Facts About Concussion and Brain Injury: Where To Get Help

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Facts about

Concussion and
Brain Injury
WHERE TO GET HELP

About Concussion
Signs and Symptoms
Getting Better
Where to Get Help
Resources

U.S. Department of Health and Human Service s

Centers for Disease Control and Prevent ion


Facts about
Concussion and
Brain Injury ABOUT
WHERE TO GET HELP CONCUSSIONS

ABOUT CONCUSSION 2
Medical Help 3
Danger Signs—Adults 4
Danger Signs—Children 4

SYMPTOMS OF CONCUSSION 5
Persons of All Ages 5
Young Children 6
Older Adults 7

GETTING BETTER 8
Tips for Healing—Adults 10
Tips for Healing—Children 11

WHERE TO GET HELP 13


Help for People with Concussion 13
Help for Families and Caregivers 14
Resources 15

“Facts about Concussion and Brain Injury:


Where to Get Help,” is a publication of the
Centers for Disease Control and Prevention,
National Center for Injury Prevention and
Control. See www.cdc.gov/TraumaticBrainInjury.
A concussion is a mild form of traumatic brain
injury (TBI) caused by a bump, blow, or jolt to the
head. Concussions can also occur from a fall or a
blow to the body that causes the head to move
rapidly back and forth. Doctors may describe these
injuries as “mild” because concussions are usually
not life-threatening. Even so, their effects can be
serious. Understanding the signs and symptoms of
a concussion can help you get better more quickly.

Leading causes of concussion


(seen in emergency departments):

• falls
• motor vehicle-related injury
• unintentionally being struck by or against an obstacle
• assaults
• playing sports
After a concussion, some people lose consciousness (“knocked out”)
for a short time. However, most concussions do not result in a loss
of consciousness. Not being able to remember events (amnesia)
prior to, or following the injury, for a period of time is another sign
of concussion. Yet, some people simply feel dazed or confused.

Symptoms of concussion usually fall into four categories:

THINKING/REMEMBERING, such as difficulties See page 5 for more


remembering recent events (even those information and a full
list of concussion
immediately before and/or after the
signs and symptoms
concussion), or feeling mentally “foggy”
PHYSICAL, such as headaches or difficulty with bright light
or loud noises
EMOTIONAL/MOOD, such as irritability, sadness, or nervousness

SLEEP DISTURBANCE, such as sleeping more or less than usual

Most people with a


concussion recover quickly
and fully. But for some
people, symptoms can last
for days, weeks, or longer.
In general, recovery may
be slower among older
adults, young children, and
teens. Those who have had
a concussion in the past
are also at risk of having another one and may find that it takes
longer to recover if they have another concussion.

2 Facts about Concussion


and Brain Injury
MEDICAL HELP

People with a concussion need to be seen by a doctor. While


most are seen in an emergency department or a doctor’s
office, some people must stay in the hospital overnight.

Your doctor may do a scan of your Persons taking blood


brain (such as a CT scan) or other thinners should be seen
tests. Other tests, known as immediately by a health
“neuropsychological” or care provider if they have a
bump or blow to the head
“neurocognitive” tests, assess
even if they do not have any
your learning and memory skills,
symptoms listed on page 5.
your ability to pay attention or
concentrate, and how quickly you
can think and solve problems. These tests can help your
doctor identify the effects of a concussion. Even if the
concussion doesn’t show up on these tests, you may still
have a concussion.

Your doctor will send you home with important instructions


to follow. Be sure to follow all of your doctor’s instructions
carefully.

If you are taking medications—prescription, over-the-


counter medicines, or “natural remedies”—or if you drink
alcohol or take illicit drugs, tell your doctor. Also, tell your
doctor if you are taking blood thinners (anticoagulant drugs),
such as Coumadin and aspirin, because they can increase the
chance of complications.

Facts about Concussion 3


and Brain Injury
DANGER SIGNS – ADULTS

In rare cases, a dangerous blood clot may form on the brain in a


person with a concussion and crowd the brain against the skull.
Contact your doctor or emergency department right away if you
have any of the following danger signs after a bump, blow, or jolt
to the head or body:
• Headache that gets worse and does not go away
• Weakness, numbness or decreased coordination
• Repeated vomiting or nausea
• Slurred speech

The people checking on you should take you to an emergency


department right away if you:
• Look very drowsy or cannot be awakened
• Have one pupil (the black part in the middle of the eye)
larger than the other
• Have convulsions or seizures
• Cannot recognize people or places
• Are getting more and more confused, restless, or agitated
• Have unusual behavior
• Lose consciousness (a brief loss of consciousness should be
taken seriously and the person should be carefully monitored).

