A concussion is a microscopic biomechanical traumatic brain injury (TBI) caused by a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth, resulting in a cascade of chemical changes in the brain. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.
If you are playing a sport, let your coach and/or athletic trainer know immediately. Otherwise, seek the help of an individual who can help you seek medical attention as soon as possible. If you think an athlete has a concussion, remove the athlete from play immediately. The athlete should sit out of play the day of the injury and should not return to play until a licensed medical professional says they are safe to return.
Children or teens who return to play too soon—while the brain is still healing—are at greater risk for a repeat concussion, worsening of current concussion or sustaining another musculoskeletal injury.
You can also visit the BrainSPORT treatment page to get more information on athletic concussion treatment or to make an appointment.
Concussion symptoms vary widely, depending on many factors (e.g., pre-injury headache, age, severity of injury, etc.). Although signs and symptoms generally show up within 48 hours after the injury, the signs and symptoms of a concussion can take minutes, hours or even days to appear. It is important to continuously check for signs of a concussion right after the injury and a few days following the injury. You should seek medical attention if you have symptoms of concussion.
Recovery is influenced by several factors. About 80% of people who suffer a concussion recover fully within one month of the injury, with adolescents taking slightly longer than adults or younger children.
Unfortunately, there is no specific test to diagnose a concussion. A concussion cannot be seen on CT or MRI scans. Concussion remains a clinical diagnosis, meaning it can only be made by health care professionals. A physical exam and thorough neurologic history are the best ways to diagnose a concussion. There are many research programs looking for a “biomarker” to predict concussion diagnosis, but none are valid for clinical use.
As soon as you suspect you may have sustained a concussion, seek immediate medical attention to determine your plan of care. UCLA BrainSPORT is one of only a handful of comprehensive programs in the country dedicated to the neurological concerns of athletes through the multidisciplinary BrainSPORT outpatient clinic.
To make an appointment with the BrainSPORT clinic, please contact us.
An appointment to see an expert in concussion management should be made so that an appropriate treatment plan can be put in place. Whether or not emergency care occurred, beginning outpatient care within 1–5 days of injury allows for an individualized treatment plan to be started.
If you or your child has a sports concussion, our specialists at the BrainSPORT clinic may recommend the following recovery process.
As symptoms begin to improve, gradually increasing physical activity should be encouraged. Until recently, the recommendation had been to rest until asymptomatic. New studies, including ones performed at BrainSPORT, suggest that limited exercise during this time allows for quicker recovery from concussion. The type of exercise that is tolerated during this time is dynamic and varies from individual to individual based on symptom burden. Determining the appropriate type and amount of exercise is part of individualized care that should be guided by a healthcare professional.
A previously concussed athlete should only return to sports with the approval of a licensed health professional. The Centers for Disease Control and Prevention (CDC) and American College of Sports Medicine (ACSM) recommend a five-step return to play progression that should be supervised by a healthcare professional. When in doubt, sit it out!
Though wearing a helmet is crucial to help reduce the risk of a serious brain injury or skull fracture, helmets are not designed to prevent concussions. Researchers and helmet manufacturers continue to work to improve helmets and other protective gear in order to make gameplay as protective as possible, but unfortunately, there is no “concussion-proof” helmet.
In more rare cases, a serious brain injury can occur, in which a collection of blood can form in or around the brain following a hard impact.
If you notice any of the following symptoms following a hard hit, call 911 and seek medical attention immediately.
Historically, 10–30% of individuals have a recovery that is considered “longer than normal.” In the past this prolonged recovery has been called post-concussive syndrome. However, because many of the symptoms experienced in the month (or more) after a concussion may be subtle non-injury related issues that have been exacerbated by the concussion (e.g., headaches due to stress, sleep difficulties, deconditioning, etc.), a more accurate label is persistent post-concussion symptoms (PPCS).
Many factors likely play a role in the development of prolonged recovery. One main factor that may contribute to the development of prolonged recovery is the lack of appropriate recognition and treatment. Identifying the factors causing symptoms and initiating appropriate treatment for them is key for prevention of prolonged recovery. The multidisciplinary BrainSPORT clinic can provide a clear understanding of the best treatment plan for your concussion and current symptoms.