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There has been much in the news about the seriousness of concussions outlined by NFL players stories and some rather tragic incidents with high school athletes. I have delt with a concussion in one of my own children and have treated many patients with concussions. I thought it would be useful the put out some basic information about concussions, what they are and how they are treated.


What is a concussion?


The simplest way to think of a concussion is a brain that has been bruised. The brain, which is a solid organ, is suspended (floats) in a small amount of fluid (cerebral spinal fluid) and is protected by the skull (bone). When the head takes a hit, for example from a fall, tackle, motor vechile accident, the force of the blow causes the brain to hit the hard surface of the skull. This force causes the brain to then move in the opposite direction and hit the skull on the opposite side.  Think of the action of the typical bobble head doll. When the dolls head is flicked the head goes back and forth several times. Depending on the amount of force it may do this a few times or many. The action of the brain hitting the skull causes injury, bruising, a concussion.


What are the symptoms of a consussion?


First a few key points. Every head injury should be evaluated immediately. If you have a child athlete, the Commonwealth of Virginia, has trained all public school coaches and trainers in sideline evaluation of head injury and all athletes have completed a pre-season concussion test. In addition, Commonwealth of Virginia law requires any school athlete who has sustained a head injury to not return to game or practice until cleared by a health provider.


That being said, symptoms of a concussion vary from person to person and are affected by factors such as the force of the hit. Symptoms can be immediate or may be delayed up to several days.


Urgent symptoms that require immediate medical treatment:


loss of consciousness


appears dazed or stunned


moves clumsily

responds to questions slowly or incorrectly

can't recall events prior to or immediatey after the hit


Less urgent signs, but evauation by a health provider is still recommended




fuzzy vision

feeling mentally foggy


balance problems

light and noise sensitivity

changes in sleeep

changes in mood (irritable, sad, nervous)

concentration problems or forgetful




Every head injury should be evaluated by a health provider. Alarm type symptoms should be evaluated immediately by the local emergency departement. Milder symptoms should be evaluated as soon as possible and ideally within 24 hours.


I recommend:


Rest. Stop physical activity and exercise.

Avoid electronics. No TV, computer, lap top, IPAD, smart phone, electronic reader devices.

Avoid mentally demanding activity (school and work).

Do not drink alcohol or use ellicit drugs.

Get plenty of sleep.

Stay hydrated and eat a healthy diet with adequate protein and complex carbohydrates.

See your health care provider and follow their recommendations.


The providers of Capital Family practice evaluate and treat concussions. If you have had a head injury call us for an appointment to be evaluated. We also work very closely with our local specialists including neurology, neurosurgery, physical therapy, and behavior therapist when more specialized care is needed.


For additonal information on this topic go to the National Center for Injury Prevention and Control at


Kathleen M. Curtis MD