Concussion most commonly occurs as a result of sports injuries, traffic accidents or falls. It is not always obvious when a head injury has resulted in a concussion. We look at the signs of concussion, when to present to hospital, and what to do when symptoms persist for several weeks.
Concussion is a mild form of traumatic brain injury, where a blow to the head or a violent shake results in unconsciousness or temporary confusion. The effects normally resolve in 10 to 14 days. Common indicators of concussion include a headache, fatigue, dizziness, nausea, or memory loss.
Sleepiness and fatigue are the most common indicators, and people can find themselves sleeping much longer than usual following a concussion incident.
Knowing when to recover at home and when you should go to hospital is important.
According to Epworth clinical neuropsychologist, Jo Sherry, where you find symptoms worsening, you start vomiting or get disoriented, you should go to the nearest Emergency Department for assessment. They might consider a brain scan to look for bleeding or a skull fracture.
For most people, a visit to the GP will be the best option, with another follow up a week later.
An uncomplicated concussion usually resolves itself within two weeks post-injury. During that time, the best treatment is resting with some light activity such as going for a walk.
“We recommend balancing activity with rest to help stop symptoms from flaring up. If you have had concussion and find yourself with a headache, stop whatever activity you are doing and rest. Over time you can build up resilience to activity, but you really do want to avoid flaring up symptoms,” Jo says.
Headaches can occur post concussion due to subtle swelling in the brain, which interferes with the way neurons ‘talk’ to each other.
Jo says it is important to avoid alcohol after concussion, as it can affect your balance and put you at risk of injuring yourself further. It can also disrupt natural recovery processes.
Activities including reading, watching television, work, screen time or listening to loud music can also be over stimulating post-concussion.
Doctors generally advise waiting two-week sor more before returning to sport — until all symptoms have ceased.
“If you return to sport while playing with unresolved concussion symptoms you are more likely to sustain another injury or a secondary concussion. Light exercise is the most anyone should undertake over this time,” Jo says.
A repeat concussion can result in symptoms taking even longer to resolve than previously, or being worse than the initial incident.
Concussion in an elderly patient sustained from a fall needs to be treated carefully, to prevent a repeat concussion.
“It is important to keep the environment clear of tripping hazards and leave a light on at night time. Looking out for ongoing symptoms of concussion after a fall is really important, as is avoiding another fall.“
If symptoms continue for more than two or three weeks after a concussion you should consider consulting a specialist.
“Some people experience difficulties with concentration or memory, and need help pacing themselves and with fatigue management. We often work over at least three to four sessions once a week with a neuropsychologist, and specialists as required, including physiotherapists for balance and vestibular (inner ear) problems after concussion.
“Our goal is to get people back to regular activity, pacing themselves and managing their symptoms while they recover,” Jo says.
The Epworth Concussion Clinic offers a multidisciplinary concussion screening and assessment clinic, developed to assess and manage individuals who display ongoing concussion symptoms through Epworth Hawthorn. Patients require a referral from a GP or other medical specialist.