What is mild TBI or Concussion?

What is mild TBI or concussion?

The least severe form of TBI is mild TBI, also known as concussion.

A concussion is a short-term disturbance to normal brain functioning due to an external force impacting the head or body. While many people believe that you need to be knocked out to be concussed, this is not actually the case. In fact, many concussions do not result in losing consciousness.

Leading causes of concussions

Concussions are often associated with sporting activities, but these injuries more commonly occur in the course of everyday life.

Some of the more common causes of concussion include:

  • Falls
  • Motor vehicle crashes
  • Sporting activities
  • Workplace accidents
  • Assault

Repeated concussions often occur as a result of contact sports, and are to be avoided as far as possible. Repeated concussions have been associated with increased likelihood of Persisting Post-Concussion Symptoms (PPCS), Chronic Traumatic Encephalopathy (CTE) and other neurodegenerative conditions such as Alzheimer’s Disease.3

Symptoms of Concussion

Following a concussion the symptoms can be quite varied and often occur in clusters. These can include:

  • Headaches and migraines
  • Sleep Disturbance
  • Fatigue
  • Anxiety and Depression
  • Neuropsychological Function
  • Balance
  • Vestibular System Function
  • Exercise Intolerance

Recovery

For the majority of people a concussion will be a short term inconvenience.

People who have experienced a concussion are encouraged to seek medical attention to manage their recovery. Most guidelines suggest an initial short period of rest followed by gradual return to normal activities, without risk of additional injury.2 Most people will recover and will be able to resume their normal lives within approximately 10 – 14 days. It’s important to note that individual recovery times are different for each person and the degree and speed of return to normal activities should be managed by a clinician to ensure symptoms are not made worse.

Approximately 20 percent of people will continue to experience symptoms for longer than normal after a concussion.4 These continuing symptoms are referred to as Persisting Post-Concussion Symptoms (PPCS), which may last for months or even years.

We do not currently know what it is about the person or their injury that leads to PPCS. There are a number of factors that have been shown to increase the likelihood of PPCS, such as a previous concussion, a history of neuropsychological conditions such as anxiety and depression, or a history of migraine.5 If you have these pre-existing conditions it would be a good idea to ensure your recovery is managed and monitored by your GP or healthcare professional.

Best Practice following a Concussion Injury

(For full information visit https://www.healthdirect.gov.au/concussion)

Rest
Rest and avoid strenuous activity for the first 24-48 hours after a concussion injury.

Sleep
It’s fine to go to sleep following a concussion, but it’s best to have someone check on you every 2 – 4 hours as a precaution, and make sure someone stays with you for the initial 24 hour period post-concussion

Drinking / Drugs
Avoid drinking alcohol or using recreational drugs for the first 48 hours, as they may change your thinking and worsen your symptoms. It may also make it difficult for other people to tell if your concussion is affecting you or not.

Pain relief
Do not take prescription drugs, particularly aspirin, strong pain relieving medications, such as codeine, or anti-inflammatory medications as they may mask worsening symptoms that indicates a deterioration of your condition. Only take medication as recommended by your doctor.

Driving
Do not drive a motor vehicle until your symptoms have resolved, or you have been cleared by a medical professional to drive.

Return to Activity 
After the initial 48 hours of rest, you may gradually increase your physical activity levels as long as it does not make your symptoms worse. Light exercise such as a quiet walk can be beneficial for your recovery. Start with 5-10 minutes at a time, and slowly build up the time and intensity of activity as tolerated over the next two weeks.

Mental Activity
You may need to “rest your brain” by reducing the length of time spent on activities that involve concentrating such as reading, television and computer or screen use if these activities make your symptoms worse. This will assist your brain’s recovery.

Disclaimer: This website does not offer medical advice for individuals. Always be guided by your medical practitioner.

References

    1. https://concussionstudy.com.au/
    2. McCrory P, Meeuwisse W, Dvorak J, et al Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016 British Journal of Sports Medicine 2017;51:838-847.
    1. Committee on Sports-Related Concussions in Youth; Board on Children, Youth, and Families; Institute of Medicine; National Research Council; Graham R, Rivara FP, Ford MA, et al., editors. Washington (DC): National Academies Press (US); 2014 Feb 4.
    2. org.au/brain-protein-traumatic-brain-injury/
    1. Scopaz KA, Hatzenbuehler JR. Risk modifiers for concussion and prolonged recovery. Sports Health. 2013;5(6):537-541. doi:10.1177/1941738112473059
    2. Health Direct, https://www.healthdirect.gov.au/concussion

 

What is Persisting-Post Concussion Syndrome (PPCS)?

Persisting-Post Concussion Symptoms is when the symptoms of concussion continue to affect the patient for months or even years following their injury. It is thought that PPCS is more likely to occur in those who have suffered from multiple concussions and there are a range of other risk factors that may increase the likelihood of PPCS.1

Reference

Committee on Sports-Related Concussions in Youth; Board on Children, Youth, and Families; Institute of Medicine; National Research Council; Graham R, Rivara FP, Ford MA, et al., editors. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington (DC): National Academies Press (US); 2014 Feb 4. 4, Treatment and Management of Prolonged Symptoms and Post-Concussion Syndrome. Available from: https://www.ncbi.nlm.nih.gov/books/NBK185342/

What is Chronic Traumatic Encephalopathy?

Chronic Traumatic Encephalopathy is a neurodegenerative disease that is observed in people who have suffered one or usually multiple TBI, including mild TBI or concussion. Symptoms may not show for years after the injury and the disease can only be conclusively diagnosed post-mortem. In CTE a protein called hyper-phosphorylated tau forms in specific structures in certain regions of the brain. Symptoms include altered mood and behaviours, aggression, depression and control problems. These symptoms may develop into progressive dementia.