Common symptoms of concussion
● Headache ● Dizziness ● Nausea ● Difficulty concentrating ● Brain fog ● Sensitivity to light and sound ● Sleep problems ● Exhaustion
Even though the symptoms are often obvious, MRI or CT often show no findings. This is because concussion is primarily a functional disturbance in the brain, not necessarily a structural injury. After the trauma, a temporary “energy crisis” occurs in the nerve cells, where the brain uses more energy than it is able to produce. During this period the brain becomes more sensitive to physical, cognitive and sensory load.
The time after a concussion
For the first 48 hours after a concussion it is wise to stay in relative rest. That means making sure you take it easy, but at the same time getting started with a gradual build-up of physical activity. A thorough examination is recommended before resuming contact sport training or other potential causes of a new head injury. It is common for symptoms to vary during the first few days, but they should stabilise after this. Symptoms that may be long-lasting are often noticed after 7-10 days, and can typically last for several months. The diagnosis post-concussion syndrome (PCS) is then used, and treatment is adapted accordingly. We have a separate article about PCS, which can be read here.
What should you do if you get a concussion?
In the past, prolonged rest was often recommended after a concussion. More recent research points towards gradual and adapted activity often giving better results than complete rest alone. Load management, vestibular rehabilitation and graded physical activity have therefore become important parts of treatment and rehabilitation for concussion. Early and appropriate help for concussion can help prevent the long-lasting symptoms, and get you back to activity.
This article was written by Carl Johan Ween, chiropractor at Behandlerverket Oslo sentrum. He has further training in concussion and dizziness, and works in particular with the assessment and treatment of patients with post-concussion syndrome, vestibular problems and other causes of dizziness.
References
Langevin, P., Frémont, P., Fait, P., & Roy, J.-S. (2022). Responsiveness of the Post- Concussion Symptom Scale to monitor clinical recovery after concussion or mild traumatic brain injury. Orthopaedic Journal of Sports Medicine, 10(10), 23259671221127049. https://doi.org/10.1177/23259671221127049
Centers for Disease Control and Prevention. (2024, May 15). Traumatic brain injury & concussion. https://www.cdc.gov/traumatic-brain-injury/
McCrory, P., Meeuwisse, W., Dvořák, J., et al. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport—Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695–711. https://bjsm.bmj.com/content/57/11/695