauma to the brain can be invisible. So regardless of whether your concussion symptoms like headache or dizziness go away, you should seek care sooner rather than later. Clinical guidelines tend to recommend being seen by a doctor within a day or two. Sandel says she “would strongly suggest” going the same day as the injury, which for many may mean seeking emergency-department care.

Concussions occur when someone experiences a bump, blow or jolt to the head or body that causes the brain to move rapidly back and forth. Concussions themselves are not usually life-threatening but the effects can be lasting and serious, the Centers for Disease Control and Prevention says.

For 50% of traumatic brain injury patients who received a CT scan, three or more symptoms, such as headache or fatigue, persist for at least a year, according to a study in the Journal of Neurotrauma last year. More than 70% reported at least one persistent symptom a year after injury. This can be patients with mild, moderate or severe brain injury — a concussion is usually considered mild. Gormally and Sandel recommended not stopping at the initial emergency room visit but following up with your primary care provider. If serious symptoms persist or new ones like neck pain appear, you should contact an outpatient traumatic brain injury rehabilitation clinic. These clinics can coordinate care among professionals in different disciplines such as neurology, mental health and physical rehabilitation.

Patients diagnosed with a concussion have an increased risk of suicidal thoughts and suicide attempts, which makes the mental health component of recovery particularly important, Sandel says.

What concussion experts don’t recommend any longer is cocooning, essentially shutting someone with a concussion away in a dark room with no mental stimulation. Instead, patients should engage in some physical and mental activity as soon as they can, Gormally and Sandel say, as long as it doesn’t involve the potential for reinjury.

One of my last questions was about children. Babies and toddlers can’t express their symptoms easily and even younger children who are very verbal aren’t the most reliable narrators. Luckily, the Concussion Alliance has a web page with advice for every stage of young childhood. Helpful recovery tips include letting kids sleep more initially if they want to and limiting — but not eliminating — screen time.

My friend was released from the hospital after a few days, but rest assured I’ll be asking him if he’s going to do any follow up. — Anna Edney