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This article has been co-written by Michael Lewis, MD, MPH, MBA, FACPM, FACN. Michael D. Lewis, MD, MPH, MBA, FACPM, FACN, is an expert in brain nutrition, specifically the prevention and recovery of brain injury. In 2012, when he retired as a colonel after 31 years of service in the US Army, he founded the Brain Health Education and Research Institute. He now practices privately in Potomac, Maryland and is the author of When the Brain Collisions: What Athletes and Parents Should Know About Preventing and Treating Concussions and Head Injuries .” He is a graduate of the United States Military Academy at West Point and Tulane University School of Medicine, and completed graduate training at the Walter Reed Army Medical Center, Johns Hopkins University, and the Army Research Institute. Walter Reed Dr. Lewis is a PhD student from the American College of Preventive Medicine and the American College of Nutrition.
There are 19 references cited in this article that you can view at the bottom of the page.
This article has been viewed 15,870 times.
When an impact causes the brain to vibrate in the space between the brain and the skull, the result is a concussion. [1] X VK Research Source , <i>First Aid Manual</i>, p. 180, (2006), ISBN 9-781405-315739 Concussion is the most common form of head injury. Concussions can occur from car crashes, sports injuries, falls, and head or upper body trauma. [2] X Source of Research Although most concussions cause only temporary shock and do not leave lasting damage, it can still cause serious problems if not treated promptly. and efficient. [3] X Australian Red Cross Research Resources , <i>First Aid: Responding to Emergencies</i>, p. 142, (2002), ISBN 0-909896-74-7
Steps
Determine if the victim has had a concussion
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Assess the victim’s condition. Examine the wound and observe the victim closely. Check to see if the victim has a bleeding wound on the head. A concussion may not cause external bleeding, but underneath the scalp there may be a “guava” or hematoma (large bruise). [4] X Research Sources
- Visible skin lesions are not always a sure sign of a concussion, as some minor injuries to the scalp can also cause profuse bleeding, while some injuries to the scalp can cause bleeding. Harder-to-see collisions can damage the brain.
- Physical symptoms to look out for include signs of a basilar skull fracture. Bruising behind the mastoid (a bruised area that swells up after days of a skull fracture due to blood seeping into the area behind the ear), periorbital bruising, and nasal discharge (cerebrospinal fluid leak). [5] X Trusted Source MedlinePlus Go to Source[6] X Research Source
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Check for physical symptoms. Mild and severe cases of concussion can lead to a variety of physical symptoms. Note any of the following symptoms:
- Fainting
- Severe headache.
- Sensitive to light.
- Double vision or blurred image.
- Seeing “fireflies”, dark spots, or other unusual patterns
- Loss of coordination and balance
- Dizzy
- Numbness, pins and needles feeling or weakness in the legs or arms
- Nausea and vomiting. [7] X Research Sources
- Lost memory
- Confusion
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Check for cognitive symptoms. Concussion is a disease of the brain and often causes brain dysfunction. These disorders include:
- Unusually irritable or agitated
- Lethargy or difficulty concentrating, thinking logically, and remembering
- Mood swings, inappropriate emotional outbursts, or crying
- Drowsiness or coma
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Assess the victim’s consciousness. When examining a concussion, it is important to know if the victim is conscious and what level of consciousness they have. To check the victim’s state of consciousness, try the AVPU method: [8] X DK Research Source , <i>First Aid Manual</i>, p. 178, (2006), ISBN 9-781405-315739
- A – (Alert – awake). Is the victim conscious ? – Do they look at you? Do they answer you? Do they respond to normal environmental stimuli?
- V – (Voice – voice). Does the victim respond to voices ? Do they react when you talk to them, even mildly and not fully awake? Victims may respond to verbal requests but remain unconscious. If they respond by asking “Huh?” When you talk, they are responding to the voice, but not in a state of consciousness.
- P – (Pain – pain) Does the victim respond to pain or touch? – Pinch the victim’s skin to see if they move or open their eyes. Another way is to clip or poke their nails. Be careful with this move lest you cause more damage to the victim. You’re just trying to test their body’s response. [9] X Research Source
- U – (Unresponsive – unresponsive). Did the victim not respond to any of the tests?
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Continue to monitor the victim. Most concussion symptoms appear within minutes of the injury. Other symptoms appear hours later. Some symptoms may change after a few days. Monitor the victim and call a doctor if symptoms worsen or change. [10] X Cleveland Clinic Trusted Source Go to Source
Treatment of mild brain injury
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Apply ice. To reduce swelling on a minor wound, you can apply an ice pack to the injured area. Apply ice every 2-4 hours for 20-30 minutes. [11] X Trusted Source National Health Service (UK) Go to Source
- Do not apply ice directly to the skin, but pack ice in a cloth or plastic bag. If you don’t have ice available, you can use a bag of frozen vegetables.
- Do not apply pressure on the head wound as strong pressure can push bone fragments into the brain.
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Take pain relievers. To treat a headache at home, you can take acetaminophen (Tylep). Do not take ibuprofen or aspirin as this can make bruising and bleeding worse. [12] X Research Source
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Attention tracking. If the victim is conscious, you need to keep asking questions. This has two purposes: the first is to assess the victim’s vulnerability, and the second is to keep the victim awake. Constantly asking questions can alert you to changes in the victim’s state of mind if they are unable to answer questions they were previously able to answer. If the victim’s state of consciousness changes and worsens, you should seek help. Questions to ask are:
- What day is today?
- Where are you?
- What happened to you?
- What is your name?
- How do you feel?
- Can you repeat after me the following words…?
