A closed head injury due to a direct blow to the head or deceleration of the head from an impulsive force.
Most common causes are motor vehicle accidents, sports, assaults, and falls.
Diagnosing concussion is difficult based on acute injury characteristics and presenting signs and symptoms.
Headache, mental slowing and fogginess, and memory difficulties are typical symptoms. Symptoms may fluctuate, but typically subside after 1 week to 1 month. Loss of consciousness is not necessary for a positive diagnosis.
CT scan and MRI are typically normal in concussive injury.
For uncomplicated cases, physical and cognitive rest is usually sufficient.
Model of axonal injury after a concussive blow
From the collection of L. Henry
- hx of previous brain trauma or alcohol abuse
- hx of direct blow to the head or deceleration of the head from an impulsive force
- feeling foggy/slow
- memory difficulties
- normal physical neurologic exam
- abnormalities on neuropsychological testing
- hx of headaches or migraines in prolonged symptoms
- hx of learning disability in prolonged symptoms
1st Tests To Order
- CT head
Other Tests to Consider
- MRI head
- functional MRI (fMRI)
- PET, single-photon emission CT (SPECT) of head
- alternative imaging techniques
- anatomic brain imaging techniques
- physical rest
- cognitive rest
- education + return to activity plan