Concussion: Frequently Asked Questions
What do I do if I suspect a concussion has occurred?
Immediately remove the athlete from all contact sports and physical activity. Athletes should be evaluated by a concussion-trained health care professional. Do not resume physical activities/sports until a healthcare professional experienced in evaluating concussions determines it is safe for the athlete to return to play.
What type of testing is administered for concussion injuries?
One of the more common tests used in post-concussion assessment is the ImPACT™ test (Immediate Post-Concussion Assessment Cognitive Test). It is a web-based, scientifically validated, computerized concussion evaluation used to test your cognitive ability. It is a measure of verbal and visual memory, processing speed, and reaction time. In addition to ImPACT, other traditional (paper-pencil) neuropsychological tests may be administered by a neuropsychologist to provide more comprehensive information about an individual's cognitive abilities.
What is the difference between an ImPACT Baseline test and an ImPACT Post-injury test?
ImPACT Baseline tests are usually administered prior to an injury. An ImPACT Post-injury test is given after an injury or suspected injury occurs and can be compared to the pre-injury baseline to determine changes in the athlete's cognition that may be attributable to the concussion.
My child is sleeping more than usual. Is this normal?
Yes, this is normal. Rest is very important in order for the brain to heal. It is not necessary to wake the athlete/patient every hour, although careful monitoring of any changes in mental status or deteriorating symptoms is highly recommended.
What can I take for the headaches I have been experiencing since my concussion?
For headaches, you can take acetaminophen, such as Tylenol®, but avoid aspirin, blood thinners, and any drug that causes drowsiness unless prescribed by a concussion-trained physician. To date, there has been no medication scientifically proven to enhance recovery from concussion. A majority of concussion symptoms resolve spontaneously within a few days with plenty of mental and physical rest.
Should I have a head CT/MRI? I went to the ER, but they didn't do a CT.
A concussion cannot be seen on a CT scan or MRI. Occasionally, imaging of the brain is needed to rule out other problems, like a skull fracture or bleeding in the brain. A normal CT or MRI scan may not mean the athlete is okay to return to sport competition. A formal evaluation with a concussion specialist is still recommended.
Is it okay to drive?
Many patients will experience impairments in their reaction time and hand-eye coordination following a concussion. In addition, a concussed patient may be prescribed medications following the injury, making it unsafe for them to drive. Therefore, an assessment of cognitive abilities and medical clearance is recommended before driving can be resumed.
It has been recommended that I get a full battery of neuropsychological tests. What does this include?
There are many tests that can be included in a full battery of neuropsychological testing. ImPACT™ is one computer-based resource for cognitive screening, but manual paper-pencil testing performed by a neuropsychologist with concussion training is usually the preferred method of assessment. Information from this type of evaluation can assist clinicians identify the types of treatments (i.e., medications, cognitive rehabilitation, and supportive psychotherapy) that may be necessary to help facilitate recovery.
Is it normal to have attitude changes or mood swings after a concussion?
It is common to experience emotional changes following a concussion. For example, a blow to the frontal portion of the head may result in changes in personality or the ability to control one's emotions. A concussion hurts, and because of your symptoms, you may not feel like doing daily activities or interacting with others. Athletes that have suffered a concussion may also feel very stressed about not being able to participate in their sport and fearful of letting their team down or even losing their position on the team. There can also be a great deal of stress over missing school and falling behind in coursework. Athletes and their families should be provided assistance with these issues during the recovery period.
Is there anything that I should do prior to my appointment?
You should get as much physical and cognitive rest (limit TV time, cell phone usage, and texting) as possible. Come prepared with questions to address with your provider. Our concussion team wants to help expedite your recovery, so you can return to sports and normal activity as safely as possible.
What is a baseline test?
A baseline is a pre-injury assessment that is performed to determine an individual's abilities and functions prior to an injury or change in health status. In the context of sports concussion, baseline assessments of cognitive function (i.e., Immediate Post-Concussion Assessment Test; ImPACT) and balance (Balance Error Scoring System; BESS) are highly recommended to help clinicians in the interpretation of tests performed after a concussion occurs. Please contact our Concussion Program to obtain specific information on how to undergo pre-injury baseline assessments. Baseline assessments are offered for ages 6 and up and may be most effective for post-injury comparisons if administered at every level of play (i.e., middle school, junior high, high school, collegiate, professional)
What if I get injured and don't have an ImPACT™ baseline?
You can still take a post-injury test, and the results will be compared to the norms (expected performance) for your age group and gender. This gives your concussion specialist an idea of where you are supposed to be cognitively and the cognitive deficits that you may be experiencing following your injury. From this information, an academic plan can also be determined to help you as you recover.
Please note that that not all physicians are trained to interpret ImPACT™ data and may not be able to administer a post-injury test. ImPACT™ is only one valuable resource used to test cognitive response following a concussion and should not be the only tool utilized to diagnose and manage concussions.
Will there be any long-term effects from my injury?
Factors that have been identified to influence the potential for persistent effects include repeated concussions occurring over a short period of time, age when concussion occurred, and co-existing conditions (i.e., psychological illness, neurological disorders, learning disabilities, attentional disorders, and sleep disorders). Individuals who are not managed from their injury properly and continue to play while symptomatic have been found to have more severe symptoms and mental status changes and become concussed more easily with less physical force.
What is Chronic Traumatic Encephalopathy (CTE), and who gets it?
CTE is a neurodegenerative disease of the brain thought to be associated with repetitive brain trauma. Currently, CTE can be diagnosed only at autopsy. The prevalence and incidence of CTE in sports concussions is unclear. It likely varies per sport, position, duration of exposure, and age of initial exposure. Not every athlete that suffers a concussion develops CTE, and research to date has included a biased sample. Continued research is required to learn more about this disease and potential therapies that may slow or reverse its course.
Is there anything I can do to prevent a concussion by wearing a helmet or a mouth guard?
There is no consistent scientific evidence to suggest that protective equipment will prevent concussions. Helmets have been shown to reduce impact forces to the brain and may help reduce the occurrence of a skull fracture or bleed. THERE IS NO CONCUSSION-PROOF HELMET. Although mouth guards have an important role in preventing dental or oral facial injury, concussions can still occur while wearing a mouth guard. Some concussion experts have recommended neck strength training exercises, education and enforcement of proper tackling techniques, and reduction in the number of contact practices as means to help reduce the number of concussions in sports.