Concussion

Concussion is a type of brain injury. It sometimes happens after a head injury, or a forceful knock to the body. You can have a concussion even if you stayed conscious (awake) after the injury. Only 10% of concussions involve someone being knocked out.

Falls and violence are the most common causes of concussion. It also often happens when someone is playing sport. If you think someone may have a concussion, they should stop doing any sport immediately. Remember, if in doubt, sit them out.

Read more about minor or severe head injuries

Symptoms of concussion can take up to 48 hours to appear after an injury.

If someone has a concussion, you may notice changes in the way they behave and act. They may:

• lose consciousness
• be confused
• have a blank expression
• take an unusually long time to answer questions
• struggle to balance
• show emotional responses that don't fit, like laughing or crying without explanation
• act out of character, like being unusually irritable
• struggle to remember events before or after the injury

They may also complain of physical symptoms, including:

• having a headache
• being dizzy
• feeling nauseous (sick)
• feeling stunned or dazed
• problems with their sight, like "seeing stars" or having blurry vision

Some symptoms of concussion can mean there is a severe head injury.

Someone has a head injury and:

• lost consciousness or was unresponsive for any length of time
• is getting more drowsy
• has lost memory of events, either before or after the injury
• is getting more and more confused or irritable
• is struggling to communicate
• is struggling to understand other people
• has had a seizure (fit)
• has a severe headache, or one that is getting worse
• is vomiting repeatedly
• has severe neck pain
• has bruising around the ears or eyes
• has fluid coming from the nose
• has a history of brain surgery
• has a bleeding disorder
• is on medicine to thin their blood, like warfarin
• is drunk or has been taking recreational drugs

• Call a doctor or the 16263 health line if you suspect someone has a concussion but they don't have symptoms that need to be seen urgently at the hospital emergency department.

If you think someone may have a concussion, you should also:

• stop them from taking part in all sport
• have a responsible adult monitor them for 72 hours
• not let them drive or operate heavy machinery
• not let them drink alcohol or take recreational drugs

There's no test that can rule out concussion. After a head injury, nobody can say for certain whether the person has a concussion or not.

If someone goes to hospital with a suspected concussion, they'll be examined for a severe head injury. Concussion is only diagnosed once other injuries have been ruled out.

Sometimes a person with a suspected concussion doesn't need to go to hospital. In that case they may not be given an official concussion diagnosis. You'll be advised to assume they have a concussion and to follow the GRAS recovery plan.

You should not diagnose concussion without consulting a health professional.

Concussion can cause complications, and these can be severe. That's why you should treat anyone with a suspected concussion as if they definitely have one.

A person recovering from concussion can take paracetamol to ease a headache. They should not drink alcohol or take recreational drugs. Plenty of rest and good, regular food will also help them get better.

The graduated return to activity and sport (GRAS) recovery plan is recommended for anyone recovering from a concussion. You increase the amount of activity slowly, over a period of time.

Recovery is different for everyone, and some people take longer than others. Studies have shown that someone is more likely to take longer to recover if they:

• are a child or young person
• have a significant history of previous concussion
• are a female athlete
• have ADHD or mental health disorders

The minimum time someone should take to return to normal life and sport is 21 days.

There are 6 stages to the GRAS recovery plan. All of them involve light physical activity, which has been shown to be more beneficial than complete rest when recovering from a concussion.

To move on to the next stage, someone does not need to be symptom free. They can progress as long as:

• they've been at their current stage for a minimum of 24 hours
• the activity level they're currently doing is not making their concussion symptoms significantly worse

They should rest for the first 24 to 48 hours after the injury, but it doesn't mean lying in bed all day. Very gentle activity is fine, like taking the dog out for 10 minutes. The main thing is to take it easy.

They should also spend as little time as possible looking at screens. That includes TVs, computers and devices like smart phones.

In stage 2 of recovery from concussion, the person can start to bring normal daily activities back, bit by bit. They should slowly do more physical activity around the house. They can also spend more time on screens and devices, and take up things like reading and games again.

In stage 3 of recovery from concussion, the person can start doing things that take more mental effort. A bit of school work is fine now, or they can begin working from home, as long as they take breaks.

Longer spells of gentle activity are also possible at this stage, such as taking longer walks.

In stage 4, a person with concussion can go back to school and work. They can also start exercise and sports training again, as long as there's no risk of another head injury.

At stage 5, the person can go back to their normal life in full. They can also return to full training for sports.

They can go back to competitive sport once they've had no symptoms for 14 days.

Almost everyone who has a concussion recovers well and goes back to normal life and sport. But a concussion can sometimes lead to complications.

When concussion isn't managed properly, a person's performance and decision making can suffer. That can show up at work and in sport. So you should follow the 6 stages of recovery for a minimum of 21 days.

If you keep playing a sport or game with a concussion, you're more likely to get another injury. Someone with concussion is 7 times more likely to get a muscle or joint injury if they play on.

Very rarely, some people develop a condition called second-impact syndrome. It can happen when one or more concussions happen close together, and it can be fatal. This is why you should never play on after a suspected concussion.

Having repeated concussions, or a concussion that goes on for a long time, can affect a person's daily life. It can cause problems at work, in their social life and with their mental health.

In some cases, the symptoms of a concussion last for more than 28 days. This is called post-concussion syndrome. If concussion symptoms last for more than 28 days, the person should contact their doctor.

Concussions that happen repeatedly and aren't managed well have been linked to conditions such as dementia and chronic traumatic encephalopathy (CTE). Research is still going on into how strong this link is. So be cautious, and follow all the recommendations when you're managing a concussion.