Concussion: The mildest form of traumatic brain injury

When we hear “concussion,” many of us automatically think of the athletic field. But the term can refer to any mild traumatic brain injury (TBI), such as one from a military accident, car crash, fall or other damage to the brain.

This can happen when our head hits or is hit by something.

It can also happen when the head thrashes. Consider a passenger in a vehicle that stops quickly, sending the head tossing back and forth.

What is a concussion, and how does it compare to more severe brain injuries?

A concussion is the mildest form of traumatic brain injury. It’s generally treated on an outpatient basis (meaning the person doesn’t need to be admitted to the hospital), and most patients recover and return to their pre-injury selves in a relatively short period of time.

That’s different from more severe forms of TBI, which can be lifelong injuries. In those cases, treatment is aimed at getting patients back to their best possible selves.

What are symptoms of a concussion?

Among the more common signs of a concussion are:

• Headache or pressure in the head
• Dizziness
• Fogginess
• Confusion, difficulty concentrating, forgetfulness
• Sensitivity to light or noise
• Balance issues
• Nausea
• Sleep issues, such as trouble falling asleep or sleeping too much
• Fatigue or drowsiness
• Mood/emotional disturbances, anxiety, sadness, irritability
• Brief loss of consciousness (typically 5 minutes or less)
• Short period of amnesia (24 hours less)

Generally, a mild TBI or concussion is diagnosed based on symptoms and imaging is not necessary.

When do symptoms of concussion start?

Some people experience concussion symptoms right after an injury. Sometimes there’s a delay. Adrenaline at the time of an injury might mask symptoms. When the body calms, you may notice you don’t feel quite right. This is when you should be evaluated by a health care provider.

What should I do if I have a concussion?

Stay active

Immediately after a concussion, it’s important to stay active to promote brain recovery. This doesn’t mean get back onto the court or sports field – do some light aerobic exercise, such as walking. If you’re experiencing dizziness, try a stationary bike. While the common course of action used to be to rest in a dark room, we’ve found that can make matters worse.

Avoid screen time

It’s important to avoid screen time, especially within the first 48 hours after a concussion injury. During this period, many people with mild TBI get headaches or eye discomfort from screens.

Get regular sleep

Sleep helps the brain recover, so try to stay on a regular sleep-wake cycle. If you’re having trouble sleeping, a neurologist or other health care provider may be able to help. We no longer recommend regularly waking someone who’s suspected of having a concussion.

Who treats concussion?

Choosing the best specialist to treat a concussion is not always cut and dried, because depending on symptoms, you’ll be treated by different providers. You’ll want to be seen by a provider who can refer you to the right experts. If you're an athlete, you’ll likely have an athletic trainer who can help with this process. Otherwise, telling your doctor what symptoms you’re experiencing can help them get you to the right treatment.

You might visit a physical therapist if you’re experiencing dizziness or balance issues, for example. If you’re having eye movement problems, you might visit an eye specialist. If you struggle with thinking or memory, you may be referred to a neuropsychologist. If you have headaches, you might see a neurologist.

What’s life like after a concussion?

The majority of people should return to their pre-injury selves within a month.

However, around 10% of people have persisting symptoms. This could be for a number of reasons.

Sometimes it’s because they didn't get the initial care that they needed, and they’ll recover once they receive appropriate care.

Other times, a person’s pre-concussion condition may have been worsened by the injury. If someone has anxiety, for example, they may have aggravated anxiety symptoms after the concussion, and it may take longer to recover. Or if a person had migraines before the injury, they may have increased migraine symptoms afterward, and those can complicate recovery.

Either way, there are a lot of treatment options. If you’re suffering with persisting symptoms, you don’t have to suffer in silence. Continue sharing your symptoms with your health care provider until you find the right specialist.

If you keep hitting a roadblock, consider reaching out directly to experts in concussion care, headache and sports concussions or physical medicine and rehabilitation.