Would you recognize a concussion if you had one?

What are the signs of a concussion?

Everyone seems to prefer the injuries with stitches and blood.

People generally have an easier time understanding and empathizing with what they can see.

But, what about the injury you can’t see?

That’s where we get into concussion territory. Concussions can’t be seen on imaging (CT/MRI), there are no blood tests that can diagnose concussion yet, and on the outside there may be ZERO evidence that an injury or impact had even occurred.

Concussion is essentially an invisible injury - with all the neurometabolic havoc happening below the surface.

Below is a (quite dramatic) animation from Barrows Neurological Institute showing how a head/body impact can result in a literal sloshing of the brain within the skull resulting in a traumatic brain injury - in most cases a “mild traumatic brain injury (mTBI)” also called a “concussion.”

I say quite dramatic because this hit resulted in a loss of consciousness as evidenced by the “rag doll, motionless” fall. In reality, a loss of consciousness (“blackout”) happens in only 1-14% of concussions, with most evidence agreeing that it occurs in less than 10% of concussions. According to this, as I type, the highest hitting team right now in the NHL is the New York Islanders with 28.5 hits per game. At that rate over an 82-game season were bound to see a concussion or two, but rarely will we see a full blown “blackout.” Just because you didn’t pass out, does not mean you don’t have a concussion.

This animation is from Barrow Neurological Institute.

So, what are the symptoms of concussion?

Below you will see a list of symptoms from the Sport Concussion Assessment Tool - 5th Edition. This is a sideline concussion assessment tool used by health professionals to assess baseline and post-concussion status.

If you have even 1 symptom following impact, you are assumed to have sustained a concussion.

That’s the reality of it. Look below. Whether it was from sport, a fall, a car accident, blast injury, etc… if even one of these symptoms occurred following the impact, then a concussion was likely sustained.

You’re not a hero for playing through it.

I’ll discuss what happens to the brain during and after a concussion in a future post, but for now please know this:

The quicker you remove yourself and seek medical care, the faster and better you recover.

If you’re an athlete reading this, it could mean the difference between missing a couple games with your team or missing the rest of a season with your team.

We know that, due to a variety of physiological parameters, it is far smarter for you to end the game as soon as you can and to start the recovery process. Continued play results in a longer recovery time. We’re talking 5-11X longer than players who remove themselves right away. In many cases that can be a least an entire month of prolonged recovery and missed playing time.

Know the symptoms. Don’t be a hero.

A concussion, also called a mild traumatic brain injury (mTBI), is a serious injury even though it is invisible. Knowing the symptoms of concussion can help you to seek care faster, which can lead to faster and better recovery. Ignoring the symptoms of concussion after a big impact can result in prolonged recovery, a potentially severe “second-impact syndrome,” and there are growing concerns surrounding chronic traumatic encephalopathy (CTE) from repeated concussions.

When concussions are appropriately managed, in a timely fashion, it appears that brain health can continue to hum along happily!