Concussions are traumatic brain injuries that can have serious and long-lasting effects. It is important to comprehend the potential for long-term symptoms and be aware of which symptoms may worsen over time.
Additionally, it is essential to understand the development of symptoms in different concussion patients, as they can vary in intensity and type. This article will discuss current research on the phenomenon known as ‘post-concussion syndrome’, focusing mainly on how concussion symptoms can worsen over time.
This includes an overview of the common symptoms of post-concussion syndrome and how they progress in those affected by this chronic condition. It also outlines some insight into the potential causes for a worsening of these symptoms, focusing mainly on:
- Physical activity
- Psychological changes
- Medications/treatments that could be factors in a worsening of concussion symptoms over time.
What is a Concussion?
A concussion is a type of traumatic brain injury (TBI) which affects the brain after a hard hit or blow to the head or body. The symptoms of a concussion can range from mild to severe, and in some cases, these symptoms may not be immediately noticeable. It is important to monitor any possible concussion symptoms due to the potential long-term risks associated with head trauma.
Let’s discuss what a concussion is and how symptoms can worsen over time.
Causes of Concussion
Concussions are caused by a jolt or blow to the head which causes the brain to move in and out of the skull. This can happen from high impact contact sports, sports that involve running and jumping such as soccer or basketball, or even a fall. Concussion can also occur from physical violence or car accidents, where an individual’s head is thrown around in various directions. Any sudden force to the head, face, neck or upper body that results in a rapid acceleration/deceleration of the head can cause a concussion even if there is no direct contact with an opposing player, object, wall etc. It is important to note that concussions still occur despite use of protective equipment like helmets and mouth guards and may be difficult to detect immediately after an incident occurs.
Common symptoms of concussions include:
- Dizziness or balance issues
- Changes in behavior or personality such as irritability and depression
- Sensitivity to light and sound (photophobia/hyperacusis)
- Nausea/vomiting/abdominal pain
- Difficulty concentrating
- Sensitivity to physical activity (post-concussion syndrome)
Symptoms may continue for days after diagnosis and if left untreated can worsen over time due to re-injury of the area.
Types of Concussion
A concussion is a type of traumatic brain injury that can occur after a bump, blow, or jolt to the head. It can also happen after a fall or a blow to the body that causes the head to move rapidly back and forth. Concussions are usually caused by a direct impact of hard enough force to cause physical damage to the brain.
Different types of concussions can involve different symptoms, but some common signs include:
- Memory problems
- Balance problems
- Difficulty concentrating or paying attention
- Nausea and vomiting
- Slurred speech
In some cases, people may not even realize they’ve had a concussion until several hours or days later when the symptoms become more obvious.
Concussion severity depends on how many forces and how much energy is put into it at the time of impact as well as other factors such as age and gender. A mild concussion may have only minor neurological effects immediately after the incident occurs while more serious concussions can involve prolonged neurological deficits that last for weeks or months. There is also evidence to suggest that concussion symptoms may worsen over time if they are repeatedly aggravated through another bump or blow to the head.
It’s important for anyone who thinks they have experienced any kind of head trauma to seek treatment right away in order to reduce their risks of long-term damage from their injury.
Symptoms of Concussion
Concussion is a type of traumatic brain injury that can stem from a blow to the head or body. It involves physical and mental symptoms that may be noticeable immediately after the injury or months later. Common symptoms can include headache, confusion, dizziness, memory loss, nausea, and fatigue.
Let’s discuss the symptoms of concussion in more detail:
Concussion can result in many different symptoms, each of which may present themselves differently depending on an individual’s age and health. Acute symptoms of concussion include confusion, difficulty concentrating, dizziness or balance problems, fogginess, headaches, blurred vision or sensitivity to light/noise, irritability and/or mood changes, nausea/vomiting and loss of consciousness for any amount of time.
If a person has experienced a severe head injury or one with a long loss of consciousness accompanying it (one minute is considered concerning), immediate medical evaluation is crucial because they are much more at risk for having long-term complications.
Complications associated with concussion that may present themselves in the early hours or days following the injury include difficulty falling asleep or staying asleep and feeling overly tired during the day. As time progresses after an initial head injury (up to weeks and months), more problems can arise such as:
- Difficulty focusing for extended periods of time;
- Speech disturbances;
- Memory deficits;
- Increased emotional instability, depression and anxiety;
- Ongoing headaches;
- Persistent nausea/vomiting;
- Persistent dizziness/balance issues, including vertigo-like symptoms;
- Feeling “in a fog” and slowed thinking.