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Stay next to the victim. During the first 24 hours of the injury, stay with the victim. Don’t leave them alone. Monitor their physical and cognitive function for any changes. If the victim wants to sleep, you need to wake them up every 15 minutes for the first 2 hours, then every half hour for the next 2 hours, then every hour. [13 ] X Research Resources New Zealand Mountain Safety Council, Inc., <i>New Zealand Outdoor First Aid</i>, p.49, (2002), ISBN 9-780908-931149
- Each time you wake the victim, apply the AVPU consciousness test as described above. You need to monitor the victim’s physical and cognitive condition if symptoms develop later or worsen.
- If the victim is unresponsive when awakened, you need to treat them like an unconscious patient.
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Avoid stressful activities. In the days following the injury, you need to avoid playing sports and vigorous activity. Avoid stressful situations during this time. The brain needs rest and healing. [14] X Research Sources Before participating in sports activities, you should consult your doctor.
- Moving too soon increases the risk of re-concussion and long-term memory problems.
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Do not drive. Do not operate a vehicle or ride a bicycle until fully healed. You should have someone drive you to the clinic or hospital.
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Rest. Do not read, watch TV, listen to music, play games, or perform tasks that require brain work. You should give your body and mind a rest. [15] X Research Source
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Eat brain foods. Food can have a positive or negative impact on brain healing. Avoid alcoholic beverages after a concussion. You should also avoid fried foods, foods containing sugar, caffeine, artificial colors and flavors. Instead, eat the following foods:
- Avocado
- Blueberry
- Coconut oil
- Nuts and seeds
- Salmon
- Butter, cheese and eggs
- Honey
- Any vegetables and fruits you like [16] X Research Source
Treatment of severe concussion
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Contact your doctor. Any suspected head injury or concussion should be evaluated by a medical professional. A seemingly minor head injury can also be life-threatening. If the victim does not wake up, call an ambulance. Or you can take the casualty to the nearest emergency room or clinic. [17] X Australian Red Cross Research Resources , <i>First Aid: Responding to Emergencies</i>, p. 143, ISBN 9-780909-896744
- If the victim is unconscious or if you are unsure of the extent of the injury, call 911. Transporting a person with a head injury to the hospital requires moving the victim, and this should not be done until the victim’s head is stable. Movement can be fatal to the patient.
- It is best for the victim to be examined in the emergency room if they are unconscious or have severe memory loss. Your doctor may order a computed tomography (CT scan) to evaluate for swelling or bleeding and diagnose a concussion. Another name for a concussion is a mild traumatic brain injury.
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Go to the hospital. In the case of a severe concussion, you may need to take the victim to the emergency room. If the victim has any of the following symptoms, you should take them to the emergency room right away:
- Unconscious, even for a short time
- There are episodes of memory loss
- Feeling dizzy or confused
- Severe headache
- Vomiting many times
- Seizures [18] X Research Source
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Stay still and avoid movement. If you think a neck or spine injury may be associated with a concussion, avoid moving the casualty while the ambulance arrives. Moving the victim can do more damage.
- If you must move the victim, be very careful. Make sure the victim’s head and back move as little as possible. [19] X Research Source
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Continue tracking. If symptoms do not improve within 7-10 days, contact your doctor. Whenever your symptoms change or get worse, you should contact your doctor right away. [20] X Research Sources
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Continue treatment. Very little is known about the effects of traumatic brain injury on the brain and cognitive function. However, some treatments prescribed by your doctor can improve long-term symptoms.
- Your doctor may order a number of imaging tests, including magnetic resonance imaging (MRI), computed tomography (CT scan), or electroencephalogram (EEG). [21] X Research Source Your doctor may also perform neurological tests, which assess vision, hearing, reflexes, and coordination. Another test that may also be ordered is a cognitive test, which includes testing for memory, concentration, and recall. [22] X Trusted Source Mayo Clinic Go to Source
Advice
- Do not play sports again on the same day of concussion. Athletes should not play again until symptoms are gone and medication is no longer required. Children and adolescents need extra precautions.
- Precautions include using helmets when playing sports such as football, baseball, ice hockey, alpine skiing, and snowboarding.
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This article has been co-written by Michael Lewis, MD, MPH, MBA, FACPM, FACN. Michael D. Lewis, MD, MPH, MBA, FACPM, FACN, is an expert in brain nutrition, specifically the prevention and recovery of brain injury. In 2012, when he retired as a colonel after 31 years of service in the US Army, he founded the Brain Health Education and Research Institute. He now practices privately in Potomac, Maryland and is the author of When the Brain Collisions: What Athletes and Parents Should Know About Preventing and Treating Concussions and Head Injuries .” He is a graduate of the United States Military Academy at West Point and Tulane University School of Medicine, and completed graduate training at the Walter Reed Army Medical Center, Johns Hopkins University, and the Army Research Institute. Walter Reed Dr. Lewis is a PhD student from the American College of Preventive Medicine and the American College of Nutrition.
There are 19 references cited in this article that you can view at the bottom of the page.
This article has been viewed 15,870 times.
When an impact causes the brain to vibrate in the space between the brain and the skull, the result is a concussion. [1] X VK Research Source , <i>First Aid Manual</i>, p. 180, (2006), ISBN 9-781405-315739 Concussion is the most common form of head injury. Concussions can occur from car crashes, sports injuries, falls, and head or upper body trauma. [2] X Source of Research Although most concussions cause only temporary shock and do not leave lasting damage, it can still cause serious problems if not treated promptly. and efficient. [3] X Australian Red Cross Research Resources , <i>First Aid: Responding to Emergencies</i>, p. 142, (2002), ISBN 0-909896-74-7
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