What we Know and Don’t Know about Concussions

Concussions are brain injuries and there is a lot more that doctors DON’T know about concussions than they do know. Usually a concussion is caused by some type of blow to the head but it can be caused by any motion that shakes or jars the head. Small children can develop concussions if they are violently shaken.

Concussions are a serious injury. Multiple concussions, especially within short time frames, are extremely serious. And an individual does not have to lose consciousness to have a concussion. Some new research is showing that moderate (as opposed to violent) blows to the head can have a cumulative effect. Fortunately much more research is being done because in severe cases the patient can experience permanent problems with memory, movement, speaking, and learning.

The Brain and the Cause of a Concussion

Your brain is a soft organ that is protected by a hard bony skull. Within your skull the brain is surrounded by cerebrospinal fluid that acts as a type of shock absorber. A single low or moderate blow to the head will cause the spinal fluid to act like a cushion and usually prevent the brain from impacting the inner skull. However, more violent blows to the head cannot be fully cushioned by the spinal fluid and the brain will slam into the inner skull. In these cases, the brain has been “bruised” like your arm or leg is bruised when you walk into a piece of furniture. But “brain bruises” or concussions are much more serious.

Concussions are common in sports such as football, skiing, soccer, rugby, and boxing. They also are common in car crashes, bicycle accidents, and playground accidents.

The head does not need to be struck for a concussion to occur. Rapid acceleration can also be a cause and bomb blasts have been a problem for the military. In these cases there is no direct impact, just an acceleration force applied to the head.

What are the Symptoms of a Concussion?

Sometimes it is not clear when a person has suffered a concussion because there are many possible symptoms. A loss of consciousness is obvious to all. However, patients with milder concussions may only exhibit a few of the many symptoms. And children’s symptoms can differ from adults’ so be aware of any change in behavior.

In general, concussion symptoms fall into 4 categories as described below.

1) Mental – amnesia, unable to focus, memory problems, unable to think clearly, unable to answer easy questions

2) Physical – headaches, vomiting, unable to walk normally, dizzy, vision problems

3) Emotional – changes in behavior, easy to anger, sadness

4) Sleep – changes in the normal sleep pattern

How Serious?

Very. Researchers believe that multiple concussions can contribute to increased risks for other brain diseases or conditions later in the patient’s life. The highest risk areas seem to be Parkinson’s disease, dementia, depression, and a variety of physical, cognitive, and emotional symptoms or deterioration.

Some of the temporary symptoms of concussions can become permanent with patients that have multiple concussions. This includes confusion, disorientation, inability to focus, and difficulty with reasoning.


In most cases of “minor” concussions the key is rest – during the day and night. Most patients will be symptom free in 7 to 10 days. However, some patients need weeks or months to recover.

In more serious cases the symptoms and treatments can vary significantly. Some patients require brain surgery as well as extended medical care.

Concussions are always serious. If you or someone you know exhibits any symptom after a blow to the head then it is always a good idea to visit a doctor.