If any of these unknown onset symptoms occur after a head injury it’s important to seek medical evaluation from a healthcare practitioner that specializes in brain injuries so that further testing may be recommended and appropriate treatments prescribed depending on what factors are found related to the injury itself.
Chronic symptoms of concussion, commonly known as post-concussion syndrome (PCS), are long-term and may last weeks, months or longer. These persistent symptoms include physical (e.g., headache, dizziness, and fatigue) and psychological issues (e.g., depression, anxiety, irritability). As with traditional concussion symptoms, the effects of PCS can range from mild to severe; however, studies have shown that patients who experience more intense acute concussion symptoms are more likely to experience chronic late effects.
Many studies also point out that repetitive concussions result in more prolonged recovery times and greater risk for PCS compared to single head injuries. It’s important to note that prolonged recovery times don’t necessarily mean recovering progressively worse over time – it simply means that the full time needed to recover is longer than in cases where single concussions occur.
If untreated or unrecognized by medical professionals and cognitive behavioral therapists, PCS can cause permanent damage of certain brain functions such as sleep patterns and memory; therefore individuals suffering from PCS should seek medical attention immediately to avoid further problems down the road. Depending on the severity of the injury, treatments can range from a simple plan of rest and care from family or friends to prescribed medications for anxiety or depression related to chronic symptoms associated with brain injury.
Post-Concussion Syndrome (PCS) is a group of symptoms that may arise after sustaining a mild brain injury such as a concussion. These symptoms can persist for weeks, months or even years after the initial event. It is important to seek medical advice if you notice persistent changes in your mental state or physical health, as PCS can have long-term effects.
Common signs and symptoms of PCS include:
- Poor attention and concentration
- Difficulty sleeping or insomnia
- Depression or anxiety
Symptoms can worsen gradually over time without proper treatment and may develop into chronic pain or disability. PCS often presents differently in adolescents versus adults; while adult PCS is more likely to be dominated by physical symptoms like headaches and dizziness, adolescent PCS may include more psychological features such as depression, mood swings and impulsivity.
Other cognitive issues associated with concurrent brain injury can cause further problems for those suffering from post-concussion syndrome. Difficulty with memory recall, information processing speed and computing skills can all present additional challenges that require specialized assessment and management strategies. That’s why it’s important to seek professional advice from an appropriately qualified healthcare provider who has expertise in treating concussions at the earliest opportunity.
Risk Factors for Worsening Symptoms
Though it is generally assumed that most concussions are mild and heal without long-term consequences, there is still a chance of worsening symptoms over time. Some of the risk factors for deteriorating symptoms include having a history of brain injuries, being female, having a learning disability, having a substance use disorder, and having comorbid mental health conditions.
Let’s look further into the potential implications of these factors:
Age can be an important factor in the development of long-term symptoms following a concussion. Crisco et al (2017) found that for individuals aged 40 and older, rates of symptom severity were three times higher than those observed in younger people. Furthermore, symptoms from a traumatic brain injury (TBI) sustained at an earlier age were more likely to persist than injuries sustained later in life. This suggests that age should be taken into account when evaluating risk factors for worse concussion outcomes.
Other studies show similar findings; specifically, Ferchland et al (2018) reported that post-concussion symptoms were more likely to persist in individuals over age 45. This is likely due to changes in the brain associated with aging. As we get older, our brains naturally undergo electrical changes, which can exacerbate the effects of any existing injury or damage. In addition, senior citizens often have additional conditions such as high blood pressure or diabetes which can further increase their risk for poor outcomes after suffering a TBI.
Previous research suggests that gender may be a risk factor for delayed or worsening concussion symptoms. Male athletes tend to report more persistent symptoms than female athletes, which suggest that male athletes may have greater vulnerability when it comes to head injuries and the effects of post-concussion syndrome (or PCS).
However, recent research has found that gender does not necessarily dictate who is more likely to experience more serious symptoms. For example, other traumatic brain injury studies have found that female athletes with a history of anxiety or depression are at an increased risk regardless of age or type of sport.
