Do concussions have long-term side effects?

There has been a lot of coverage in the media about the connection between repeated concussions and long-term health consequences, particularly for athletes. It’s enough to make some parents want to pull their children from school sports teams.

How concerned should you be?

Do concussions have long-term consequences?

Jeffrey English, M.D., a neurologist at Piedmont, says for most people (that is, non-professional athletes), there is no scientific evidence that a simple concussion has long-term side effects. The caveat: The brain must be allowed to fully heal before a person risks a subsequent concussion.

“The best we can tell, for people who are not professional athletes, is that 80 to 85 percent will recover within two to three weeks and there are no known long-term health consequences,” he says. “People who have had a concussion, which is a mild traumatic brain injury, need to make sure their brain is completely healed before it is potentially reinjured, such as during a sporting event. For patients with a more complicated recovery – with persistent post-concussive symptoms – we have to be more cautious.”

Athletes who return to play without allowing their brain to heal first may be setting themselves up for serious long-term consequences.

“There is evidence that if you have another brain injury when you haven’t recovered from a concussion, the recovery can be very prolonged and possibly result in long-term deficits,” he says.
An injury of this nature can impact memory, balance, sleep and mood. It can also result in chronic headaches.

What is a concussion?

A concussion is a mild traumatic brain injury. In the skull, the brain is surrounded by cerebral spinal fluid, which absorbs shock during minor impact. A concussion can occur if the brain moves too rapidly inside the skull. It can be sustained during head trauma from contact sports, a fall, a car accident or a violent encounter.

If someone exhibits the following symptoms after sustaining a head injury, he or she should be examined by a physician immediately:

Temporary loss of consciousness
Confusion
Headache or pressure in the head
Dizziness
Fatigue
Vomiting
Delayed responsiveness
Nausea
Amnesia regarding the injury
Looking dazed
Slurred speech

When to see a doctor?

All head injuries should be taken seriously.

“If someone has acute neurological symptoms like loss of consciousness, vomiting or seizures after a head trauma, he or she needs to see a doctor in the emergency room,” says Dr. English.

When to return to normal activity

“We have strict protocol for releasing a patient to resume normal activities,” says Dr. English. “They must be back to school or work, and be asymptomatic at rest before they can resume physical activity. Prior to being released to full activity, they need to first follow at five-step progressive physical exertion plan [from their physician].”

“The most worrisome thing for young athletes is second impact syndrome,” he says. “Although rare, a patient can die from another concussion before the brain is able to recover.”

He encourages coaches and players to watch for signs of a concussion on the field.

If a player exhibits prolonged confusion, appears dazed, experiences loss of consciousness, runs the wrong play or has a slowed reaction time, he or she should be removed from the activity and examined by a medical professional specializing in concussions. He or she should not return to physical activity until released by a professional.

The most critical time after sustaining a concussion is the first few days. The injured patient should rest, as cognitive demands can worsen symptoms or delay recovery. He or she should avoid technology use, loud noises, bright lights, as well as social and physical activity for the first few days.

That said, Dr. English says parents shouldn’t be overly concerned about their children safely participating in contact sports.

He recommends learning concussion signs and symptoms, undergoing baseline neurocognitive and vestibular testing if you are an athlete or very active individual, and, if you sustain a minor concussion, seeing a physician who can refer you to a concussion specialist if needed.

“Sports are amazing growth opportunities for children and young adults. We want them to keep playing, but play safely.”