Nicholas R. Metrus, MD, is a board-certified neurologist and neuro-oncologist. He currently serves at the Glasser Brain Tumor Center in Summit, New Jersey.
A concussion is a brain injury that affects cognitive function. It can be caused by a blow to the head, a head-on collision (for example, two football players bumping helmets), or violent shaking. A mild form of traumatic brain injury (TBI), concussions cause cognitive, emotional, and physical symptoms. Physical and mental rest are the primary treatment for concussion.
An acceleration-deceleration injury is a brain injury caused by movement of the brain within an unrestrained head, such as whiplash. The force in which the brain shifts in the skull can lead to an injury of the brain tissue, such as a concussion.
Amnesia is a form of memory loss caused by damage to parts of the brain used for memory processing. Also known as amnestic syndrome, amnesia can be temporary (transient global amnesia) or permanent. People with amnesia may have difficulty learning new information after the onset of amnesia (anterograde amnesia) or difficulty remembering past events and information (retrograde amnesia).
A blast injury is an injury caused by an explosion. Blast injuries result from blast overpressure, elevated atmospheric pressure created by an explosion. Common blast injures include concussion, ruptured eardrum, eye rupture, and blast lung.
A brain injury is an injury to the brain that leads to temporary or permanent cognitive difficulties. Typically caused by a blow to the head or a head-on collision, brain injuries range from a mild concussion to a traumatic brain injury.
Cognitive tests are assessments of brain processes such as thinking, memory, language, judgment, and the ability to learn new things. The most common cognitive tests are the Montreal Cognitive Assessment (MoCA), Mini-Mental State Exam (MMSE), and Mini-Cog, which measure mental functions through a series of questions and simple tasks.
A dilated pupil is an enlarged pupil, the black circle in the center of the iris, which is the colored part of the eye. The pupil is similar to a camera aperture, it dilates and constricts to let in more or less light.
A direct impact injury means the head has hit something directly, such as a windshield or the ground, or an object, such as a ball, has hit the head. A direct impact injury can lead to a brain injury, such as a concussion.
Imaging tests are diagnostic tests that provide a picture of the inside of the body using radiation, sound waves, or magnetic fields. Common imaging tests include X-rays, computed tomography (CT), ultrasound, and magnetic resonance imaging (MRI).
A neurological examination is an evaluation of a person’s nervous system, which includes the brain, spinal cord, and associated nerves. Also called a neuro exam, it is used to assess motor and sensory skills, balance and coordination, mental status, reflexes and functioning of the nerves.
In general, most concussion symptoms take two to three weeks to resolve with proper rest, although each concussion is different. An undiagnosed or poorly treated concussion can take months or even longer before you feel like yourself again. If you are still experiencing symptoms 14 days after your injury, check in with your doctor.
Concussion is treated primarily with physical and cognitive rest. This includes avoiding physical activity, reading, screen time, and even music. How long you need to rest will depend on the severity of the concussion and its symptoms. After a day or two of complete rest, it is recommended to ease back into activities and let symptoms be your guide. If a particular activity triggers symptoms, avoid it for a while.
A concussion is caused by trauma to the head. Symptoms are usually present within minutes to several hours after the impact and include headache, nausea, vomiting, confusion, dizziness, blurry vision, tinnitus, sensitivity to light and noise, difficulty focusing, and drowsiness.
Some people may temporarily lose consciousness, but do not have to be knocked out to have a concussion.
If you have suffered a blow to the head or been in a car accident, a physical and neurological examination can determine if you have a concussion. Your doctor will check your vision, balance, coordination, and reflexes, and evaluate your memory and cognitive function. A brain scan, such as a computerized tomography (CT) or magnetic resonance imaging (MRI), may be ordered to rule out a skull fracture and check for a brain bleed or inflammation.
Concussion symptoms are a mix of cognitive, physical, emotional, and sleep-related issues. The primary physical symptom is a headache. Other symptoms include confusion, memory problems, difficulty focusing and thinking, dizziness, nausea, vomiting, blurry vision, tinnitus, sensitivity to light and noise, and drowsiness.
Yes, you can sleep with a concussion. Years ago, the advice was to wake head-injury patients hourly to assess their status, but this changed with imaging technology like CT and MRI. However, each concussion is different, and you should follow your doctor’s guidance.
Explore interactive models below that illustrate what happens to a brain inside the skull during a head injury, and how damaged brain cells (neurons) can cause the symptoms of a concussion.
American Society of Neuroradiology. Traumatic Brain Injury (TBI) and Concussion.
American Association of Neurological Surgeons. Concussion.
U.S. Department of Defense: Blast Injury Research Coordinating Office. What is blast injury? Updated June 18, 2019.
U.S. National Library of Medicine: MedlinePlus. Cognitive testing. Updated February 24, 2020.
American Academy of Ophthalmology. Dilate Pupils. Updated September 30, 2020.
Merck Manual (Consumer Version). Overview of imaging tests. Updated July 2019.
Johns Hopkins Medicine. Neurological exam.
Centers for Disease Control and Prevention. Recovery from concussion. Updated February 12, 2019.
Cleveland Clinic. Concussion: management and treatment. Updated June 2, 2020.
U.S. National Library of Medicine: MedlinePlus. Concussion. Updated September 29, 2020.
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