Section 6. Brain, Spinal Cord, and Nerve Disorders

Chapter 87. Head Injuries

Topics: Introduction | Skull Fracture | Concussion | Cerebral Contusions and Lacerations | Intracranial Hematomas

Concussion

A concussion is a brief loss of consciousness after a head injury that does not cause visible physical damage.

Concussions result in a temporary malfunction of the brain but no visible physical damage. They may occur after even a minor head injury, depending on how the brain is jarred within the skull.

A person who has a concussion may temporarily feel dazed or mildly confused. Consciousness may be lost for a brief time. Memory for events just before or just after the injury may be lost. Most people recover completely within a few hours or days. Occasionally, symptoms of worsening brain function develop hours or sometimes days after the original injury, especially in older people. If these symptoms occur, prompt medical attention is essential.

Postconcussion syndrome is a group of symptoms that occur after a concussion. The syndrome lasts from a few days to several weeks but rarely longer. People may feel somewhat confused, headachy, and abnormally sleepy. Dizziness, difficulty concentrating, forgetfulness, depression, lack of feeling or emotion, and anxiety may develop. Meanwhile, people may have trouble working, studying, and socializing. Postconcussion syndrome is puzzling; why these problems commonly occur after a minor head injury is unknown. Experts disagree about whether the symptoms are caused by microscopic damage or psychologic factors.

Usually, once doctors have determined that severe damage has not occurred, no treatment is needed. As long as symptoms do not worsen, acetaminophen may be used for pain. Adults may take aspirin or another nonsteroidal anti-inflammatory drug (NSAID) (see Section 6, Chapter 78) after the first 3 or 4 days if the injury is not severe and no bleeding is detected by computed tomography (CT). These drugs should not be taken any sooner, because they interfere with blood clotting and may prolong bleeding from damaged blood vessels.

People with postconcussion syndrome may be given drugs used to treat headache (see Section 6, Chapter 79) or dizziness (see Section 6, Chapter 80). Psychiatric treatment helps some people.