What are the signs of a concussion?
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Signs of a Concussion: Key Indicators and Symptoms
Immediate Signs of Concussion: Disorientation and Balance Issues
Concussions often occur without a loss of consciousness or overt neurological signs. One of the most immediate and prevalent indicators of a concussion is disorientation or confusion right after the event2. Impaired balance is another common sign observed within the first day following the injury2. These signs are critical for on-field assessments, especially in sports settings where quick decisions about a player's ability to continue are necessary.
Acute Symptoms: Headache, Nausea, and Dizziness
Within the first 24 hours post-injury, individuals commonly experience a range of acute symptoms. These include headaches, nausea, dizziness, and balance problems1. Visual disturbances such as blurred vision, along with cognitive issues like confusion and memory loss, are also frequently reported1. These symptoms are typically most severe during the initial 24 to 48 hours and tend to diminish over several days to weeks in most cases1.
Observable Signs in Sports: Slow to Get Up and Clutching the Head
In professional sports, video analysis has identified several observable signs of concussion. These include players being slow to get up, clutching or shaking their head, exhibiting gait ataxia (unsteady walking), having a vacant stare, and in rare cases, experiencing seizures3 4. These signs are particularly useful for sideline assessments and decisions about removing players from the game.
Cognitive and Neurobehavioral Symptoms: Memory and Reaction Time
Cognitive deficits such as impaired verbal learning and memory, as well as slower reaction times, are prevalent within the first two days after a concussion2. These cognitive symptoms can significantly impact an individual's ability to perform daily tasks and are crucial for healthcare providers to monitor during the recovery process.
Evolving Symptoms: Fatigue, Irritability, and Sensitivity to Light
In the days following a concussion, additional symptoms may emerge. These can include fatigue, irritability, nervousness or anxiety, sleep disturbances, and sensitivity to light or noise1. These evolving symptoms highlight the importance of continuous monitoring and follow-up care to ensure a comprehensive recovery.
Long-term Indicators: Dizziness and Protracted Recovery
Dizziness at the time of injury has been associated with a higher likelihood of a protracted recovery, defined as taking more than 21 days to return to normal activities8. This finding underscores the need for early identification and management of dizziness to potentially mitigate longer-term impacts.
Conclusion
Recognizing the signs and symptoms of a concussion is vital for timely diagnosis and effective management. Immediate indicators such as disorientation and balance issues, along with acute symptoms like headaches and dizziness, are critical for initial assessments. Observable signs in sports settings, cognitive deficits, and evolving symptoms over time further inform the comprehensive care required for concussion recovery. Continuous monitoring and tailored interventions are essential to address the diverse and evolving nature of concussion symptoms.
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Most relevant research papers on this topic
What is the lowest threshold to make a diagnosis of concussion?
Sport-related concussions can be difficult to diagnose, with symptoms typically most severe within 24–48 hours and diminishing over days to weeks in most athletes.
Systematic Review
Highly CitedConcussion guidelines step 1: systematic review of prevalent indicators.
Disorientation, impaired balance, slower reaction time, and impaired verbal learning and memory are common indicators of concussion, providing an evidence-based foundation for developing diagnostic criteria and prognostic indicators.
Systematic Review
Very Rigorous JournalHighly CitedEvidence of Concussion Signs in National Rugby League Match Play: a Video Review and Validation Study
Using video analysis in the National Rugby League can identify concussion signs in players, but some common signs may not indicate concussions.
Observational StudyVery Rigorous JournalA video review of multiple concussion signs in National Rugby League match play
Video review in the National Rugby League can accurately identify combinations of concussion signs, aiding in sideline concussion identification and removal from play decisions.
Observational StudyVery Rigorous JournalAcute clinical signs and outcome of concussion in National Hockey League (NHL) players
Concussions in NHL players can produce a spectrum of acute on-ice clinical signs, but acute observable signs do not predict poor recovery outcomes.
Observational StudyInternational consensus definitions of video signs of concussion in professional sports
Six video signs of possible concussion have reached international consensus, and are recommended for use by professional sporting bodies.
Observational Study
Rigorous JournalWhich On-field Signs/Symptoms Predict Protracted Recovery From Sport-Related Concussion Among High School Football Players?
On-field dizziness at the time of injury is associated with an increased risk of a protracted recovery from sports-related concussions in high school athletes.
Observational StudyHighly CitedCan Adults Recognize Concussion Symptoms? A Critical Review of Empirical Research Using the Rosenbaum Concussion Knowledge and Attitudes Survey
Adults recognize 3 concussion symptoms (headaches, dizziness, and confusion) well, but struggle with sleep disturbances, nausea, and loss of consciousness.
Systematic Review326 Concussion Subtype Symptomatology in Complicated Mild Traumatic Brain Injury Patients
Patients with extra-axial bleeds have better subtype scores compared to those with intra-axial bleeds, suggesting subtype-directed therapy may improve symptom recovery in mild TBI patients.
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