DANGER SIGNS – CHILDREN

Take your child to the emergency department right away if they


received a bump, blow, or jolt to the head or body, and:
• Have any of the danger signs for adults listed above
• Will not stop crying and cannot be consoled
• Will not nurse or eat

4 Facts about Concussion


and Brain Injury
SYMPTOMS OF CONCUSSION

PERSONS OF ALL AGES

“I just don’t feel like myself.”

Most people with a concussion have one or more of the


symptoms listed below and recover fully within days,
weeks or a few months. But for some people, symptoms of
concussion can last even longer. Generally, if you feel that
“something is not quite right,” or if you are feeling “foggy,”
you should talk with your doctor.

Concussion symptoms are often grouped into four categories,


including:

THINKING/ PHYSICAL EMOTIONAL/ SLEEP


REMEMBERING MOOD DISTURBANCE

• Difficulty thinking • Headache • Irritability • Sleeping more


clearly • Nausea or • Sadness than usual
• Feeling slowed vomiting • More emotional • Sleeping less
down (early on) than usual
• Nervousness
• Difficulty • Balance or anxiety • Trouble falling
concentrating problems asleep
• Difficulty • Dizziness
remembering new • Fuzzy or blurry
information vision
• Feeling tired,
having no
energy
• Sensitivity to
noise or light

Facts about Concussion 5


and Brain Injury
Some of these symptoms may appear right away, while
others may not be noticed for days or months after the
injury, or until the person starts resuming their everyday life
and more demands are placed upon them. Sometimes,
people do not recognize or admit that they are having
problems. Others may not understand why they are having
problems and what their problems really are, which can
make them nervous and upset.

The signs and symptoms of a concussion can be difficult to sort


out. Early on, problems may be missed by the person with
the concussion, family members, or doctors. People may look
fine even though they are acting or feeling differently.

YOUNG CHILDREN

Very young children (i.e., infants, toddlers, and preschoolers)


often bump and bruise their heads. This can happen as a
result of motor vehicle crashes, falls, getting hit in the head
with a ball or toy, or from tricycle/bike accidents.

Sometimes these events can be serious and result in a concussion.

6 Facts about Concussion


and Brain Injury
Young children can have the same symptoms of a
concussion as older children, but it is harder for them to let
others know how they are feeling. In addition to the
symptoms mentioned on page 5, call your child’s doctor right
away if your child seems to be getting worse or if you notice
any of the following:
• Crying more than usual
• Headache that will not go away
• Change in the way they play, perform or act at school
• Change in nursing, eating, or sleeping patterns
• Becoming easily upset or increased temper tantrums
• Sad mood
• Lack of interest in usual activities or favorite toys
• Loss of new skills, such as toilet training
• Loss of balance, unsteady walking
• Poor attention

OLDER ADULTS

Because concussions are often missed or misdiagnosed


among older adults, be especially alert if you know that an
older adult has fallen or has a fall-related injury, such as a
hip fracture. Older adults may have a higher risk of serious
complications from a concussion, such as bleeding on the
brain. Headaches that get worse or increased confusion are
signs of this complication. If they occur, see a doctor right
away. Older adults often take blood thinners; if they do, they
should be seen immediately by a health care provider if they
have a bump or blow to the head or body even if they do not
have any of the symptoms listed on page 5.

Facts about Concussion 7


and Brain Injury
GETTING BETTER
“Sometimes the best thing you can do is just rest
and then try again later.”

Although most people recover fully after a concussion, how


quickly they improve depends on many factors. These factors
include how severe their concussion was, their age, how
healthy they were before the concussion, and how they take
care of themselves after the injury.

Some people who have had a concussion find that at first it


is hard to do their daily activities, their job, to get along with
everyone at home, or to relax. Ignoring your symptoms and
trying to “tough it out” often makes symptoms worse.

Rest is very important after a concussion because it helps


the brain to heal. You’ll need to be patient because healing
takes time. Only when the symptoms have reduced
significantly, in consultation with your doctor, should you
slowly and gradually return to your daily activities, such as
work or school. If your symptoms come back or you get new
symptoms as you become more active, this is a sign that you
are pushing yourself too hard. Stop these activities and take
more time to rest and recover. As the days go by, you can
expect to gradually feel better.

If you already had a medical condition at the time of your


concussion (such as chronic headaches), it may take longer for
you to recover from the concussion. Anxiety and depression

8 Facts about Concussion


and Brain Injury
may also make it harder to adjust to the symptoms of a
concussion. While you are healing, you should be very
careful to avoid doing anything that could cause a bump,
blow, or jolt to the head or body. On rare occasions, receiving
another concussion before the brain has healed can result in
brain swelling, permanent brain damage, and even death,
particularly among children and teens.

