All you need to know about concussion including its causes, symptoms and treatment

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While most of us know to look out for sickness, confusion or headaches after a blow, bump or jolt to the head, there are gaps in our knowledge when it comes to temporary brain injury. So what else should you be aware of – and when is it time to worry?

You don’t have to actually hit your head
Concussion isn’t always caused by a direct blow to the head. It can actually happen as a result of jarring motions, such as whiplash, in the head or neck that can occur during a car crash, for example, or a bad fall.

“Concussion can result from sudden acceleration and deceleration forces to the head, essentially causing the brain to strike the inner surface of the skull,” says Catherine McMahon, clinical lead for trauma and hydrocephalus at The Walton Centre NHS Foundation Trust.

There can be a time delay on symptoms
“Following a knock to the head you may not initially spot any symptoms, particularly if you are taking part in a competitive game – the adrenaline in your system can prevent you from noticing,” says Catherine.

“That means it can sometimes take hours – or even a day – before a sufferer realises they have a concussion.”

According to the NHS, some symptoms may not appear for up to three weeks, so stay vigilant following any head injury.

It may make you feel blue
Concussion can affect your mood and you might find yourself feeling moody, irritable or even overwhelmed in the aftermath.

“A brain injury can affect all parts of the brain, including the limbic system, which is responsible for emotions,” says Catherine.

“That means emotional changes such as short-temperedness and sadness can sometimes be seen after concussion.”

It could cause insomnia
Many people believe you shouldn’t sleep after a head injury, but that’s a myth. The only reason not to is it will make it more difficult for others to notice any symptoms. In reality, you’re more likely to struggle to drift off if you have a concussion.

“Concussion can cause tiredness, but surprisingly it can also lead to difficulty falling asleep,” says Catherine.

“Due to the brain dysregulation caused by a traumatic brain injury, your sleeping pattern can be disturbed. This can lead to either excessive sleeping or brain ­overactivity, which may make it harder for you to drift off for a couple of weeks afterwards.”

As frustrating as this is, it’s important to try to rest as much as possible after a concussion.

Avoid watching TV
It might seem tempting to curl up in front of the TV, but this could do you more harm than good. The same goes for texting or checking social media on your phone.

“In the first couple of days after a ­concussion, screen time should be kept to an absolute minimum,” says Catherine. “The brain needs rest and time to recover so stimulation should be significantly reduced until your symptoms start to resolve.”

It can cause tingling in limbs
“Concussion can cause a variety of ­symptoms, including numbness and tingling of the limbs, dizziness, fatigue, feeling in a fog as well as difficulty concentrating,” says Catherine.

“This is because trauma to the brain can cause dysfunction ­including altered sensory perception. That can lead to symptoms such as tingling in the hands.”

You don’t have to be knocked out
In reality, unconsciousness precedes less than 10% of cases of ­concussion, but that does not mean it’s not serious.

“Concussion is rarely associated with unconsciousness,” says Catherine.

“A person may simply be momentarily dazed and the ­concussion can still be substantial.”

In rare cases it can be fatal
“Although very rare, a second concussion closely following an initial concussion can lead to delayed brain swelling, known as second impact syndrome,” says Catherine.

“This can be life ­threatening as it can lead to rapid and potentially fatal swelling, so seek urgent help if you suffer another injury.

“It’s worth noting concussion can even be fatal without a second impact and it is impossible to predict, so if you’re concerned seek ­immediate medical help. This is because a severe injury to the brain can cause bleeding or swelling.

“You should look out for bloody discharge from the ears, severe headaches, loss of balance and slurred speech,” she adds.

Symptoms can last for months
Most symptoms of a concussion resolve in between two to four weeks, but some can last several months.

“When trauma lasts months, we define this as post-concussion syndrome,” says Catherine.

“It is unclear why this happens in certain individuals, but symptoms that tend to persist can include dizziness, anxiety, depression, drowsiness, difficulty concentrating and headaches.

Once you’ve had it, you’re more likely to have it again
“A recent concussion increases the risk of sustaining a further ­concussion, which may then take longer to recover from,” Catherine warns. “Concussion also increases the risk of sustaining other sports-related injuries.”

This is because your brain is more vulnerable after that first injury and as it is not working quite as it should,you are more likely to have a second accident.

When to seek help
Seek emergency medical treatment if you have had a head injury and have experienced any of the following symptoms, however brief:

Loss of consciousness, however brief
You’ve been sick since the injury
You’re confused
You feel dizzy or drowsy
You are struggling to understand what people are saying to you or have trouble speaking, hearing, reading or writing
You have a headache that persists after taking painkillers
Your behaviour has changed, for example you have become more irritable, have lost interest in things around you or you have become more short-tempered
You feel more emotional than usual
You have problems with your memory
You had consumed alcohol or taken drugs just before the injury
You take blood-thinning medicines or suffer from a blood-clotting disorder such as haemophilia
You have had brain surgery in the past