Mayuri Bhakta, FNP-BC
Traumatic brain injuries (TBI) lead to nearly three million ER visits, hospitalizations, and deaths per year. 1 A mild TBI is commonly known as a concussion. Even though they are called “mild” because they are not typically life-threatening, the effects of a concussion can be serious, and recovery can be lengthy. Anyone can suffer a concussion in any number of life situations, including at home, on the road, and at work. Safety precautions can reduce the chances of brain injury and employers and employees should take protective steps to ensure a safe work environment to minimize the risk of a TBI.
What Causes Concussions?
TBI are brought on by blows, jolts, hits, and similar sudden impactful movements—either directly to the head or to the body—that bounce the brain against the inside of the skull, causing chemical changes in the brain and damaging brain cells.
Falls are the most common cause of TBI and count for about half of emergency TBI-care. 2 Other common causes of concussions include:
- Being struck by or against an object
- Motor vehicle crashes
- Occupational and recreational accidents
- Contact sports such as football, soccer, rugby, hockey, and boxing
- Physical abuse
Men are more likely than women to have a brain injury, because men may be more likely to participate in high-risk activities. 3
What are Symptoms of a Concussion?
Symptoms of a concussion may begin within a few minutes of injury or may appear within hours or days of the initial injury. The most common symptoms that occur within minutes to hours include loss of memory, also known as amnesia, headaches, and confusion. Most people who experience amnesia will not remember the incident that caused the concussion. Most people with concussions do not lose consciousness.
Other early symptoms include:
- Inability to respond to questions right away
Symptoms that may develop later, within hours to days, include:
- Trouble concentrating
- Difficulty sleeping
- Feeling irritable
- Trouble with memory
- Inability to control emotions
Children may have the following symptoms:
- Increased crying or crankiness
- Difficulty with balance
- Loss of appetite
- Blank expression
What Should I Do if I Think I Have a Concussion?
If you’ve had a head injury, you should seek medical care. Only a provider can diagnose you with a concussion and rule out other, more severe, head injuries.
Your provider will ask for a history of events that lead to the injury and review your signs and symptoms. Your provider will do a physical examination, including a check of your brain function. You may also get cognitive testing, which tests your thinking ability. If some cases, your provider may order a CT scan or an MRI to rule out other conditions.
Symptoms that may indicate a more severe injury include:
- Loss of vision or difficulty with vision
- Loss of bowel or bladder control
- Weakness or numbness in the body
- Multiple episodes of vomiting
- Neck pain
If you have sustained a head injury while playing contact sports, your team provider or primary care provider will have to clear you before you are able to resume any kind of contact activity.
How Are Concussions Treated?
Your provider may recommend that you avoid any kind of activity that could increase your risk of another head injury, for a period of time. Your provider will most likely advise that you rest to allow your brain time to recover. The rest period may include avoidance of physical exertion and/or limitation of computer, phone, or gaming time. Your provider may recommend certain over-the-counter medications or prescribe medications for symptom relief. It is always important to discuss all of your medications with your healthcare provider.
Based on your symptoms and severity of concussion, your provider may restrict your work or school schedule. Your provider will let you know when you can resume normal activity.
If you have a complicated concussion, have significant symptoms, or have had multiple brain injuries, your provider may refer you to a concussion center or a neuropsychologist for further evaluation and treatment.
Are There Long-Term Complications of Concussions? Long term side effects and post-concussion complications that can last up to a few months include: 4
- Post-concussion syndrome, which includes headaches, dizziness, and difficulty concentrating
- Second Impact syndrome, which occurs when one experiences a second injury before the initial concussion resolved
It is important to try and prevent another concussion as more than one concussion may lead to long-term side effects. The long-term side effects of more than one concussion is still being studied by healthcare professionals.
How Can I Prevent Concussions?
Taking appropriate safety precautions is the best way to reduce your risk of undergoing an event that could cause a TBI. Tips for home, on the road, and at play:
- Wear a seat belt
- Wear a helmet when riding a bike, scooter, or motorcycle
- Wear a helmet and other protective equipment when playing contact sports
- Prevent falls by removing loose objects around the house that could present a tripping hazard
- Exercise regularly to help keep muscles strong and improve your balance
At work, OSHA is the golden rule to follow to ensure a hazard-free workplace. Some general tips include:
- Wear head protection and PPE in compliance with OSHA and ANSI
- Use signs to designate areas where there may be falling debris or slippery walking surfaces
- Clean up spills right away
- Make sure areas are well-lit and obstructions are clearly marked
- Make sure cords, wires, and rugs do not present tripping hazards
- Do not stand or kneel on furniture; use ladders in compliance with OSHA and ANSI
- Ask for assistance from designated staff when placing things in or removing things from storage
1 Centers for Disease Control and Prevention, “TBI: Get the Facts,” https://www.cdc.gov/traumaticbraininjury/get_the_facts.html
3 Randolph W Evans and Christopher T Whitlow, “Acute mild traumatic brain injury (concussion) in adults,” UpToDate, updated March 8, 2019.
4 Mayo Clinic, “Concussion,” https://www.mayoclinic.org/diseases-conditions/concussion/symptoms-causes/syc-20355594
William P Meehan III and Michael J O’Brien, “Concussion in children and adolescents: Clinical manifestations and diagnosis,” UpToDate, updated January 16, 2019.
David T Bernhardt, “Concussion,” Medscape, September 24, 2019, https://emedicine.medscape.com/article/92095-overview
Centers for Disease Control and Prevention, “What is a Concussion?” https://www.cdc.gov/headsup/basics/concussion_whatis.html
Healthline, “Concussion,” March 15, 2017, https://www.healthline.com/health/concussion
Northern Brain Injury Association, “Preventing Workplace Brain Injury,” https://www.nbia.ca/preventing-workplace-brain-injury/