Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The signs and symptoms of concussion may be obvious or subtle. Football, hockey, and soccer have high potential for head injury, and
player research has given insight into what symptoms may occur.
While dramatic, loss of consciousness or
seizure are not common in concussion
and do not predict severity. More common are mild
confusion and disorientation.
Symptoms tend not to be objective and may be hard to describe. They also may
be delayed for many hours after the injury, and sometimes the initial injury may
have been forgotten or discounted.
Typical symptoms of concussion include:
headache
dizziness
nausea
dazed feeling
visual symptoms
irritability
Physical Signs
Since, by definition, concussion does not damage the structure of the brain,
the physical examination should be normal. More subtle findings may include...
Mild traumatic brain injury, or concussion, can be defined as a short-lived
loss of brain function due to head trauma that resolves spontaneously. With
concussion, function may be interrupted but there is no structural damage to the
brain.
The brain floats in cerebrospinal fluid and is encased in the skull. These
protections allow it to withstand many of the minor injuries that occur in day
to day life. However, if there is sufficient force to cause the brain to bounce
against the rigid bones of the skull, then there is potential for injury. It is
the acceleration and deceleration of the brain against the inside of the skull
that can cause the brain to be irritated and interrupt its function. The
acceleration can come from a direct blow to the head or face, or from other body
trauma that causes the head to shake. While temporary loss of consciousness due
to injury means that a concussion has taken place, most concussions occur
without the patient being knocked out. Studies of football players find that the
majority aren't aware that they had sustained a head injury.
What are the types of concussion?
Historically, attempts to classify the severity of concussion were based on
the loss of consciousness and its duration, and the presence of amnesia. It was
presumed that there was a correlation between those two events and the amount of
potential brain damage. The International Conference on Concussion in Sports
recommended that concussion be divided into two groups: simple and complex.
Simple concussion: In a
simple concussion, the person the symptoms gradually resolve, and the patient
returns to normal function in 7 - 10 days.
Complex concussion: In complex concussions, symptoms
persist and thought processes are affected. Patients with repeated concussions
would fall into the complex category.
Picture of the brain and potentially brain injury areas
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Internal bleeding occurs when an artery or vein is damaged and blood to escapes the circulatory system and collects inside the body. Internal bleeding can be caused by a variety of situations such as blunt trauma, deceleration trauma, medications, fractures, and spontaneous bleeding. Treatment of internal bleeding depends on the cause of the bleeding.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Hydrocephalus is an abnormal buildup of cerebrospinal fluid (CSF) in the ventricles of the brain. The fluid is often under increased pressure and can compress and damage the brain. Symptoms of hydrocephalus vary with age, progression of the disease, and individual tolerance to the condition. Hydrocephalus is most often treated by surgery in which a shunt system is inserted.
Hypothermia is having a body core temperature of less than 35 C or 95 F. Most causes of hypothermia are preventable. Risk factors for hypothermia include age, mental status, medical conditions, and medications. Symptoms of hypothermia generally depend upon the severity of the condition. Treatment depends upon the severity of hypothermia. If not treated early, hypothermia can lead to cardiac arrest, coma, or death.
Coma is the inability to waken or react to the surrounding environment. The Glasgow Coma Scale is frequently used to measure the depth of coma. Causes of coma include trauma, bleeding, edema, lack of oxygen, poisoning, or hypoglycemia. Prognosis for a patient in a coma depends on the cause of the coma.
In the United States, head injuries are one of the most common causes of death and disability. Head injuries due to bleeding are generally classified by the location of the blood within the scull, these include: epidural hematoma, subdural hematoma, subarachnoid bleed, intracranial bleed, sheer injury, edema, and skull fracture. Some common symptoms of a head injury include: vomiting, bleeding from the ear, speech difficulties, paralysis, difficulty swallowing, and body numbness. Treatment of a head injury depends on the type and severity of the injury.
Brain lesions (lesions on the brain) are caused by trauma, inflammation, autoimmune diseases, cancers, other diseases, stroke, bleeding, pituitary adenomas, and cerebral palsy. Symptoms of brain lesions include headache, nausea, fever, neck pain and stiffness, affected vision and speech, weakness or paralysis to one side of the body. Diagnosis of brain lesions is generally with imaging studies like CT or MRI scans. Treatment and prognosis of brain lesions depends on the cause of the lesion.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
First aid is a complicated subject and it is situation-specific. First aid is the help and medical assistance that someone gives, not only to an injured person, but to a person who is sick. Preparedness is a key element of first aid, like having basic medical emergency kits in your home, car, boat, or RV. Cuts, puncture wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart attacks, strokes, seizures, and heat stroke are examples of more critical first aid emergencies.
A computerized axial tomography scan is an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. Computerized axial tomography is more commonly known by its abbreviated names, CT scan or CAT scan. A CT scan is used to define normal and abnormal structures in the body and/or assist in procedures by helping to accurately guide the placement of instruments or treatments.
A large donut-shaped x-ray machine takes x-ray images at many different angles around the body. These images are processed by a computer to produce cross-sectional pictures of the body. In each of these pictures the body is seen as an x-ray "slice" of the body, which is recorded on a film. This recorded image is called a tomogram. "Computerized Axial Tomography" refers to the recorded tomogram "sections" at different levels of the bod...
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