Concussion Treatment at UPMC in Central Pa.

Our concussion experts and board-certified sports medicine doctors provide diagnosis and treatment for a range of concussion-related symptoms in people of all ages.

Concussion is one of the most common sports injuries, with about 2 million sports-related concussions reported each year. While more and more people are becoming aware of the frequency and dangers of concussion, the advice about what to do for concussion can be confusing. That is why it is important to seek expert medical treatment as soon as possible.

What Is a Concussion?

A concussion is a type of traumatic brain injury that is caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull. Although there may be cuts or bruises on the head or face, there may be no other visible signs of a brain injury.

You don't have to pass out (lose consciousness) to have a concussion. Some people will have obvious symptoms of a concussion, such as passing out or forgetting what happened right before the injury. But other people won't. With rest, most people fully recover from a concussion. Some people recover within a few hours. Other people take a few weeks to recover.

It's important to know that after a concussion the brain is more sensitive to damage. So while you are recovering, be sure to avoid activities that might injure you again.

In rare cases, concussions cause more serious problems. Repeated concussions or a severe concussion may lead to long-lasting problems with movement, learning, or speaking. Because of the small chance of serious problems, it is important to contact a doctor if you or someone you know has symptoms of a concussion.

What Causes a Concussion?

Your brain is a soft organ that is surrounded by spinal fluid and protected by your hard skull. Normally, the fluid around your brain acts like a cushion that keeps your brain from banging into your skull. But if your head or your body is hit hard, your brain can crash into your skull and be injured.

There are many ways to get a concussion. Some common ways include fights, falls, playground injuries, car crashes, and bike accidents. Concussions can also happen when you take part in any sport or activity such as football, boxing, hockey, soccer, skiing, or snowboarding.

What Are the Symptoms of Concussion?

It is not always easy to know if someone has a concussion. You don't have to pass out (lose consciousness) to have a concussion.

Symptoms of a concussion range from mild to severe and can last for hours, days, weeks, or even months. If you notice any symptoms of a concussion, contact your doctor.

Symptoms of a concussion fit into four main categories:

Thinking and remembering

• Not thinking clearly
• Feeling slowed down
• Not being able to concentrate
• Not being able to remember new information

Physical

• Nausea and vomiting
• Headache
• Fuzzy or blurry vision
• Dizziness
• Sensitivity to light or noise
• Balance problems
• Feeling tired or having no energy

Emotional and mood

• Easily upset or angered
• Sad
• Nervous or anxious
• More emotional

Sleep

• Sleeping more than usual
• Sleeping less than usual
• Having a hard time falling asleep

Young children can have the same symptoms of a concussion as older children and adults. But sometimes it can be hard to tell if a small child has a concussion. Young children may also have symptoms like:

• Crying more than usual.
• Headache that does not go away.
• Changes in the way they play or act.
• Changes in the way they nurse, eat, or sleep.
• Being upset easily or having more temper tantrums.
• A sad mood.
• Lack of interest in their usual activities or favorite toys.
• Loss of new skills, such as toilet training.
• Loss of balance and trouble walking.
• Not being able to pay attention.

Concussions in older adults can also be dangerous. This is because concussions in older adults are often missed. If you are caring for an older adult who has had a fall, check him or her for symptoms of a concussion. Signs of a serious problem include a headache that gets worse or increasing confusion or both. See a doctor right away if you notice these signs. If you are caring for an older adult who takes a blood thinner and who has had a fall, take him or her to a doctor right away, even if you don't see any symptoms of a concussion.

Sometimes after a concussion you may feel as if you are not functioning as well as you did before the injury. This is called postconcussive syndrome. New symptoms may develop, or you may continue to be bothered by symptoms from the injury, such as:

• Changes in your ability to think, concentrate, or remember.
• Headaches or blurry vision.
• Changes in your sleep patterns, such as not being able to sleep or sleeping all the time.
• Changes in your personality such as becoming angry or anxious for no clear reason.
• Lack of interest in your usual activities.
• Changes in your sex drive.
• Dizziness, lightheadedness, or unsteadiness that makes standing or walking difficult.

If you have symptoms of postconcussive syndrome, call your doctor.

Concussion Diagnosis and Evaluation

In diagnosing and evaluating concussion, experience matters. As of now there is no precise diagnostic exam for concussion. Our concussion experts will evaluate the severity of your concussion by reviewing your medical history and doing a thorough physical exam of your symptoms, balance, and physical condition.

If our experts think that you have a concussion, he or she will ask questions about the injury. Our experts may ask you questions that test your ability to pay attention and your learning and memory. Our experts may also try to find out how quickly you can solve problems. He or she may also show you objects and then hide them and ask you to recall what they are. Then our experts will check your strength, balance, coordination, reflexes, and sensation.

Expert Concussion Treatment

The best treatment for concussion is resting your brain so it can heal. This means that your concussion management plan may include:

• Uninterrupted sleep
• Cognitive rest, meaning limited reading, television, texting, and schoolwork
• Over-the-counter medications
• Massage, ice and other comfort measures to treat pain
• A quiet environment to manage headaches and sensitivity to light or noise
• Prescription medications
• Physical or occupational therapy

Return to Activity

The decision to return to normal activity is one of the most difficult aspects of concussion management. Returning to activity too early or getting a second concussion before your brain has healed can have serious consequences.

Your doctor will work with you to decide when you should return to your normal activities. Although you may be able to go back to work or school fairly quickly, it may take much longer for you to be able to return to physical activity.

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