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What to Expect After a Concussion

A concussion may be caused by a blow, bump or jolt to the head, or by any fall or hit that jars the brain. This invisible injury disrupts the way the brain works by decreasing mental stamina, as the brain must work longer and harder even to complete simple tasks. Concussions may involve loss of consciousness, but in the majority of concussions, loss of consciousness does not occur. 

It is important to know the signs and symptoms of a concussion.

Concussion danger signs

In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. A patient should be seen in an emergency department right away if symptoms worsen and / or if the patient has: one pupil larger than the other, worsening headaches, seizures, neck pain, unusual behavior change, increased drowsiness, repeated vomiting, slurred speech, problems recognizing people or places, increased confusion, weakness or numbness in arms or legs, or if the patient can’t be awakened or is less responsive than usual.

Concussion recovery and treatment

Approximately 80 percent of concussions resolve over seven to 14 days, with an average of 10 days. People with concussions should never return to sports or other physical activity sooner than one week from sustaining the injury.

A concussed patient’s recovery has two and sometimes three phases depending on the severity of the concussion:

Acute phase is the initial period after sustaining a concussion in which the patient is still experiencing symptoms. This phase can last a week or more. During the acute phase, the concussed brain requires mental and physical rest to recover from the injury. Absence from school or half-day attendance may be recommended because academic work demands focus, memory, and concentration – all brain processes that are affected by a concussion. Decreasing the amount of activity in the brain through absence from school and schoolwork (and therefore achieving mental rest) will help decrease symptoms and begin the healing process.

People who have had a concussion should avoid texting, computer use, video games, television, driving, loud music and music through headphones because all of these activities make the brain work harder to process information and can exacerbate symptoms and slow the recovery process.

Additionally, people with concussions may not participate in any physical activity until cleared by a health care provider, including gym class, weightlifting and sports activities due to the risk of second impact syndrome. This potentially life-threatening event may result from a second, often minor, blow to the head suffered before recovery from the initial injury has occurred. Ultimately, the key to a speedy recovery is both physical and mental rest.

The patient may take pain medicine as prescribed, and use an icepack on the head and neck for comfort. They may also sleep or rest.

Recovery phase occurs once the patient feels physical improvement, such as headaches subsiding, and postconcussion neurocognitive test scores have improved. During this phase, the patient can gradually return to academic and athletic activity as directed by a health care provider. However, academic accommodations may be required during the recovery phase because the concussion may still affect thinking, attention, focus, memory, learning speed and mental processing.

Chronic phase occurs in some cases when the patient may experience more long-lasting (chronic) problems with cognitive function. This may require consideration of a 504 plan, home schooling or a medical leave of absence.

If unmanaged, these problems have the potential to significantly impact the patient’s life as a whole. Patients who are in the chronic phase of a concussion will be referred to one of our neuro rehab specialists who will treat the chronic symptoms.

No two concussions are exactly the same, so individualized treatment is necessary. Developing brains are highly variable, so the symptoms experienced by one person may be completely different from  another. Some patients will take longer to recover from a concussion for various reasons. Therefore, each concussion is managed on an individual basis.

Remember: Concussion affects people differently. While most people with a concussion recover quickly and fully, some will have symptoms that last for days or even weeks. A more serious concussion can last for months or longer. Do not compare your concussion symptoms and recovery to that of someone else or even to any previous concussions you may have sustained.