Mild traumatic brain injury (concussion)

What is a mild traumatic brain injury?

Mild traumatic brain injury (MTBI) or concussion is not easily diagnosed. You (or the person you care for) may not have been seen in a hospital immediately after the injury because you did not think the injury was severe enough. Some symptoms are hard to detect. It is strongly recommended that you visit your local doctor as soon as possible to monitor and manage any ongoing symptoms.

Causes

The brain may be damaged when the head or body hits something or is violently shaken. These injuries commonly occur following a fall or assault. They can also happen during sporting, car or workplace accidents.

Symptoms

MTBI can lead to physical, thinking or emotional difficulties. Common symptoms include:

• headache
• neck pain
• confusion or disorientation
• reduced concentration or attention
• memory difficulties
• nausea
• tiredness
• irritability or difficulty controlling emotions and interacting with family
• dizziness and vertigo
• balance problems
• sensitivity to light or noise.

Some people find it hard to describe their symptoms. They may simply report not ‘feeling right’. It is important to take statements like this seriously and provide support to allow the person to rest as necessary. Your local doctor can guide your recovery. Be kind to yourself as it can take some time to recover.

Treatment

While in the emergency department, you (or the person you care for) will be closely monitored and may have:

• a series of tests to understand how serious the symptoms are and to provide a diagnosis
• medications for headache or pain
• medications for nausea or vomiting
• nurses checking you to see if your condition changes in ways that may indicate a more serious brain injury
• a CT scan of the brain or neck
• an X-ray, if it is thought your neck may be injured.

When serious injury is ruled out, you will be sent home with family or friends. You should be seen by your local doctor during the week after the injury. Or, if symptoms get a lot worse, you should return to the emergency department.

Home care

To help your recovery after a MTBI, you should:

• rest quietly and get good amounts of sleep
• limit mobile phone, computer and television use
• limit long periods of reading
• treat headaches with non-prescription pain medications such as paracetamol. Check the packet for the right dose and use only as directed. Do not use aspirin and other anti-inflammatory medications such as ibuprofen. Do not take sedatives or other medication unless instructed by a doctor
• use ice packs over swollen or painful areas. To do this, wrap ice cubes, a bag of frozen peas or a sports ice pack in a towel. Do not put ice or ice packs directly on the skin
• gradually increase physical activity and do light exercise according to how you feel
• be aware that symptoms may come and go over the course of a day or week.

You should not:

• play sports or do strenuous physical activities for 48 hours or until your symptoms have gone
• drink alcohol, take sleeping pills or use recreational drugs for 48 hours. These will make you feel worse. They also make it harder for other people to tell whether the injury is affecting you.

What to expect

It can take time for the brain to recover, even following a minor brain trauma. Most people will recover fully and have no symptoms after 48 hours. But it can also be common that, for a few days, you could have fluctuations in fatigue levels, headaches, and mild problems with concentration, remembering things and performing complex tasks. You could also experience mood changes or feel more tired than usual.

• During this early period, there is no specific treatment apart from lots of rest.
• If it does not make your symptoms worse, gradually reintroduce normal activities around the home and do some gentle exercise, such as going for a short walk. Speak to your local doctor or physiotherapist about when you can return to serious exercise, such as weight training, running, high-intensity training and competitive sport.
• Ongoing symptoms should be tracked and managed by your local doctor. As symptoms go away, the doctor will provide specific advice regarding how you can return to work or school or do other activities and play sport.
• You may need to take a short amount of time off work or study if you have trouble concentrating or remembering things. You may also need to return to work or study gradually. This may involve working flexible hours and having rest breaks during the day. Everyone is different. How you manage work or study will vary depending on your symptoms, role and responsibilities.

If 10 days after injury, you have specific concerns or experience symptoms, such as difficulties with concentration, memory and behaviour, talk to your local doctor. They can give you more information or referrals to other healthcare providers.

When to seek help urgently

It doesn't happen very often, but some people develop a serious brain injury after discharge from an emergency department. Go to the nearest hospital or call an ambulance (000) if you, or your carer, notice any of these symptoms:

• feeling like you will pass out, or have a blackout or seizure
• weakness or numbness involving any part of the body
• increasing confusion or difficulty staying awake when you would normally be awake
• difficulty waking up at the time you would normally wake up
• difficulties with vision or slurred speech
• you are not able to control your bladder or bowel
• repeated vomiting
• a constant headache or a headache that gets worse
• problems in remembering new events or recognising people or places
• any fluid or blood coming from the ear or nose
• loss of hearing.

For more information

Ask your local doctor or healthcare professional. You can also call healthdirect 24 hours a day on 1800 022 222 or visit www.healthdirect.gov.au