In my early 20s, during a night out, I fell. I thought I only ended up with a black eye and a throbbing headache, until I was diagnosed with a concussion. I was surprised — concussions were just for athletes, right?
While we hear plenty of news about people getting concussions due to contact sports like football, they can happen to anyone with a head. The good news is that they’re relatively easy to recognize and treat if you know what to look out for. We break down everything below.
Concussions 101
A concussion is a traumatic brain injury that occurs when something bumps or jolts the head hard enough for your head to move rapidly back and forth. When this happens, the brain basically twists and bounces inside the skull, which breaks apart neurons, the messengers of your brain. This throws off the neurons’ delicate chemical balance and makes it harder for them to function.
Despite how violent this sounds, medical providers still describe individual concussions as “mild” brain injuries, because they’re usually not life-threatening and their effects tend to be temporary. While symptoms are immediate, they’re not typically permanent.
Still, your brain is your body’s control center, so when it’s damaged, there are repercussions. Concussions manifest differently depending on the severity of the initial injury, but some of the typical symptoms are:
- Headache
- Short-term memory loss (for instance, an inability to recall what happened before the injury)
- Clumsiness
- Falling asleep or losing consciousness
- Nausea
- Blurred vision or dizziness
- Tinnitus (ringing in the ears)
- Difficulty concentrating
The nonathlete’s dilemma
It’s true that if you play football, you’re more likely to get a concussion. Between 2014 and 2019, there were an average of 247 reported concussions per year in the NFL, and around 10 percent of college football players and 20 percent of high school football players sustain brain injuries in a given season.
However, there are plenty of other ways to get a concussion. Your brain is delicate. It’s the consistency of gelatin, cushioned from everyday bumps by important fluid in your skull — but any bump or jolt that’s too violent will overwhelm that protective layer. Life is full of unforeseen bumps.
Falls (off a barstool or otherwise) are the most common cause of a concussion, but there are others. Dr. Laura Goldberg, a pediatric sports medicine specialist at Case Western Reserve University School of Medicine, says that any unexpected blow to the head can lead to a concussion. “This can happen by standing up quickly and hitting an object above, like a cabinet or bunk bed, or falling off your bike without a helmet,” she says. Another common cause is sudden acceleration or deceleration, which can happen in car crashes.
Test as old as time
Concussions are usually diagnosed through observation and patient self-reporting. In fact, fancy imaging scans like MRIs and CTs typically won’t even register a concussion, since the injury is microscopic and metabolic in nature.
If you ever had to take a “follow my finger” concussion test in high school, you’re familiar with one of the standbys used to diagnose the head injury. “Following a finger with your eyes evaluates several things,” Goldberg says. “We use it to evaluate your ability to follow instructions, to focus both eyes on an object and your tolerance to eye motion.”
However, there’s no one test that’s universally used to diagnose the head injury. Dr. Michael McGrath, an instructor at the University of Washington’s School of Medicine, says doctors often use something called the acute concussion evaluation (ACE) tool, a comprehensive questionnaire on everything from symptoms to family medical history. However, there’s no one universal test.
Besides assessing all of the symptoms listed above, doctors will also check for focal neurological changes, which can indicate an internal head injury that needs emergency care.
If you’re at home, trying to figure out if anything’s wrong, make sure you’re seeing objects and people in your vision symmetrically. “If anything is unequal, it’s best to go to the ER,” Goldberg says.
A heads-up on treatment
In certain cases, a concussion merits a trip to the emergency room, like if a person is losing consciousness, vomiting repeatedly, slurring their speech or experiencing other extreme symptoms. But generally, it’s okay to see a primary care doctor or sports medicine doctor 24 to 48 hours after the injury. And that old warning about not letting someone with a concussion fall asleep lest they slip into a coma? Untrue. If a concussed person doesn’t need emergency treatment, it’s okay to let them snooze.
For most concussions, the treatment protocol is nothing — literally. Recovery requires your brain cells to rebalance their levels of chemicals, which were thrown off by an influx of calcium post-injury. Limit exposure to video games, loud music, prolonged screen time, or mental activities requiring high levels of focus and concentration.
Healing requires a lot of energy, so it’s vital that patients conserve as much as they can. Post-concussion, patients are encouraged to avoid any strenuous or even moderate physical and mental activities. Overexertion during this time period can lengthen the time it takes for your brain to heal. “Treatment really depends on the severity of the concussion,” McGrath says.
Concussions are scary. Luckily, by taking a break, your brain will heal and function normally in a matter of days.