Concussion in adults

A concussion frequently occurs as a result of an accident, e.g., at work, at home, or while playing sports or engaging in other physical activities. It is the mildest form of traumatic brain injury (TBI).

The brain is the body’s command and control center. It is also a particularly sensitive organ. This is why it is well protected within the skull, surrounded by fluid called cerebrospinal fluid.

The brain can become concussed if someone receives a blunt-force trauma to the head through a bang, blow, or collision, which causes the brain to come into contact with the hard inner walls of the skull. Some people will have visible external injuries on the skin, while others won’t. A brief loss of consciousness, feeling dazed or groggy, headache, and memory lapses are typical indicators of a concussion.

The typical indicators of concussion occur either immediately after the injury or within a period of 24 to 48 hours afterwards.

The symptoms of concussion include:

• headaches
• feeling dazed or groggy
• dizziness
• nausea and/or vomiting
• impaired hearing
• impaired vision

People frequently experience gaps in their memory (amnesia) when they suffer a concussion. As a result, they may be unable to remember receiving the injury or the events that occurred immediately before or after. Another possible indicator is a brief loss of consciousness or a period of impaired consciousness, during which they appear disoriented, sleepy, and confused. Sleep disturbances or difficulty concentrating may also be observed.

The brain is normally protected from small, harmless concussions because it is encased within the skull, surrounded by cushioning brain fluid (cerebrospinal fluid). However, if the head receives a heavy blow or impact, the cushioning brain fluid cannot offer adequate protection, and the brain comes into contact with the hard inner walls of the skull.

Most head injuries are accidental. These accidents often occur when playing sports or engaging in other physical activities, such as skiing or cycling without a helmet.

People who play certain types of sport, such as ice hockey, are particularly likely to suffer traumatic brain injuries.

Concussions are common. In Germany, approximately 320,000 people suffer a traumatic brain injury each year. Around 91 percent of these experience the mildest form, i.e. a concussion.

The typical symptoms of a concussion may occur immediately after the injury or within a period of 1 to 2 days afterwards. The symptoms often disappear within a few days. If the symptoms are severe, the individual must be monitored in hospital. Continuous rest is also recommended for a concussion. No permanent effects are to be expected in most cases.

However, some people who suffer a concussion continue to have symptoms like headache, sleepiness, anxiety, or memory lapses for many weeks afterwards. This is particularly likely to occur with people involved in sports where their heads are frequently exposed to impact. To prevent long-term consequences like these, it is important to take time to rest and recuperate after any concussion, no matter how mild.

Doctors take a detailed medical history and conduct a physical examination to determine whether a patient is suffering a concussion.

They check, for example, whether any neurological symptoms are present, such as memory lapses or impaired vision. They also check the patient’s motor skills and state of consciousness.

Doctors only use computed tomography (CT) if the symptoms are severe or if the patient presents with risk factors for developing complications.

As a rule, a mild concussion without any major functional impairments does not require treatment. Medication can help alleviate nausea or severe headache.

It is essential to rest for 1 to 2 days, both physically and mentally – in some cases, reading or engaging in stimulating conversations can cause the symptoms to worsen. Bed rest may also help. After a period of rest, the patient should resume their daily routine on a gradual basis, beginning with light activities that are unlikely to trigger further symptoms.