Dr. Dawn Waters is our guest in tonight's Ask the Doctor segment. She's a neurosurgeon with Sierra Neurosurgery Group. We are talking about concussions. To speak with her tonight, dial 858-2222 between 5- 6PM. For future questions, visit her office online at


A concussion is a traumatic brain injury that alters the way your brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination.


Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. These injuries can cause a loss of consciousness, but most concussions do not. Because of this, some people have concussions and don't realize it.


Concussions are common, particularly if you play a contact sport, such as football. But every concussion injures your brain to some extent. This injury needs time and rest to heal properly. Most concussive traumatic brain injuries are mild, and people usually recover fully.


The signs and symptoms of a concussion can be subtle and may not be immediately apparent. Symptoms can last for days, weeks or even longer.


Common symptoms after a concussive traumatic brain injury are headache, loss of memory (amnesia) and confusion. The amnesia, which may or may not follow a loss of consciousness, usually involves the loss of memory of the event that caused the concussion.


Signs and symptoms of a concussion may include:

Headache or a feeling of pressure in the head

Temporary loss of consciousness

Confusion or feeling as if in a fog

Amnesia surrounding the traumatic event

Dizziness or "seeing stars"

Ringing in the ears

Nausea

Vomiting

Slurred speech

Delayed response to questions

Appearing dazed

Fatigue


Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury, such as:

Concentration and memory complaints

Irritability and other personality changes

Sensitivity to light and noise

Sleep disturbances

Psychological adjustment problems and depression

Disorders of taste and smell


Symptoms in children


Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they may not be able to describe how they feel. Nonverbal clues of a concussion may include:

Appearing dazed

Listlessness and tiring easily

Irritability and crankiness

Loss of balance and unsteady walking

Crying excessively

Change in eating or sleeping patterns

Lack of interest in favorite toys


When to see a doctor


See a doctor within 1 to 2 days if:

You or your child experiences a head injury, even if emergency care isn't required


The American Academy of Pediatrics recommends that you call your child's doctor for advice if your child receives anything more than a light bump on the head.


If your child doesn't have signs of a serious head injury, and if your child remains alert, moves normally and responds to you, the injury is probably mild and usually doesn't need further testing. In this case, if your child wants to nap, it's OK to let him or her sleep. If worrisome signs develop later, seek emergency care.


Seek emergency care for an adult or child who experiences a head injury and symptoms such as:

Repeated vomiting

A loss of consciousness lasting longer than 30 seconds

A headache that gets worse over time

Changes in his or her behavior, such as irritability

Changes in physical coordination, such as stumbling or clumsiness

Confusion or disorientation, such as difficulty recognizing people or places

Slurred speech or other changes in speech


Other symptoms include:

Seizures

Vision or eye disturbances, such as pupils that are bigger than normal (dilated pupils) or pupils of unequal sizes

Lasting or recurrent dizziness

Obvious difficulty with mental function or physical coordination

Symptoms that worsen over time

Large head bumps or bruises on areas other than the forehead in children, especially in infants under 12 months of age


Athletes


No one should return to play or vigorous activity while signs or symptoms of a concussion are present.


Experts recommend that an athlete with a suspected concussion not return to play until he or she has been medically evaluated by a health care professional trained in evaluating and managing concussions. Children and adolescents should be evaluated by a health care professional trained in evaluating and managing pediatric concussions.


Experts also recommend that adult, child and adolescent athletes with a concussion not return to play on the same day as the injury.