After you have recovered from your concussion, you should


protect yourself from having another one. People who have
had repeated concussions may have serious long-term
problems, including chronic difficulty with concentration,
memory, headache, and occasionally, physical skills, such as
keeping one’s balance.

Facts about Concussion 9


and Brain Injury
TIPS FOR HEALING - ADULTS

Tips to help you get better:


• Get plenty of sleep at night, and rest during the day.
• Avoid activities that are physically demanding (e.g.,
heavy housecleaning, weightlifting/working-out) or
require a lot of concentration (e.g., balancing your
checkbook). They can make your symptoms worse
and slow your recovery.
• Avoid activities, such as contact or recreational sports,
that could lead to a second concussion. (It is best to
avoid roller coasters or other high speed rides that can
make your symptoms worse or even cause a concussion.)
• When your doctor says you are well enough, return to
your normal activities gradually, not all at once.
• Because your ability to react may be slower after a
concussion, ask your doctor when you can safely drive
a car, ride a bike, or operate heavy equipment.
• Talk with your doctor about when you can return
to work. Ask about how you can help your employer
understand what has happened to you.
• Consider talking with your employer about returning to
work gradually and about changing your work activities
or schedule until you recover (e.g., work half-days).
• Take only those drugs that your doctor has approved.
• Do not drink alcoholic beverages until your doctor says
you are well enough. Alcohol and other drugs may slow
your recovery and put you at risk of further injury.
• Write down the things that may be harder than usual for
you to remember.

10 Facts about Concussion


and Brain Injury
• If you’re easily distracted, try to do one thing at a time.
For example, don’t try to watch TV while fixing dinner.
• Consult with family members or close friends when
making important decisions.
• Do not neglect your basic needs, such as eating well and
getting enough rest.
• Avoid sustained computer use, including
computer/video games early in the recovery process.
• Some people report that flying in airplanes makes their
symptoms worse shortly after a concussion.

TIPS FOR HEALING - CHILDREN

Parents and caregivers of children who have had a concussion


can help them recover by taking an active role in their recovery:
• Having the child get plenty of rest. Keep a regular sleep
schedule, including no late nights and no sleepovers.
• Making sure the child avoids high-risk/ high-speed
activities such as riding a bicycle, playing sports, or
climbing playground equipment, roller coasters or
rides that could result in a second bump, blow, or jolt
to the head or body. Children should not return to
these types of activities until the doctor says they
are well enough.
• Giving the child only those drugs that are approved by
the pediatrician or family physician.
• Talking with the doctor about when the child should
return to school and other activities and how the parent
or caregiver can help the child deal with the challenges
that the child may face. For example, your child may

Facts about Concussion 11


and Brain Injury
need to spend fewer hours at school, rest often, or
require more time to take tests.
• Sharing information about concussion with parents,
siblings, teachers, counselors, babysitters, coaches,
and others who interact with the child helps them
understand what has happened and how to meet the
child’s needs.

12 Facts about Concussion


and Brain Injury
WHERE TO GET HELP

HELP FOR PEOPLE WITH CONCUSSION

“It was the first time in my life that


I couldn’t depend on myself.”

There are many people who can help you and your family as
you recover from a concussion. You do not have to do it alone.

Show this booklet to your doctor or health care provider and


talk with them about your concerns. Ask your doctor about
whether you need specialized treatment and about the
availability of rehabilitation programs.

Your doctor can help you find a health care provider who has
special training in treating concussion. Early treatment of
symptoms by a specialist may speed recovery. Your doctor
may refer you to a neuropsychologist, neurologist, or
specialist in rehabilitation.

Keep talking with your doctor, family members, and


loved ones about how you are feeling, both physically and
emotionally. If you do not think you are getting better, tell
your doctor.

For more information, see the Resources on page 15.

Facts about Concussion 13


and Brain Injury
HELP FOR FAMILIES AND CAREGIVERS

“My husband used to be so calm. But after his injury,


he started to explode over the littlest things. He didn’t
even know that he had changed.”

When someone close to you has a concussion or a more


serious brain injury, it can be hard to know how best to help.
They may say that they are “fine,” but you can tell from how
they are acting that something has changed.

If you notice that your family member or friend has


symptoms of a concussion that are getting worse, talk to
them and their doctor about getting help. They may need
help if you can answer YES to any of the following questions:
• Are any of the concussion symptoms substantially
affecting their life activities (such as feeling restricted in
their activities due to symptoms, performance in school
or at work has changed, unhappy with life changes)?
• Has their personality changed?
• Do they get angry for no reason?
• Do they get lost or easily confused?
• Do they have more trouble than usual making decisions?

