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Concussions and Traumatic Brain Injury: 4 Things You Need to Know

On December 25, actor Will Smith will appear on the big screen in “Concussion,” portraying Dr. Bennet Omalu, the forensic neuropathologist who made the first discovery of chronic traumatic encephalopathy (CTE). While this thriller focuses on the discovery of this devastating condition and the NFL’s reaction to it, the flick highlights the seriousness of concussions.

“Even just 10 years ago, people would have been playing sports, experience a hard hit, shake it off, feel bad for a few days and never realize they had a head injury,” said Dr. Evan Neft, an Abington-Jefferson Health physician specializing in family medicine. “The awareness is improving, but it’s still not quite there across the board.”

Here’s what you need to know about concussions.

1. A concussion is a traumatic brain injury

Although concussions are the least serious type of traumatic brain injury (TBI), they are in fact a brain injury.

“I try to explain to patients that it’s a functional brain injury to distinguish from a structural injury such as bleeding in the brain or a skull fracture,” Dr. Neft said.

A concussion is a type of TBI that’s caused by a blow or bump to the head or body, a fall, or another injury that jars or shakes the brain inside the skull. The brain is made of soft tissue, cushioned by spinal fluid and encased and protected by the skull. If you sustain a concussion, the impact can jolt your brain, possibly causing it to move around inside the skull. TBIs can cause bruising, damage to the blood vessels and injury to the nerves in the brain.

Just because you can’t see a concussion doesn’t mean you should brush it off as just a bump on the head.

“In the short term, it can shut down someone's life,” Dr. Neft said. For a young kid in school, it can negatively affect their performance, their extracurricular activities or their social life. For adults with a concussion, it can impact their ability to work and take care of their families, and carry out other responsibilities.

2. Athletes aren’t the only ones at risk

All of the headlines surrounding regulations and bans on youth soccer players heading the ball and the new policies in the NFL over the past few years have raised the public’s general awareness of concussions. But, athletes aren’t the only people at risk for suffering a concussion.

“[Concussions] are fairly common, but they're certainly not just [a risk for] athletes or student athletes. I see people come in with concussions after car accidents, people falling on ice in the winter, and accidental injuries or bumps to the head,” Dr. Neft said.

3. Recognizing the signs is the first step toward recovery

Since there aren’t visible marks that indicate someone has suffered a concussion, being aware of and recognizing the signs is crucial.

“People don’t generally appear different after they’ve sustained a concussion – most of the symptoms are somewhat subjective,” Dr. Neft said.

Someone doesn’t have to pass out or lose consciousness to have a concussion. Symptoms can range from mild to severe and last for hours, days, weeks or even months.

If you suffer a concussion, you may experience a headache or pressure in your head as well as nausea or vomiting, problems with balance or dizziness, blurry or double vision, sensitivity to light or noise, feeling sluggish, foggy or groggy, trouble remembering or concentrating, confusion and simply just not “feeling right.”

If you think a loved one has a concussion, signs you can look for include:

  • Appearing dazed or stunned
  • Difficulty recognizing people or places
  • Weakness, numbness or decreased coordination
  • Answering questions slowly
  • Slurred speech
  • A loss of consciousness, even briefly
  • Mood, behavior or personality changes
  • One pupil that’s larger than the other
  • Drowsiness or inability to be woken up
  • Seizures or convulsions
  • Repeated vomiting or nausea
  • Increasing confusion, restlessness or agitation

“These symptoms are often exacerbated by physical or mental activity,” he said. If you or someone you know is experiencing these symptoms, it’s imperative to get medical treatment right away.

4. Even if you’ve had one or more concussions, you likely don’t have to worry about CTE

“[CTE] is caused by changes in the brain caused by repetitive brain trauma,” Dr. Neft said. It’s an incredibly rare condition – there are only a few dozen officially confirmed and documented cases of CTE.

It’s not a condition that’s caused by two or a few concussions.

“We don't think it's the issue of having a few concussions, it's the people who have those repetitive hits and trauma,” he said. It’s really only been seen in athletes including football players, boxers, wrestlers, hockey players and other athletes who are constantly suffering blows to the head.

To make an appointment with one of our concussion specialty physicians, call 215-481-HEAD (4323).

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