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UR Medicine / Concussion / Common Questions

 

Common Questions

What If I Have Had A Head Injury?

  • On the Field - An initial evaluation may be done by your athletic trainer with a standardized sideline screen. However, if a concussion is suspected, an evaluation must be conducted by one of our physicians.
  • At an Emergency Center - If there are any worrisome signs, you may need to be taken to an emergency room for further evaluation and possibly brain imaging with a CT scan. For example, a worsening headache, vomiting, drowsiness, and/or confusion after a head injury are all warning signs that there may be a more serious brain injury.
  • In Our Office - If you are seen in our office, our physicians will perform an exam and review your symptoms. If your trainer used a computerized neuropsychological test, such as ImPACT, we will review your completed test results. This test is helpful, although not essential, in both diagnosing concussion as well as assessing recovery. If your trainer did not use this test, we generally will not perform one. In some cases, our physicians may involve the athletic training staff to perform a standardized balance test (BESS).

What is Post-Concussion Syndrome?

While the majority (80% to 85%) of concussions resolve in a short (seven to 10 day) period, in some instances an individual may have symptoms that persist for more than three to four weeks. This is called “post-concussion syndrome.” If untreated, this syndrome can lead to difficulties at work or school, considerable discomfort and/or depression. If your symptoms have been ongoing for longer than one month since your concussion, you may require more in-depth neurologic care. Our physicians will examine you and facilitate further evaluation if needed.

Do the Symptoms of a Traumatic Brain Injury Differ from a Concussion?

Traumatic brain injury can have wide-ranging physical and psychological effects. The most common signs and symptoms of a mild traumatic brain injury include:

  • Loss of consciousness for a few seconds to a few minutes
  • No loss of consciousness, but a state of being dazed, confused or disoriented
  • Memory or concentration problems
  • Headache
  • Dizziness or loss of balance
  • Nausea or vomiting
  • Sensory problems such as blurred vision, ringing in the ears or a bad taste in the mouth
  • Sensitivity to light or sound
  • Mood changes or mood swings
  • Depression and/or anxiety
  • Drowsiness or feeling fatigued
  • Difficulty sleeping or sleeping more than usual

Symptoms of a more severe brain injury can include:

  • Loss of consciousness from a few minutes to hours
  • Profound confusion, agitation, combativeness or other unusual behavior
  • Slurred speech
  • Inability to awaken from sleep
  • Weakness or numbness in the extremities
  • Loss of bladder or bowel control
  • Convulsions or seizures
  • Dilation of one or both pupils of the eyes
  • Clear fluids draining from the nose or ears

If you experience any of these symptoms, you should seek care immediately in an emergency department.

How is a Concussion Diagnosed?

Ongoing research being conducted by Dr. Jeffrey J. Bazarian at the University of Rochester Medical Center as well as other medical facilities, is looking into the role of blood tests in the diagnosis and management of concussions.

How is a Concussion Treated?

Immediately following the concussion, you should be periodically monitored, especially for the first few hours. (There is no need to wake the individual every several hours at night.) During the first week after the concussion or until all symptoms are gone, rest and protection from further injury is the most important treatment.

Despite a common belief that concussions are not treatable, multiple pharmacologic and physical therapy-based treatments exist. These treatments can speed recovery and a return to normal activities.  Medications such as acetaminophen may be useful in alleviating headache symptoms. Avoiding alcohol, tobacco and other drugs is strongly recommended.

When Can I Return to Sports?

Most athletes recover completely and can return to play following an appropriate period of recovery. Typically, athletes are removed from sports until all symptoms have resolved and, if they have taken the ImPACT test, their scores have normalized.

Athletes usually miss one to two weeks of sports and the vast majority recover in three to four weeks. Once symptoms have resolved, your physician and athletic trainer will supervise a standardized and graduated return-to-play protocol.

Recovery from concussions may be slower in those who have already had one or more concussions.