Content

Introduction

Introduction

Concussion (also called concussion) is an alteration, usually temporary, of brain function caused by a traumatic event, such as a bump or blow to the head, or by violent shaking of the neck and torso.

It is the most frequent type of brain injury; it can occur as a result of a fall, a road accident, a sports accident, or when a person is shaken with great force.

In most cases, the effects are temporary and reversible, but they can include confusion, headaches, problems with memory, difficulty coordinating movements and balance; generally, there is no loss of consciousness.

In some cases the effects are mild, in others medical attention is required.

Symptoms

Symptoms

Usually, the signs and clinical manifestations (symptoms) of a concussion appear immediately after the traumatic event but, sometimes, they can occur even after a few hours or days and can last for days, weeks or even longer. They include:

  • headache
  • confusion, lightheadedness
  • dizziness
  • ringing in the ears
  • dizziness
  • nausea
  • He retched
  • tiredness, sleepiness
  • blurred vision
  • difficulty speaking and answering a question
  • memory loss (amnesia), limited to the traumatic event
  • loss of consciousness (not frequent)

Other disorders that can arise and be more lasting include:

  • concentration problems
  • irritability and other personality changes
  • sensitivity to light and noise
  • sleep disorders
  • disturbances of taste and smell
Causes

Causes

Concussion is caused by trauma that affects the head and can impair brain function.

The brain is separated from the bones of the skull by a liquid, the cerebrospinal fluid, which allows to absorb shocks and prevent the brain tissue from being damaged. A bump or violent blow to the head and neck, a sudden movement of the head back and forth caused by a car accident or shaking of the upper body, can cause the contents of the skull (the brain, consisting of the brain, cerebellum and medulla oblongata) undergoes rapid acceleration and deceleration and impacts violently against the internal walls of the skull. This type of trauma can cause a diffuse alteration of the brain tissue, in the absence of lesions in a specific area, which affects brain function, usually for a short time, giving rise to the signs and disorders (symptoms) characteristic of concussion. .

In severe cases, brain trauma can cause blood vessels to rupture with bleeding that can be fatal. For this reason, anyone who has suffered a trauma to the head (head trauma) must be carefully followed and assisted in the following hours in order to be subjected to emergency therapies if the ailments worsen.

Diagnosis

Diagnosis

It is usually not necessary to see a doctor immediately if, after a mild injury to the head, you have only mild ailments (symptoms) that do not last long, such as headache, dizziness, lightheadedness and fatigue.

Head injuries are common in children, especially in the first two years of life, often caused by falls. Concussions, however, are more difficult to recognize in infants and children. In most cases, these are minor or modest head injuries, but a "careful reconstruction" of what happened and an accurate evaluation of the child are essential to ascertain the severity of the brain damage.

It is necessary to go immediately to the emergency room or call the single telephone number 112 if in an adult or in a child who has suffered a head injury there is:

  • repeated vomiting or nausea
  • loss of consciousness, short or long
  • headache that persists or gets worse over time
  • bleeding from the nose or ears
  • vision disturbances
  • continuous ringing in the ears
  • weakness, fatigue
  • difficulty in movement
  • drowsiness
  • prolonged pallor
  • changes in behavior, irritability
  • confusion or disorientation, difficulty in recognizing people or places
  • slurred speech, slurred speech
  • continuous and inconsolable crying (in children)
  • convulsions
  • repeated dizziness
  • disorders that worsen over time

These cases require urgent hospitalization to ascertain the severity of the damage that has occurred. The specialist doctor will evaluate the clinical manifestations present and will perform a neurological examination to detect any alterations in brain functions.

Neuroradiological investigations are recommended following a head injury if the disorders are severe and structural brain injury is suspected. They include:

  • cranial computed tomography (CT scan), an examination indicated to evaluate brain damage immediately after the injury and to discover possible edema and bleeding inside the skull
  • magnetic resonance (MRI), used to evaluate brain changes or possible complications resulting from concussion
Therapy

Therapy

Treatment of concussion involves close observation of the person, usually by a family member, in the hours immediately following the traumatic event. This is necessary in order to quickly identify the appearance of the aforementioned disorders (symptoms) and arrange for transport. in the hospital to carry out the appropriate checks.

In the days immediately following a concussion, physical rest is the best way to allow brain function to resume. This means avoiding physical exertion, sports activities and sudden movements. Rest must also include limiting activities that require mental focus and attention. To reduce the pain due to headaches, the treating physician may prescribe pain relieving medications.

As clinical manifestations improve, normal physical and intellectual activity can be gradually resumed. Resuming sporting activity too early increases the risk of a second concussion. It is therefore necessary to proceed gradually in the convalescence phase, until the complete disappearance of the disorders (symptoms) and the doctor's approval when normal activities are resumed.

Risk factors and prevention

Risk factors and prevention

Events and activities that can increase the risk of concussion are:

  • falls
  • contact sports, such as boxing, soccer, rugby, ice hockey
  • speed sport, such as motoring, motorcycling, cycling, skiing
  • the lack of adequate protections while performing high-risk sports
  • road accidents (accidents in cars, motorcycles, bicycles, and pedestrian accidents)
  • physical violence

To prevent or minimize the risk of head injuries it is essential:

  • wear a protective helmet, when engaging in contact sports, sports and recreational activities on bicycles, motorcycles, skis or snowboards, roller skates or skateboards, equestrian sports
  • always fasten the seat belt in the car
  • always secure the child in the car with approved restraint systems (carrycot, infant carrier, seat with safety belt, depending on weight and height)
  • increase the security level of the houseadapting it to the needs of children and the elderly, identifying all potential sources of risk, and eliminating any obstacles that could cause falls or trips; falls at home are a leading cause of head injuries
  • install non-slip surfaces or carpets, in the bathtub and shower
  • provide information on the prevention and treatment of concussionsin particular, coaches, athletes and parents can contribute to spreading knowledge and awareness of the risks of brain trauma
Complications

Complications

Complications that can appear after a concussion include:

  • post-traumatic headache, in some cases, it can last for several weeks
  • post-traumatic dizziness, you may feel dizzy or dizzy for days, weeks, or even months after the traumatic event
  • concussion syndromeIn 15-20% of people, ailments such as headache, dizziness and difficulty concentrating may persist in the weeks following the head injury. If these ailments persist for more than three weeks we are talking about concussion syndrome
  • second impact syndrome, is a rare, serious complication of concussion. Having a second concussion before the signs and disorders of the previous one are resolved can cause more serious and potentially life-threatening brain damage. It is of particular interest to athletes; they should absolutely avoid resuming sporting activities if the signs and complaints of a concussion are still present
In-depth link

In-depth link

Mayo Clinic. Concussion (English)

Bambino Gesù Children's Hospital. Head trauma

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