Concussion is defined as a closed-head injury (that is, one that doesn't involve a skull fracture) generally caused by blunt-force impact. Concussion was traditionally utilized by doctors to refer to temporary loss of consciousness from a head injury, but in everyday language, the term usually means any minor injury to the head or brain. Concussions usually aren't life-threatening but might involve long-term as well as short-term health issues.
Concussion occurs when the brain is pushed against one side of the skull, often by impact with a blunt object. The impact can result from a person's striking the head against an object as well as being hit by something or someone. Athletic injuries are the most common trigger of concussions, but concussions may also result from automobile, bicycle, or other transportation accidents, criminal assaults, workplace accidents, or accidents in the house particularly falls.
Concussions are most likely underreported because many mild cases resolve on their own and because many athletes do not wish to miss scheduled competitions. One estimate is that there are six instances of concussion per 1,000 people per year in the United States, but this figure is most likely too low. Among children between the ages of five and fourteen, the most common causes of concussions are sports and bicycle accidents; among adults, the most typical causes are falls and auto accidents. Soldiers in combat might have rates of concussion from bomb blasts as high as 15 percent.
The sports that location participants at the highest risk of a concussion are boxing, football, ice hockey, wrestling, rugby, and soccer. At the high school level, girls are more likely to be injured than boys (in sports played by both sexes) because of their smaller head and neck structure. According to the American College of Sports Medicine, studies of high school athletes show that the rate of concussions per 1,000 games is as follows: 0.59 for football; 0.25 for wrestling; 0.18 for boys' soccer and 0.23 for girls' soccer; 0.09 for girls' field hockey; and 0.11 for boys' basketball and 0.16 for girls' basketball.
The fundamental trigger of a concussion is the rotation of the brain inside the skull as well as compression of the brain tissue against the sides of the skull when a individual receives a blow on the head. Even though the brain is cushioned against minor bumps by cerebrospinal fluid (CSF), the quantity of fluid between the brain and the skull is not sufficient to absorb the force of a heavy blow. Doctors do not agree as to regardless of whether concussion is a disturbance of brain function only or regardless of whether it involves damage to the structure of the brain as well. It is presently thought that the forces from a blow to the head disrupt the regular activity of the cells in the brain tissue, and that it is this disruption that causes temporary alterations in consciousness. The brain's secretion of neurotransmitters (the chemicals that convey signals from one nerve cell to an additional), its oxygen supply, and its use of glucose (blood sugar) are all affected by concussion.
In addition, a little number of cells in the brain tissue might die as a result of even temporary interruptions of blood flow to the parts of the brain affected by the concussion. The symptoms of a concussion include emotional and well as cognitive and physical symptoms:
It is feasible for a individual to suffer a mild concussion without knowing it, particularly if their attention was focused on something else such as getting out of a damaged car, helping someone else to safety, or escaping from an attacker. They may not seek medical help afterward. Most individuals, nevertheless, will go to the physician after a head injury if they've briefly lost consciousness, are having prolonged vomiting spells, severe headaches, or such vision issues as seeing double or seeing bright lights.
Simply because of the potential seriousness of a closed-head injury, the physician will take a careful history of the injury (its trigger along with other details of the incident, as well as how long the patient was unconscious) as well as a general medical history. The physician will particularly need to know whether the patient has had previous head injuries; is taking any bloodthinning medications; or has a bleeding disorder. The history is followed by a number of examinations and imaging studies:
Treatment of mild concussion usually consists of a mild over-the-counter pain reliever like acetaminophen (Tylenol) or ibuprofen (Advil) plus bed rest and extra fluids. Aspirin should be avoided simply because it increases the risk of bleeding. If the patient has a bruise under the skin of the head (a "goose egg"), ice wrapped in a washcloth can be applied to relieve the swelling. Cuts in the skin may be treated in the doctor's office with a local anesthetic and stitches if essential. People injured in an athletic competition ought to not play again for at least seven to ten days after the concussion.
Prognosis depends on the severity of the concussion. Most individuals heal completely in one to two weeks, although healing may be somewhat slower in adults over fifty-five. About 10 percent of patients develop what is known as post-concussion syndrome (PCS). This is really a condition marked by persistent headaches for two weeks to a number of months after the concussion. The patient might also have nausea and vomiting, or difficulty reading or concentrating on their work. PCS usually goes away on its own. If it persists after a couple of months, the patient will usually be referred to a neurologist for further evaluation.
The effects of concussions tend to add up over time; it's known, for instance, that each concussion a individual sustains makes it easier for them to suffer an additional concussion in the future. Repeated concussions can lead to permanent loss of memory and depression or other psychiatric disorders. Professional athletes are particularly likely to suffer long-term injuries from repeated concussions; several studies have found that the rate of depression is 3 times higher and also the risk of Alzheimer disease five times higher in athletes who have had 3 or more concussions.
Not all accidents or other causes of concussions can be prevented. People can, however, lower their risk of concussions by taking the following safety measures:
Concussions are likely to continue to be relatively commonplace head injuries, particularly in victims of bicycle, motorcycle, and auto accidents. Stricter regulations about allowing injured athletes to play, however, may decrease the rate of concussions and their long-term consequences in amateur as well as professional sports.
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