What is Concussion?
Concussion is a mild head injury that occurs after sustaining a blow to the head. It can also be termed a mild Traumatic Brain Injury (mildTBI).
It can occur with or without loss of consciousness at the time of injury and includes symptoms affecting physical, emotional, and mental wellbeing.
Post-concussion syndrome results from chemical and energy changes that occur in the brain due to trauma. The brain becomes inefficient at carrying our normal physiologic processes resulting in the symptoms listed. This can last for weeks to months post head injury.
Signs and Symptoms of Concussion
Immediate symptoms may include vacant stare, disorientation, slurred speech, nausea and vomiting, headache and dizziness. Ongoing symptoms may also develop. Each person may report a variety of different symptoms that impair their daily activities:
Physical symptoms:
- Headache
- Dizziness
- Imbalance
- Nausea/vomiting
- Fatigue
- Difficulty sleeping
- Double or blurred vision
- Photophobia (sensitivity to light)
- Phonophobia (sensitivity to sound)
Emotional symptoms:
- Irritability
- Restlessness
- Anxiety
- Depression
- Panic attacks
- Mood swings
- Aggression
- Decreased tolerance to stress
Sleep symptoms:
- Sleeping more than usual
- Sleeping less than usual
- Trouble falling asleep
Cognitive symptoms:
- Poor short or long term memory
- Confusion
- Slowed processing
- Fogginess
- Difficulty concentrating
Concussion and Dizziness
Up to 79% of people report dizziness and 56% report balance issues post-concussion. The vestibular system is a small and fragile structure located in the inner ear within the skull. Trauma to the head can cause damage to the vestibular system. The following vestibular-related conditions may occur:
- 1. Benign position paroxysmal vertigo (BPPV)
- 2. Labyrinth concussion causing a unilateral loss of vestibular function
- 3. Base of skull fracture that damages the vestibular labyrinth or nerve causing a unilateral loss of vestibular function
- 4. Vestibular sensory integration dysfunction causing poor processing of vestibular processes
- 5. Post traumatic migraines
- 6. Perilymphatic fistula or semicircular canal dehiscence
- 7. Brain-stem concussion.
Management of Concussion
The dizziness that you get can be a big contributing factor to falls. Symptoms may persist or get worse if treatment is not considered.
Your Vestibular Physiotherapist will complete a comprehensive assessment on current problems and can assist with reintroducing physical activity. This is a gradual process as it is important not to overload the system. It is important to be relatively symptom-free to progress activity levels.
Vestibular rehabilitation may be necessary for individuals experiencing dizziness and balance issues