According to the Zurich 3rd International Conference on concussion, a concussion is defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. The actual word concussion is derived from the Latin word meaning to “shake violently.” Concussion and mild traumatic brain injury are often used interchangeably.
A concussion results from a traumatic force on the brain, head or neck. A concussion can be caused by the impact of direct contact or also the sudden force of acceleration or deceleration. Concussion diagnosis is critical because second impact symptoms can be induced by subtle contact or motion to the head or neck.
A concussion is a functional injury rather than a structural injury. The recovery process is not always linear so maintaining an accurate account of the injury is important for understanding the recovery process and severity of symptoms. Second impact concussions delay the recovery process and complicate the path or pattern of recovery.
Headache is the most common symptom reported and also the symptom that lingers during recovery. Headache symptoms can begin immediately following a concussion or even days later. Predicting the onset of concussion symptoms is challenging. Feeling dizzy and nauseous after a concussion is completely normal. Flu like symptoms are often reported as a result of the onset of a combination of multiple symptoms. Fatigue is frequently reported as a result of a concussion and also the demanding recovery process. Memory challenges are also often experienced following a concussion. Mood swings are also common during the recovery process and it is not abnormal to experience sudden changes in mood or behavior. Depression and anxiety are commonly reported following a concussion or mild traumatic brain injury. Insomnia is another common symptom reported.
There can be differences in the physical, emotional and behavioral symptoms that are reported versus symptoms that are observed.
Headache, dizzy, nauseous, visuospatial difficulties, ears ringing, pain, trouble speaking, irritated, clumsy, apathy, fear, hopelessness, depression and anxiety.
Vacant stare, lack of insight, lack of focus or direct eye contact, blurred speech, impulsive, aggressive, paranoid or socially inappropriate behavior. Isolation and lack of interest in all activities. Delayed motor or verbal skills. Acting self centered or disorganized throughout daily activities. Appearing withdrawn and depressed.
Be clear with practitioners that concussion symptoms are present. Do not rush the recovery process and do not feel shame in addressing concerns about symptoms that may arise during treatment. Never risk a second impact concussion.
Address someone with care and caution. Speak slowly and make gentle movements. Avoid any activities or environments that can cause stress or elevate stress. Quiet and carefully constructed environments will encourage trust between victims and family or peers. Ask simple and non-invasive questions and expect answers that are related to concussion symptoms, especially physical symptoms. Continue to ask questions even if you know the answer may be the same as it was the day before - How are you feeling? Do not ask questions that provoke fear or uncertainty – What did you do today? Remember physical symptoms can become overwhelming which can lead to shifts in behavior and mood which can increase cognitive impairments. The cycle can lead to additional stress for someone trying to rest and recover. Time and space are important for someone to absolve the situation. Don’t take it personally if someone becomes overwhelmed and frustrated. Do not set someone up to fail by challenging how they feel.
Write lists every day. Set really small goals for daily activities. For example...
Sit down while having a shower. Set an alarm if you are cooking or try and make sure someone else is present while cooking. Create a food schedule, write down what you have had to eat and add the time of day, in case memory is poor. Raw foods, ginger, and peppermint tea can help with nauseous feelings. Move a radio in to the area where you rest. Breathing or relaxing tools can help with chronic pain or insomnia. Use a small towel to cover eyes if headaches persist. Take one day at a time. Seek advice of a physician for any questions regarding your recovery.