When you experience a blow to the head, knowing whether you've suffered a concussion isn't always clear cut. Head injuries have a range of physical, psychological and intellectual effects — and notably, less than 5% of people actually lose consciousness.
"It's critical for parents, coaches, players and trainers to recognize the potential signs and symptoms of a concussion," says Baibing Chen, M.D., a neurologist at Henry Ford Health. "The basic rule is that a concussion can affect any aspect of brain function."
Signs Of A Concussion
The Latin root of the word "concussion" means "to shake violently" — which makes sense. Concussions happen when there's a combination of movement and impact. So any injury that involves a hit to the head — a fall, collision or hard hit by a heavy object — could cause one. So could a hit to the body that causes the head to move quickly.
"But every brain injury is different," Dr. Chen says. "Some symptoms show up right away while others develop gradually over the first 72 hours."
Modern guidelines categorize symptoms into four main domains: somatic (physical), cognitive, affective (emotional) and sleep.
Here are common concussion symptoms to watch for:
Physical (Somatic) Concussion Symptoms
- Headache
- Nausea or vomiting
- Dizziness or balance difficulty
- Sound and light sensitivity
- Visual problems
- Numbness or tingling
Cognitive Concussion Symptoms
- Confusion
- Difficulty concentrating
- Feeling "slow" or "foggy"
- Memory problems
Emotional (Affective) Concussion Symptoms
- Anxiety
- Depression
- Irritability
- Mood swings
Concussion-Related Sleep Disturbances
- Fatigue
- Changes in sleep patterns (sleeping more or less than usual)
How Doctors Diagnose Concussions
One reason concussions are frequently misdiagnosed is because they're assessed on the field or courtside during game play. While it was once thought that these "lightning-fast" decisions were largely unreliable, the tools available today are much more sophisticated.
"Medical professionals should still make the final diagnosis but validating tools like the Sports Concussion Assessment Tool-6 (SCAT6) for acute sideline evaluation have improved diagnostic accuracy," Dr. Chen says. "For office-based follow-ups beyond 72 hours, newer multi-domain tools like the Sport Concussion Office Assessment Tool-6 (SCOAT6) help us identify specific areas for rehabilitation."
According to Dr. Chen, the historic practice of “baseline testing” is no longer a required standard of care because everyone — and every concussion — is different.
Management of concussion injuries have also evolved.
“Current guidelines now emphasize an individualized, active approach with light physical activity and graduated aerobic exercise initiated within 24-72 hours after the injury instead of a prolonged period of rest.”
When To Seek Emergency Care For A Possible Concussion
No matter how hard (or lightly) you think you’ve been hit, it’s important to take head injury symptoms seriously. Even a seemingly minor blow could have a major impact. You should see immediate emergency care if you have any of the following “red flags” appear right after a hit:
- Unconsciousness (even briefly)
- Repeated vomiting
- Seizures
- Difficulty walking or weakness on one or both sides
- Persistent or worsening confusion
- Inability to wake up
A complete evaluation by a medical professional will not only determine whether you have a concussion, it can also identify more serious, or even life-threatening, concerns.
Reviewed by Dr. Baibing Chen, a neurologist who sees patients at Henry Ford Hospital and Henry Ford Medical Centers in Plymouth and Taylor.
