Concussion
It happens to many — but it can have serious consequences
editorial.overview
What happens in a concussion?
A concussion, also called commotio cerebri, is the mildest form of a traumatic brain injury and often occurs in accidents at home, during sports or in road traffic.
Although the brain is protected inside the skull by cerebrospinal fluid that cushions movement, a strong blow to the head or a sudden, jerking motion can cause the brain to strike the skull wall. This can tear nerve connections and impair the brain's function so that it can no longer process signals and stimuli properly. Symptoms usually subside within a few days and typically do not lead to permanent damage.
editorial.facts
- Repeated and inadequately treated concussions can lead to long‑term brain damage known as chronic traumatic encephalopathy, which may cause symptoms similar to those of Alzheimer’s or Parkinson’s disease.
- About 20 percent of all concussions occur during sports. Examples include falls when cycling or riding or collisions in football that can lead to concussions. In boxing, almost every knockdown is associated with a concussion.
- In contact sports such as rugby, American football and hockey, concussions occur considerably more often than in sports with less direct body contact such as volleyball.
What are typical symptoms of a concussion?
Typical symptoms of a concussion affect various areas of the body and mind. Physical complaints include headache, dizziness, balance problems, visual disturbances as well as nausea and vomiting. There may also be perceptual and thinking disorders with dazedness and confusion, as well as slowed actions and thinking.
Immediately after the injury, concentration and orientation problems often occur. Memory disturbances (amnesia) are also possible; these generally last less than 24 hours and cause the affected person not to remember events shortly before, during or after the accident. General well-being can also be affected, with symptoms such as irritability, anxiety and sleep disturbances, including problems falling asleep and staying asleep. The severity of symptoms depends on the extent of the brain injury.
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When is it a traumatic brain injury and when a concussion?
A concussion can sometimes be accompanied by a brief loss of consciousness. Even if a concussion diagnosis may initially seem harmless, it should be thoroughly investigated. The transition from a mild concussion to a severe traumatic brain injury is fluid and difficult to detect.
A traumatic brain injury can cause symptoms similar to a concussion, although life-threatening bleeding in the head may already be present. Therefore, it is important that a thorough medical examination is always performed if a traumatic brain injury is suspected, in order to rule out serious complications.
What are the symptoms of concussion in children?
Children and infants are more frequently affected by concussions than adults because they fall more often or injure themselves while playing and doing sports. Since infants and toddlers cannot clearly express their pain, it is particularly important for parents to observe them closely after an accident.
If the child was even briefly unconscious, a medical visit is essential. Crying immediately after the fall is initially a good sign, but if crying continues, the child vomits or appears especially restless, apathetic or drowsy, a doctor should be consulted.
It is important to know that concussion symptoms in young children sometimes appear delayed and only become noticeable after six, twelve hours or more. Therefore, it is advisable to have the child examined by a paediatrician after a fall or a blow to the head.
Mild concussions do not always require treatment. For headaches, pain relievers such as paracetamol or ibuprofen may help; sometimes the doctor prescribes an anti‑nausea medication. It is recommended to keep the child in bed for a few days and to avoid activities such as watching TV or reading, as these can worsen symptoms. If a severe concussion is suspected, the doctor usually recommends 24‑hour observation in hospital.
How do doctors diagnose a concussion?
Doctors diagnose a concussion through a thorough medical history and physical examination. They look for neurological abnormalities such as memory or vision problems and observe the patient's motor skills and level of consciousness.
Only if the symptoms are very severe or there are risk factors for complications do doctors order a computed tomography (CT) to obtain detailed images of the brain.
How do doctors treat a concussion?
People who do not need hospital admission should ideally not be left alone for at least 24 hours but remain under supervision by relatives or friends. Activities such as watching TV, working or playing on the computer, reading and sport should initially be avoided. A few days of rest are usually sufficient to recover. However, if new symptoms appear or existing complaints worsen, a doctor should be consulted immediately.
Contrary to earlier guidance, those affected can, in close consultation with a doctor, be cautiously reintroduced to everyday activities already 24 to 72 hours after the event. This can speed up the healing process. Excessive exertion should, however, be avoided.
How to prevent a concussion: practical tips
- Always wear a well‑fitting helmet for sports with increased risk of falls such as cycling, inline skating, climbing or skiing.
- Make sure children also wear the correct protective equipment.
- When riding a motorcycle or scooter, it is advisable to always wear a helmet to prevent head injuries. If you fall, watch for signs such as dizziness and headaches and respond immediately to such warning signals. See a doctor in time and rest in bed if necessary.
- Pay attention to warning signs and barriers at construction sites and other hazardous areas.
- Always wear a seat belt when driving and use child seats of the correct size.
- Secure windows, stairs and balconies, especially in homes with children, by opening windows only on tilt and fitting gates to stairs.
- Place non‑slip mats and runners and remove trip hazards such as cables and toys.
- Use handrails on stairs and install additional guard rails if needed.
- Never leave young children unattended on a changing table.
- Be aware of possible obstacles such as street lamps or low‑hanging signs.
- Wear slip‑resistant shoes on icy or wet surfaces and adapt your walking speed to the conditions.
- Check unknown waters for depth and possible hazards before diving in.
- Take appropriate safety precautions and use the right equipment when working at height.
Concussions should be taken seriously, and if symptoms occur, an immediate medical examination is essential to rule out possible complications and promote recovery. With caution and attention we can effectively reduce the risk of concussion and protect the safety of our children and ourselves.