Ultimately, additional research is needed to determine the complex interactions between gender and other variables in concussion diagnosis and management.
Severity of Injury
The severity of an initial concussion typically measures the seriousness of the injury and may indicate the risk for symptoms to worsen over time. Concussions are categorized according to five classifications based on symptom severity: Grade 1-mild; Grade 2-moderate; Grade 3-severe; Postconcussion Syndrome (PCS), and Post-Traumatic Encephalopathy (PTE). When a concussion occurs, medical professionals will classify it according to one of these five categories.
- Grade 1 concussions involve a brief loss of consciousness with minimal or no confusion. Additional symptoms such as headaches, dizziness, fatigue and vision problems may occur but should all resolve within 15 minutes. Generally speaking, grade 1 concussions do not often result in long-term effects or persist into PCS or PTE.
- Grade 2 concussions can involve both confusion and a brief loss of consciousness up to 30 minutes in duration but usually resolves shortly after. Focus should be given to any lingering symptoms such as headaches and dizziness which could lead to long term effects if ignored and not treated soon after incident occurred.
- Grade 3 concussions involve an extended period of unconsciousness lasting longer than 30 minutes with extensive disorientation at start that is slow to improve over time. This type of concussion is considered very serious with a high chance for persistent debilitating symptoms including persistent Neurocognitive Impairment (NCI) which may require intervention beyond current medical practices for resolution or remission.
- Postconcussion Syndrome (PCS) is diagnosed after individuals who have been diagnosed Grade 1 through Grade 3 deliver similar indications despite returning from initial injury months earlier. Case by case studies indicate that PCS can last from weeks up until months depending on severity, age, gender among other factors associated with that specific case history/study analysis reviewed/implemented before determining plan for corrective care needed applicable during time frame implemented/required treatment initiated across specified duration noted within documentation provided before notes made regarding final outcome associated with recovery patient noted post accepted till end phase monitoring results noted permitting closure conceptualized providing necessary resolution program undertaken upon completion marking successful treatment initiative prescribed accordingly per clinical evaluation reported strongly recommending follow up protocol twice observed suggested conducted twice yearly ensuring program encouraged remains followed throughout subsequent twelve month period appointed client record slot booked scheduled implementation rendered continued support assessment granted ahead procedure mandating further evaluation required following year approximated promoted pushed concluded satisfactory above average if not outstanding professional opinion confirming healthy status document details maintained exceeding standards set enabling excellence thus acquired propelled result progressive improvement registered recognizing continuing ongoing care recommended evaluated intensely closely monitored eventually favored discernible formulated possibility probabilities listed accessible suitable available identified identified contributing associated risks highlighted prone circumstances revealed entailed discovered likely consequences posited potential issues communicated recorded final conclusion reached attesting mitigating affected key elements reviewed leading logically influential core reality brought addressed analyzed remarked reputable mode procedure providing proper care needed purposes confirming conclusions awarded decreed patient happy safe protective cover applied reassuring thankful response cautioned carefully following instructions provided reiterated prescribed format elaborate treatment plan mapped thereby achieving desired positive results indicated confirmation entirety content fulfilled highlighted properly advised completed fully overall promising resulting effect captured suggestion indicated generated.
Number of Concussions
The number of concussions sustained can act as a risk factor for the worsening of symptoms in many patients. It is thought that any concussion causing forces tend to pile on one another, leading to a cumulative effect related to symptom severity. This accumulation has been seen in cases where an individual had multiple concussive events with symptoms becoming more severe after each incident.
Individuals with incomplete resolution of symptoms due to their initial concussion should be especially careful when considering returning to activities which have the potential for concussion or head contact, as additional blows can compound initially occurring damage. Those who have experienced multiple head injuries should always seek out a medical opinion on whether or not playing such sports is wise, or even recommended.
Fewer numbers of mild traumatic brain injury (MTBI) do not require as thorough management and could recover significantly faster than those with multiple such incidents. Therefore, high active individuals are advised to take preventative measures by placing themselves in situations that reduce the possibility of acquiring MTBIs, particularly when partaking in sports which result in significant physical contact between participants and opponents. Additionally, having specialized helmets and taking sufficient rest time after each competitive season will help significantly reduce the recurrence rate of MTBIs over time, allowing greater protection and decreased chance for symptom deterioration brought on by repeated trauma.
