Common concussion myths

Myth #1 – You don’t have a concussion unless you had loss of consciousness

Fact – Loss of consciousness occurs only a small percent of the time with concussion.  When this occurs, the athlete and those who observed the injury can easily see that the injury was a concussion.  In most cases, however, since there is not loss of consciousness, we rely on the symptoms experienced after a head injury to determine if a concussion has occurred. “We now know that there are a variety of other symptoms besides losing consciousness that are important indicators of a concussion. Headache, fatigue, nausea, light or noise sensitivity, balance problems, dizziness and ringing in the ears are common physical symptoms that can occur without loss of consciousness and may indicate the possibility of a concussion.”

Myth #2 – Concussions are only caused by a hard hit to the head

Fact – While concussions are often caused by a direct impact to the head itself, a concussion can occur other ways.  When there is a sudden movement that causes the brain to move in the skull, such as whiplash caused by a fall or by hard hit to the chest or neck, a concussion can also occur.  So, when concussion symptoms are present, be sure to ask about other types of injuries that could have caused the concussion.

Myth #3 – After a concussion, a brain scan (CT scan or MRI) is always needed

Because convention CT scans and MRI’s do not show cellular injury (the type of injury that occurs with a typical concussion), they are not helpful to diagnose a concussion.  Additionally, they often have a high out of pocket cost, and in the case of CT scan, expose the patient to radiation.  “For cases when more severe injury to the brain is suspected, a CT scan can be used to identify intercranial clots that require neurosurgery but the frequency of this is very low (less than 1 percent).”  Thankfully, we can determine if a concussion is present without these tests, by the symptoms a person has experienced after the injury.  Then, through neurologic exam, balance testing, and cognitive testing, we can monitor recovery.

Myth #4 – After a concussion, a person needs to be awakened every 20 minutes.

Fact – “On the contrary, rest is very important to the brains healing and recovery process. For at least the first 12 hours, someone should wake up the person suffering from a concussion every 2 or 3 hours to ask them a simple question and look for any changes in the way they look or act.” After a visit with the primary care provider, he/she will offer guidance on sleep guidelines.  “Getting plenty of sleep is actually one of the most important aspects of concussion treatment.”

Myth #5 – No pain medication is safe after a concussion

Fact – After a concussion, at least for the first 3 days, the safest pain medication to use is acetaminophen (Tylenol).  After this time, and after the child has been evaluated for any signs of intercranial bleeding, ask your primary care provider if they recommend any non-steroidal anti-inflammatory medications like ibuprofen (Advil or Motrin) and naproxen (Aleve). “Always talk to your health care professional before taking medications, especially when you are unsure of what to take for your condition and symptoms. Prescription medication may even be necessary to assist the brain’s recovery and may be prescribed by your doctor.”

Myth #6 – Brain injury only occurs at the time of the head hit

Fact – “A concussion involves processes at the microscopic level of the brain. Chemical changes can occur for days, weeks, or even months after impact. In moderate and severe traumatic brain injuries, symptoms may be triggered by imbalances in the production of hormones required for the brain to function normally. After a concussion, the brain is also more susceptible to injury, so it is critical to prevent any second concussions or other impacts to the brain during the healing process.” The brain injury is evident through concussion symptoms that typically last 2-4 weeks after the injury. These symptoms can include headache, fogginess, memory impairment, dizziness, impaired balance, irritability, light and noise sensitivity, fatigue, sleep disturbances, etc.  “It is critical to seek proper treatment of the concussion early on and to monitor changes in symptoms.”

Myth #7 – Older people sustain concussion more easily than those that are younger

Fact – “Children are actually more likely to suffer traumatic brain injury than adults and their symptoms can be longer lasting and more severe. The young brain more susceptible to concussion than the adult brain and may require more time to recover.” Also, it is important to monitor children and teens after a head injury because occasionally concussion symptoms may not present until hours or days after the injury. 

“Concussions are a big deal and should be taken seriously. Getting concussion treatment early, taking time to heal, and avoiding future head trauma can lessen the impacts of concussion and lead to a healthier overall recovery.   Also, every concussion makes the brain more vulnerable the next time the child gets hit. Traumatic injuries are cumulative, so several minor injuries can create a tipping point from which the brain struggles to fully recover. “  Please talk to your primary care provider if you have any concerns about concussion.