You might want to talk with people who share your


experience. The Brain Injury Association of America can put
you in contact with people who can help (see page 15).

14 Facts about Concussion


and Brain Injury
RESOURCES

“I thought I was all alone, but I’m not.


There are lots of people out there who understand
what I’ve been through.”

Several groups help people and their families deal with


concussion and more serious brain injuries. They provide
information and put people in touch with local resources,
such as support groups, rehabilitation services, and a variety
of health care professionals.

u CDC’s Injury Center has created resources and conducts


research to help prevent concussion and more serious
brain injuries and improve outcomes for survivors.
For more information contact CDC toll-free at
1-800-CDC-INFO (1-800-232-4636) or visit CDC’s Injury
Center on the Web at www.cdc.gov/TraumaticBrainInjury.

u The Brain Injury Association of America (BIAA)


has a national network of many state affiliates and
hundreds of local chapters and support groups across
the country that provide help in your community.

Facts about Concussion 15


and Brain Injury
You can reach BIAA by calling the toll-free National
Brain Injury Information Center at 1-800-444-6443.
You can also get information through their website at
www.biausa.org. Both the help line and the website
can provide you with information about the BIAA
affiliate closest to you.

u The Defense and Veterans Brain Injury Center (DVBIC)


works to ensure that active duty military and veterans
with brain injury receive the best evaluation,
treatment, and follow-up. You can reach DVBIC by
calling toll-free at 1-800-870-9244 or by visiting their
website at www.dvbic.org.

u For more information about TBI in the military,


including an interactive website for service members,
veterans, and families and caregivers, please visit:
www.TraumaticBrainInjuryatoz.org.

16 Facts about Concussion


and Brain Injury
ADDITIONAL CDC CONCUSSION RESOURCES

Information about Mild Brain Injuries


(Información Acerca de la Lesión Cerebral Leve) booklet
This booklet is written for Spanish-speaking people with brain injuries and
their family members or caregivers. The booklet provides information about
brain injury, its symptoms, tips for healing, and resources.

Heads Up: Brain Injury in Your Practice initiative


Physicians and other health care providers can play a key role in helping to
reduce the occurrence of mild traumatic brain injury (TBI) or concussion by
educating patients and the community about risks and how to prevent these
injuries. This initiative provides physicians with tools and information for
improving the clinical diagnosis and management of mild TBI.

Heads Up: Concussion in High School Sports initiative


Concussions can happen to any athlete—male or female—in any sport. This
initiative, developed for high school coaches, athletic directors and trainers,
contains practical, easy-to-use information, such as a video, guide
for coaches, wallet card, clipboard sticker, posters, and fact sheets.

Heads Up: Concussion in Youth Sports initiative


To help ensure the health and safety of young athletes, CDC developed the
“Heads Up: Concussion in Youth Sports” initiative to offer information about
concussions to youth sports coaches, administrators, parents, and athletes.
This initiative provides information about preventing, recognizing, and
responding to a concussion and includes fact sheets for coaches, athletes,
and parents, and a clipboard, magnet, poster, and quiz.

Help Seniors Live Better, Longer: Prevent Brain Injury initiative


This initiative was developed for caregivers and children of older adults to raise
their awareness of ways to prevent, recognize, and respond to fall-related TBI
among adults ages 75 and older. As part of this initiative, CDC developed
English- and Spanish-language materials for older adults and their caregivers,
including a brochure, booklet, fact sheet, magnet, posters, and e-cards.

For more information and resources, including multiple fact sheets available on concussion
and TBI, or to order additional materials free-of-charge, call CDC toll-free at 1-800-CDC-INFO
(1-800-232-4636) or visit CDC’s Injury Center on the Web at www.cdc.gov/TraumaticBrainInjury .
A bump, blow, or jolt to the head can cause a
concussion, a type of traumatic brain injury
(TBI). Concussions can also occur from a fall
or a blow to the body that causes the head
to move rapidly back and forth.

Some symptoms of a concussion are:


• Headaches that won’t go away
• Having more trouble than usual remembering things or concentrating
• Confusion about recent events
• Feeling tired all of the time
• Feeling sad or anxious
• Becoming easily irritated or angry for little or no reason

For more information about danger signs, tips for getting better,
and where to go for help, look inside this booklet.

PARTICIPATING ORGANIZATIONS
American College of Emergency Physicians
Brain Injury Association of America
Children’s National Medical Center
Emergency Nurses Association
Human Resources and Services Administration
Indian Health Service
National Academy of Neuropsychology
National Association of State Head Injury Administrators
North American Brain Injury Society
Special Olympics International

U.S. Department of Health and Human Service s

Centers for Disease Control and Prevention

2010

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