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Concussion

IntroductionWake Forest Physical Therapy Balance and Vestibular

A concussion is a type of traumatic brain injury that is caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull.  Although there may be cuts or bruises on the head or face, there may be no other visible signs of a brain injury.

Anatomy

Your brain is a soft organ that is surrounded by spinal fluid and protected by your hard skull.  Normally, the fluid around your brain acts like a cushion that keeps your brain from banging into your skull, but if your head or your body is hit hard, your brain can crash into your skull and be injured.

Causes

There are many ways to get a concussion, but some common ways include fighting, falling, playground injuries, car crashes, or bike accidents.  Concussions can also happen while participating in many different sports or activities such as football, boxing, hockey, soccer, skiing, or snowboarding.

Symptoms

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.  The most common symptoms after a concussive traumatic brain injury are headache, amnesia and confusion.  The amnesia almost always involves the loss of memory of the impact that caused the concussion.  Some other common symptoms may include dizziness, ringing in the ears, nausea or vomiting, slurred speech, and fatigue.

Diagnosis

If your physician thinks you may have suffered from a concussion, he or she may ask you questions that test your ability to pay attention or about your learning and memory.  Your doctor will check your strength, balance, coordination, reflexes, and sensation, and may also order imaging tests such as a CT scan or a MRI to make sure your brain is not bruised or bleeding.

Treatment

If you have dizziness or difficulty with your balance following a concussion, vestibular physical therapy may help.  The vestibular system, which includes the inner ear and its connections with the brain, is responsible for sensing head movement, keeping your eyes focused when you move your head, and helping you keep your balance. Your physical therapist can provide specific exercises and training to reduce or stop dizziness and improve balance and stability.  Also, neck injuries can cause headaches and contribute to some forms of dizziness so your therapist can also assess your spine for possible injuries.  As symptoms due to concussion improve, your physical therapist will help you resume physical activity gradually, to avoid overloading the brain and nervous system that have been compromised by concussion.

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