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Concussion

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Concussion, also referred to as mild traumatic brain injury (MTBI), is a temporary disruption of normal neurological brain function caused by a sudden and violent external force, such as:

  • A blow to the head
  • The head striking an object
  • Whiplash
  • Penetration by an object (i.e., bullet, knife, etc.)

Most often, a brain concussion is associated with a fall, a sports accident or a motor vehicle accident involving drunk driving. (Those convicted of drunk driving typically face a number of legal consequences, including possible jail time and fees for DUI charges; for more information, refer to our DUI section.)

A concussion is a serious injury that can have harmful and costly consequences. When another party is at fault in a concussion, people who have been injured often qualify for compensation for medical bills and accompanying pain and suffering. If you suspect your concussion was caused by someone else's carelessness, contact a personal injury attorney who can provide injury legal help to protect your rights and provide you with examples of personal injury settlements and court awards. Head injury claims can help offset the often high costs associated with medical treatment, recovery, loss of work, etc.

In this article you will learn about what causes a concussion, how to diagnose and treat a concussion and what prognosis to expect.

Causes of Concussion

When the head experiences a traumatic force, the brain is rotated and dashed against the inside of the skull, compressing, lacerating, stretching and straining brain tissue.

The primary destructive mechanism of a concussion is stretching and straining. This creates injury to or disturbance in individual neurons (nerve cells), usually over a wide area of the brain's surface. Neurons below the surface, even deep below the surface, may be harmed in severe concussions.

Under normal circumstances, neurons communicate with other neurons and glia (support cells) by means of orderly electrical and chemical signals. However, when neurons are strained or otherwise harmed by a head trauma, they discharge electrical impulses in sudden and haphazard bursts, sending erratic and confused messages. These miscommunications trigger unhealthy chemical and metabolic changes that can further damage or kill already injured neurons. Restricted blood flow to the brain may also occur. This sequence of events, commonly referred to as a "neurometabolic cascade," is a crisis situation.

After an interval of days or weeks, during which time the damaged neurons struggle for life, the process reverses and proper neuron communication returns. If, however, the neurons are damaged again by a second concussion before they have fully recovered, their chances of survival are greatly reduced. This can result in permanent brain damages or brain death. Patients who suffer brain damage due to someone else's negligence may have grounds for a substantial settlement or court award. To learn more about obtaining compensation for your injuries, contact a personal injury lawyer.

Concussion Symptoms

Primary symptoms of a concussion are temporary confusion and amnesia. Loss of consciousness may or may not be present. Other signs of a concussion may include vertigo, nausea, vomiting, headaches, lethargy, ringing in the ears, lightheadedness, irritability, blurred vision, slurred speech, nervousness, depression, trouble balancing and difficulty sleeping.

Concussion Diagnosis

Diagnosis begins by assessing the seriousness of the concussion. A number of different grading scales can be used. Two that are frequently used are The American Academy of Neurology Grading Scale and the Cantu Evidence-Based Grading Scale. In an emergency room setting, the Glasgow Coma Scale (GCS) may also be used.

The American Academy of Neurology Grading Scale.This grading scale probably is the most used method for classifying a concussion after a traumatic brain injury. It uses a three-grade scale that ranks the concussion at the time of injury, attending more to how long confusion and loss of consciousness last than to other signs and symptoms.

  • Grade 1: No loss of consciousness, temporary confusion and symptoms lasting less than 15 minutes.
  • Grade 2: No loss of consciousness, temporary confusion and symptoms lasting longer than 15 minutes.
  • Grade 3: Any loss of consciousness.

The Cantu Evidence-Based Grading Scale. The Cantu Evidence-Based Grading Scale assesses a concussion after all signs of concussion have disappeared. The severity of the concussion is determined by how long loss of consciousness and loss of memory lasted.

  • Grade 1: No loss of consciousness and post-traumatic loss of memory lasting less than 30 minutes.
  • Grade 2: Loss of consciousness for less than five minutes and post-traumatic loss of memory loss lasting between 30 minutes and 24 hours.
  • Grade 3: Loss of consciousness for longer than five minutes and post-traumatic loss of memory for longer than 24 hours.

The Glasgow Coma Scale. The Glasgow Coma Scale measures verbal response, eye opening response, and motor response using a 15-point scale. It is meant to assist doctors in determining the seriousness of injury, odds of survival and chances for recovery. Mild concussions may not show up on this scale.

Following initial assessments, physical and neurological examinations are conducted. The physical examination takes into consideration breathing, blood circulation, broken bones (skull, spine, face bones) and other factors. The neurological examination considers eye responses (e.g., pupillary reflexes), degree of sensation and strength in the arms and legs, as well as coordination and balance.

An EEG, which monitors the brain's electrical activity, and imaging with X-rays, CT-scans, MRIs and other tests, may also be employed, though mild concussions often do not show up during these tests.

Concussion Treatment

When monitoring and testing have ruled out more serious head injuries, bed rest, plenty of fluid, nutritious food and, in some cases, a mild pain reliever, are prescribed. In addition, the patient is cautioned against sustaining a second concussion while recovering. A repeat concussion can cause the brain to swell and permanent brain injury or even death to occur.

A follow-up visit to the doctor is important to be sure all symptoms have cleared.

Prognosis

Most concussed patients recover within 72 hours of their injury. Occasionally, postconcussion syndrome, a condition that prolongs the duration of symptoms, occurs.

A single concussion usually causes no permanent injury. However, multiple concussions, such as those caused by contact sports (i.e., boxing, football, soccer, etc.), may have a cumulative effect leading to serious brain injury, such as chronic traumatic encephalopathy (CTE). CTE shows up as Parkinson-like trembling, staggering and slurred speech. In the sport of boxing, having CTE is commonly referred to as being "punch drunk."




Did You Know?

Some 3.8 million sports-related concussions occur in the United States every year.

Source: Centers for Disease Control and Prevention (CDC)