What is a concussion?

A concussion is a mild — but still serious — traumatic brain injury. Normally, liquid surrounding the brain cushions it against jostling and bumps. In a concussion, the brain is shaken or jolted with enough force to cause it to twist or bounce inside the skull.

Short- and long-term effects can include:

• Changes in memory and reasoning
• Dizziness or balance problems
• Blurry or double vision
• Changes in the ability to communicate and understand
• Emotional changes such as depression, anxiety, aggression and personality changes
• Trouble sleeping

Concussion causes

Anything that shakes or jolts the brain can cause a concussion. Causes can include:

• Car and bike accidents
• Falls, especially for young children and older adults
• Contact sports such as football, soccer, lacrosse, hockey or boxing
• Physical activities without proper safety gear or supervision
• Physical abuse

Second concussions

Having one concussion raises the risk of a second one because your brain is more vulnerable while healing. Your balance and judgment also may be impaired, making a second injury more likely.

Signs and symptoms of concussion

Signs and symptoms of a concussion may develop right away, or after hours or days. They go away within 10 days for about 80% of people, according to the National Institutes of Health, but last longer for others. They can include:

• Unable to remember events before, during or after the injury
• Dizziness
• Blurry vision
• Nausea or vomiting (early on)
• Headache
• Ringing in ears
• Trouble speaking or finding the right words
• Confusion
• Sluggishness
• Changes in mood or personality
• Sensitivity to light or noise
• Problems with sleep

Diagnosing a concussion

Concussions can be difficult to identify because symptoms may develop over hours or days. At OHSU, you’ll find specialists with the expertise to give you a clear diagnosis.

Tests may include:

• A neurological exam to test your vision, balance, hearing, strength and reflexes.
• A cognitive (thinking) test to evaluate your memory and ability to concentrate.
• Rarely, spending a night in a hospital to make sure your symptoms aren’t severe.

Concussion treatments

At OHSU, your doctor or care team will recommend a treatment plan for your specific needs. Specialists may include:

• Sports medicine doctors
• Neuropsychologists
• Athletic trainers who specialize in concussion
• Physical, occupational and speech-language therapists
• Neurologists who specialize in headache management
• Pain medicine doctors to help with headaches and spine pain
• Psychologists to help you cope with concussion symptoms

Care can include:

Rest: Both mental and physical rest are important in the first few days after you are diagnosed with a concussion. Avoid sports or vigorous movement, which could make your symptoms worse. Your doctor will help you ease back to regular activity.

Pain relief: You may have headaches in the days and even weeks after a concussion. Your doctor may recommend pain treatments or medication.

Rehabilitation: You might benefit from physical, occupational or speech therapy to help you improve:

• Balance and movement
• Vision and perception
• Thinking and processing

Neuropsychological care: A neuropsychologist will evaluate your thinking, mood and behavior. The doctor can help you regain function, and improve sleep and quality of life. 

Athletic training: A certified athletic trainer will gather records to go over your medical history. The trainer also:

• Does intake and follow-up assessments.
• Teaches you exercises, and provides other education and handouts.
• Helps you make progress toward returning to play or work.
• Serves as your concussion care manager.

Returning to school and sports

Providers from many specialties work together to tailor a plan for each patient.

• Students: We help identify accommodations the student needs to return to school, and we ease the transition. We follow Oregon School Activities Association guidelines.
• Athletes: We determine when it’s safe to return play based on OSAA guidelines. Our specialists can interpret results of testing (the ImPACT Concussion Test) to offer guidance.