Treatment and Prevention
Concussion is a type of traumatic brain injury that can have immediate and long-term effects. Treatment and prevention are key factors to reduce the risk of further complications.
Treatment and prevention strategies can involve:
- Lifestyle changes
- Cognitive retraining
- Physical therapy
This section will discuss various treatment and prevention strategies that can help manage concussion symptoms over time.
Medical treatment for a concussion typically includes rest and limiting activities that may cause further injury. Rest allows for the brain to heal, so it’s important to limit activities that may disrupt this healing process. The doctor or healthcare provider may recommend limiting physical activity, work, school or concentration intensive tasks.
Medications may be prescribed to reduce headache and dizziness associated with a concussion. Additionally, the doctor may suggest pain relievers such as ibuprofen or acetaminophen to manage pain and other symptoms associated with a concussion. It is not unusual for a doctor to refer a person who has had a concussion to other healthcare providers such as therapists (physical therapist or occupational therapist), psychologists, social workers or counselors. A referral may be made in some cases if:
- To monitor progress
- Help with symptom management
- Provide cognitive retraining
- Assist in planning return-to-activity protocol
- To address potential behavioral or emotional difficulties
In cases where long-term problems are suspected, your doctor may order specialized tests such as structural MRI scans and cognitive tests that evaluate memory and reaction time which can help diagnose any abnormalities in brain functioning caused by the injury.
The stress of a head injury can cause an imbalance in both physical and psychological wellbeing. Taking personal responsibility for one’s health and engaging in lifestyle changes can be beneficial in the long-term. This includes things like getting enough rest and exercise, practicing relaxation techniques, and striving for work-life balance. It is also important to avoid activities that could lead to further head injuries, such as sports and contact activities where blows to the head are possible.
Nutrition may also play a role in concussion treatment and prevention. A balanced diet rich in nutritious foods like fruits, vegetables, lean proteins, complex carbohydrates, healthy fats, whole grains and plant proteins is essential for maintaining overall functioning of the brain and body. Eating plenty of antioxidants such as vitamins A and C can help reduce inflammation while avoiding unhealthy processed foods has been linked to improved mental clarity after a concussion or other head trauma or injury.
Safety measures are the best way for athletes to prevent and protect themselves from head injuries, such as concussions. Coaches and players alike should be well-informed regarding these potential dangers, the signs and symptoms of concussions, and how to properly protect themselves. In addition to being knowledgeable about the risks of playing sports, taking proper precautions on the field or court is necessary in order to minimize the chances of concussion or other head injuries.
Below are some tips for coaches, players and parents that can be used when participating in any sport:
- Wear protective equipment properly: Ensure that all protective equipment including helmets, mouth guards and eyewear is properly fitted. Players with glasses must wear approved eyewear designed to resist impact.
- Teach proper technique: Coach athletes on how to tackle someone safely or slide into base without resorting to risky behavior.
- Increase awareness: Educate athletes on what constitutes a concussion – what it looks like and feels like – so they know when a head injury has occurred. Teach players when it’s important not only to speak up but also listen if another player reports feeling any of the common symptoms associated with a concussion.
- Encourage dialogue between coaches, parents and children: Make sure that young athletes understand the value of safety in relation to their sport participation by engaging in open conversations about their concerns, the importance of following training protocols and recognizing warning signs for overuse injury or fast play related incidents.
- Have an emergency plan: Train coaches on concussion recognition protocol with designated coaches who will remove injured players from competition as needed until they can be assessed by a medical professional.
The effects of a concussion can vary from person to person, so it is impossible to answer ‘yes’ or ‘no’. However, there is evidence to suggest that the symptoms of mild traumatic brain injury, such as those associated with a concussion, can worsen over time in some people.
It is important for anyone who has experienced a concussion to seek medical advice, as the symptoms can worsen without timely treatment. Following medical and rehabilitation guidance is essential for a safe return to activities such as sports or traditional school attendance.
Regular follow-up visits and activities may help reduce further complications. Careful attention should also be paid to lifestyle and any activity that increases the risk of further head trauma or exacerbates concussion symptoms. If these symptoms are occurring regularly or worsening over time, it could be an indication that something else is wrong. In these cases, you should consult a medical professional immediately.