Understanding Concussions – A Beginner’s Guide
By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD
Concussion, defined as a traumatically induced transient disturbance of brain function, is a type of neurologic injury known as traumatic brain injury (TBI) [2]. The Center for Disease Control estimates that when accounting for outpatient visits for TBIs and patients not seeking care for injuries, the actual incidence of concussions may range from 1.4 to 3.8 million per year [3]. The severity of TBI may be different for each individual. In today’s blog post, we will dive deeper into concussions, including mechanisms of injury, management options, and future directions.
A concussion usually occurs as the result of either a direct or indirect injury to the head. Indirect traumatic forces in other places in the body can also lead to an acute acceleration/deceleration injury to the brain, which can precipitate a concussion. Some of the causes of concussion include motor vehicle accidents, being struck by an object, physical assault, and recreational athletics. Sports-related head injuries remain a common contributor to current research of concussions. Further, football has one of the highest percentage of athletics-related concussions in high school and college athletes [2]. In females, the sport that contributes the highest percentage of concussions is soccer [4].
When a traumatic force is applied to the brain, it disrupts the balance of cells and triggers a series of chemical and metabolic changes in the brain [5]. The force causes the cell membranes to stretch and shift, leading to small holes that let potassium leak out of cells. This triggers a widespread electrical disturbance in the neurons, which leads to a kind of brain-wide shutdown. This is similar to what happens during a migraine after there are sudden electrical changes in the brain. This abnormal activity is thought to lead to the symptoms of concussion, such as confusion, dizziness, and headache. The changes in electrical activity are part of the brain’s immediate response to injury during a concussion, contributing to the neurological symptoms experienced afterward. These are just some of the changes that occur following a concussion, as the pathophysiologic changes underlying the post-TBI period are multifactorial and correlate with subsequent symptoms and recovery.
When assessing a patient with a possible concussion, the focus is on gathering information on the occurrence of the injury, the present symptoms, timing of symptom onset, severity of symptoms, and persistence of symptoms. The concussion may impact the individual on the emotional, cognitive, or physical level. In addition, concussion can impact the sleep/wake cycle. The Sports Concussion Assessment Tool 6 (SCAT6) is a tool that examines possible concussion symptoms. It is important to note that concussion symptoms do not always develop immediately after an injury, and the individual does not have to lose consciousness. The development of symptoms within hours to days after an injury may indicate a concussion.
After diagnosing a concussion, it is important for the individual to be observed by a responsible individual and to be aware of any warning signs. Patients with concerning signs or symptoms may require further evaluation or continued hospital observation. Treatment of a concussion involves primarily supportive care. The patient should have initial physical cognitive activity limitation, and then gradually return to activity. There is no optimal time for the initial rest period, it may depend on the patient’s symptoms and severity of the case.
In conclusion, concussions are complex injuries that involve a cascade of events that disrupt brain function. Whether the injury is from sports, a motor vehicle accident, or other causes, taking steps to prevent and safely manage concussions is crucial for protecting long-term brain health. At the Westport Headache Institute, we are here to support you on your brain health journey.
References:
- Pexels
- Ferry B, DeCastro A (2025) Concussion. In: StatPearls. StatPearls Publishing, Treasure Island (FL)
- Laker SR (2011) Epidemiology of concussion and mild traumatic brain injury. PM R 3:S354-358. https://doi.org/10.1016/j.pmrj.2011.07.017
- Lincoln AE, Caswell SV, Almquist JL, et al (2011) Trends in concussion incidence in high school sports: a prospective 11-year study. Am J Sports Med 39:958–963. https://doi.org/10.1177/0363546510392326
- Romeu-Mejia R, Giza CC, Goldman JT (2019) Concussion Pathophysiology and Injury Biomechanics. Curr Rev Musculoskelet Med 12:105–116. https://doi.org/10.1007/s12178-019-09536-8