Caring for Concussions

Dr. Jesse Coenen talks with a patient at St. Luke's Medical Arts Clinic. 

An estimated 1.6 to 3.8 million concussions happen in the United States¹. However, that’s likely an underestimate since it’s suspected that many with concussions do not get medical attention².

Head injuries are common and can be very serious. While most people will fully recover with time, in rare cases a life-threatening complication could develop. Therefore, it’s important to be able to recognize the symptoms of a concussion and get the medical attention needed as soon as possible.

Could it be a concussion?

Concussions can be difficult to diagnose. It’s even possible to have a concussion and not realize it. As a mild form of traumatic brain injury, a concussion affects how the brain functions. Usually caused by a blow to the head, these brain injuries can happen during sports or a fall. Other violent motions of the head and upper body can also lead to a concussion.

Generally, symptoms are temporary, lasting hours to days. They can include the following:

• Headache or feeling of pressure in the head
• Loss of memory of the event causing the concussion
• Confusion
• Nausea
• Sensitivity to light and sound
• Reduced balance and coordination (clumsiness)
• Fatigue
• Loss of consciousness

If you sustain a concussion, you should be evaluated by a health care provider. If possible, see your primary care provider first. Serving as the main point of contact in a health system, a primary care provider is a physician, physician assistant or nurse practitioner who specializes in family medicine, internal medicine or pediatrics. They are a great resource for most medical concerns.

If your primary care provider is unavailable and your symptoms are mild, St. Luke’s Urgent Care Clinics offer same-day treatment without an appointment. When symptoms are more severe, go to the emergency room as soon as possible. Severe symptoms that require immediate attention include worsening headache, recurrent vomiting, excessive drowsiness or difficulty with speech, vision or hearing.

The first 24 to 48 hours

After being evaluated by a medical professional, it’s time to rest. For the first 24 to 48 hours, it is recommended that you be monitored by an adult for any of the severe symptoms mentioned above. If symptoms worsen or new symptoms begin, call your primary care provider.

It may be necessary to break from both physical and mental activities during this time including reading, work and exercise. Stay hydrated, avoid alcohol and try to get plenty of sleep. It is unnecessary to be awakened from sleep, as had been recommended in the past. Exposure to blue light from electronic devices should be minimized. This includes phones, computers, tablets and television. Loud noises, powerful smells and bright light (indoor and outdoor) may worsen symptoms.

After 48 hours

Continue getting plenty of rest as your recovery progresses. Also continue to steer clear of things that worsen your symptoms, which may include certain lights, sounds or excessive use of electronic.

As long as symptoms are present, do not partake in vigorous movement or any activity that could cause re-injury to the head. Athletes should not return to play until officially cleared by a medical professional.

Some symptoms of concussion may appear days after the injury. These can include the following:

• Difficulty with concentration and memory
• Irritability or other personality changes
• Sleep disturbances
• Depression

If you experience any new symptoms or have questions, discuss with your primary care provider.

Recovery and returning to normal

Gradually increase your daily activity level as long as symptoms do not worsen. Return to work or school when you can perform your daily self-care routines without symptoms. To ease into this process, consider a gradual return. This may involve initially returning to work or school for a limited number of hours.

Recovery time from a concussion can vary. For adults, it may take one to two weeks. For children, recovery often takes three to four weeks.

If you continue to have symptoms beyond these ranges, or you experience new ones, call your primary care provider. They may refer you to a specialist based on the severity and nature of your symptoms.

Having a primary care provider is valuable when dealing with new medical issues such as a concussion. It means having someone who can provide help and direction as well as coordinate your care across a team of specialists if needed. To establish care with a St. Luke’s primary care provider, call 218.249.4000 or visit www.ChooseStLukes.com.

This article was published in the Positively Superior magazine August-September 2019 issue.

References:

1 - Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil. 2006 Sep-Oct;21(5):375–378.

2 - Faul M, Xu L, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002-2006. US Department of Health and Human Services; Mar, 2010.