Fall sports season has begun and now is the time for football and soccer among other fall activities. Most sports run some type of risk for a head injury, especially if a helmet is part of the safety equipment. Any sport where the head can be hit or suddenly moved is a risk for a concussion. Head trauma used to be thought of as a minor inconvenience, but now we are beginning to understand the severity of the problem, especially concussions.

Wearing protective equipment such as helmets was thought to be the only necessary precaution to prevent injury. As information collection and the use of computers has grown, the ability to study medical problems and spot trends has allowed us to understand simple and complex issues like head trauma. Awareness of the issues became evident when athletes begin developing unusual early onset of diseases like dementia, ALS, and Parkinson’s disease, or much more frequently than the rest of the population. The significance of severe head trauma was always known – statistics just allowed us to find the effects of smaller trauma that was repetitive.

Effects of Head Trauma

Any repetitive head trauma is bad, but severe head trauma can be really problematic. Trauma to the brain can cause permanent damage. The need to wear appropriately fitted and designed helmets is without question. Unfortunately, with better gear, people tend to take more risks, which may lead to more trauma. For example, when football players played without helmets, very few players led with their head when making a tackle. Today, players are launching themselves headfirst at other players because they believe their heads are protected by the helmet.

The brain is the most complex structure in the body, and how it processes information so effectively is amazing. There is an extremely complex interaction within and between the cells of the brain. Smashing the head can disrupt the subtle interactions in the brain. If the brain is shaken, then the connections between cells can be disrupted. The result of this is a degree of confusion, and often is accompanied by ongoing headaches. No athlete should immediately return to a sport if any signs of a concussion have occurred. All coaches and athletic trainers should be aware of the signs. If you have had any confusion after a head trauma, immediately stop what you are doing and sit down to rest. The brain needs time to recover, so do not force the issue.

Signs of a Concussion

Headaches, dizziness, light sensitivity, fatigue and confusion all are signs of a concussion. Return to sports and even school or work needs to wait until all signs of a concussion have cleared. If headaches or any other signs of head injury last longer than a day, one should see a doctor. If there is an immediate severe headache after trauma, a doctor should be consulted immediately. Rest and symptomatic management of head trauma is necessary.

A headache after sports trauma is not a good sign. We only have one brain, and it is not replaceable. It needs to be kept safe. If it is injured, and one has headaches, see a doctor, as a head scan may be necessary. With a significant injury, recovery can be prolonged. Until the headaches are gone, returning to any high level activity should be limited. Many professional athletes have ended their careers due to head injury. Now, we are beginning to learn the late effects of multiple small injuries to the brain, and these are even scarier. A young athlete needs to realize they have only one brain, and no sport is worth permanent damage.

Concussions have been a recent hot topic in the news and in medicine. But for Neurologists and Physical Medicine physicians, this is actually a very old topic. Recently, due to high profile athletes having problems with concussions, the general public is better understanding the significance of this disorder.

What is a Concussion?

Concussions are traumatic brain injuries. The severity of symptoms is highly varied. Neurologists have long been in the forefront with diagnosis of brain injuries and Physical Medicine doctors as part of their training have extensive experience treating and coordinating care for these patients.

Concussions result from blows to the head. They are a “mild” form of traumatic brain injury. Loss of consciousness is not necessary for problems. The severity of the blow to the head also does not correlate to severe symptoms. Any blow to the head, or sudden shaking of the head can cause problems. The trauma to the brain is felt to cause microscopic damage to the brain and connections between neurotransmitters. The first symptoms may occur almost immediately with the person being slightly dazed or confused. Recognizing a possible concussion is important such that a person is removed from further injury and healing can be facilitated.

Concussion Headaches

Headaches are one of the most common symptoms of concussions. The headaches are diffuse throughout the head, and often are worse with noise, bright light, and movement. Accompanying symptoms can include:

Memory issues
Mood changes
Irritability
Fatigue
Balance problems and dizziness

The symptoms can appear immediately or within one to two weeks. If one has had head trauma, and has symptoms of a possible concussion, see a physician and seek treatment. Remember, the suggestion to seek evaluation is to help the brain heal and prevent further damage. It is not a punishment to keep a person out of sports or other activities.

The diagnosis of concussion and headaches from injury is made clinically; it is based on history and exam. MRI scans of the brain or spine may be done to evaluate for possible problems contributing to symptoms or to see if there may be subtle tissue changes in the brain that are consistent with exam. If dizziness is an issue, then an Ear specialist may also be involved with symptom evaluation and management.

Concussion Headache Treatment Options

Treatment of post–concussion syndrome and headaches is dependent on severity of symptoms. Initially, it is recommended to rest and avoid too much activity and stimulation to the brain. That may mean no computer use, no reading and no watching TV or videos. As the headaches improve, gradual increase in activity as tolerated. The brain needs to heal on its own time frame without being damaged or stressed. Medications that are used are the same medications we use for muscle tension headaches or migraines, but we start simple and hopefully they will be unnecessary very quickly. Repeated concussions often heal very slowly if ever.

Concussions and headaches from them are serious problems. Medicine and everyone else is just starting to become aware of the seriousness of these injuries. Treating ongoing headaches from concussions is serious; ignoring them may lead to long-term issues. Once a diagnosis is made, follow the doctor’s orders and allow the brain to heal. There is no such thing as brain transplants, so allow the brain time to heal.

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