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Dr. Rajalakshmi VK (AIIMS)MBBS

January 15, 2020

March 06, 2020


Arguably the most common brain injury worldwide, concussions are usually caused by a sharp blow to the head or upper neck. Whether it is sustained while playing a sport, or in a car accident or simply due to a fall, a concussion temporarily affects the functioning of the brain.

Often described as a mild traumatic brain injury, concussions are usually not life-threatening. However, it is important to monitor the patient for a few days for symptoms like confusion, headache, difficulty coordinating movements and memory loss.

It’s important to take the patient to a doctor immediately in case they vomit repeatedly, lose consciousness for over 30 seconds or have seizures.

Here’s what happens when someone has a concussion: the brain is encased in a spinal fluid inside the skull. When the head gets a sudden jolt, it can cause the brain to move around vigorously inside the skull. If the brain then hits the inside of the skull, it can lead to trauma that can temporarily affect brain function.

Causes of Concussion

Head injury is the biggest cause of concussion. Sportspeople, including cricketers and footballers, are in the high-risk group for concussion. As are survivors of domestic abuse. (According to the latest National Crime Records Bureau [NCRB] Report, over 600 cases were filed under The Protection of Women from Domestic Violence Act across India in 2017.)

Most traumatic brain injuries in India occur as a result of road accidents, according to the Indian Head Injury Foundation (IHIF). IHIF data show that about 60% of all traumatic brain injuries are caused by road accidents, including vehicle collisions and falling from a motorcycle. (According to one estimate, India sees 53 road accidents every hour. Additionally, NCRB data show that 134,803 Indians died in road accidents in 2017.)

Concussions are also common among babies as their heads are larger in proportion to their bodies. Violent shaking of the head or even a minor bump to the head can cause a concussion. Children may not be able to process or express how they are feeling. So, look out for signs of lethargy, repeated vomiting, lack of interest in toys, poor balance (in children who've already learnt to walk) and excessive crying (more than usual). If you're unsure about how hard your child might have hit his/her head, it is a good idea to take your child to a doctor immediately.

Symptoms of Concussion

There may be cases when someone with a head injury won't feel anything immediately, but have a delayed episode of concussion. In most cases, however, the symptoms of a concussion are visible immediately. Here are some of the things to look out for:

  • Constant headache
  • Blurred vision
  • Memory loss
  • Slurred speech
  • Loss of coordination
  • Difficulty sleeping
  • Irritable or cranky mood
  • Loss of balance
  • Nausea and vomiting
  • Confusion or disorientation
  • Dizziness or drowsiness
  • Fatigue

Take the patient to a doctor immediately if you notice any of the following signs:

  • Vomiting again and again
  • Fainting
  • Symptoms like headache are getting worse
  • There are noticeable changes in behaviour
  • Slurred speech
  • Difficulty recognising people

In young children, lethargy, losing interest in play, walking unsteadily, appearing dazed and crying much more than usual can also signal a concussion. See a doctor immediately if your child hurt his/her head and exhibits any of these symptoms.

Diagnosis of Concussion

If you have suffered a head injury, it is advisable to see a doctor as soon as possible to determine the extent of the damage it may have caused. The doctor may begin by asking simple questions to determine your cognitive abilities, even do an eye test in some cases. He/she may ask you about how the injury took place and how you feel.

Based on your responses, your doctor may advise you to get a CT scan or an MRI to assess the extent of damage, and advise medication based on it. Concussions are typically classified within three different grades, from mild to severe.

Treatment for Concussion

Concussions are very common in sports like football and cricket. So much so that the International Cricket Council or ICC has its own guidelines and protocol for dealing with a concussion. In the event of a concussion while playing a sport, it’s important to stop playing immediately.

Remember that the symptoms can show up immediately, within a few hours or even a few days later. So visit a doctor or a hospital if you hit your head, and notice symptoms like dizziness, blurred vision, confusion or short-term memory loss. Do not ignore symptoms like fainting and repeated vomiting, as they can signal a deeper injury. If your child is hurt, and you suspect that he/she may have hurt their head, see your paediatrician immediately.

Rest and recuperation are the best medicine for a concussion. Try to avoid activities that strain your eyes, including watching TV and reading. Mild over-the-counter pain medication like paracetamol can be used to manage any pain. But try to avoid aspirin, as it increases the chances of bleeding.

Avoid drinking alcohol for a while, as it may slow the recovery process down.

Prevention of Concussion

While it is difficult to take precautions against such an event, it is advisable to wear the right protective equipment for the sport you're playing. Like a helmet while batting in a game of cricket, or appropriate headgear while boxing. Always remember to wear a helmet while riding a motorcycle, even if you are riding pillion.

Whiplash from car accidents are also a common cause for concussions. Remember to wear a seatbelt always and do not remove the headrest from the seats.

Parents can try to make their homes safe, especially for very young children who are prone to losing balance and injuring themselves.

If you yourself have poor balance for any reason, make sure to use the appropriate walking sticks or rails to avoid falling.

For able-bodied people, exercises and yoga to improve the body's balance can also help to avoid falling.

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