Overview: What Is A Concussion?
Concussions are the most common form of head injury caused by an impact or forceful motion of the head or other part of the body, resulting in rapid movement of the brain within the skull.
A concussion can happen to anyone at any time. Common causes include falls, motor vehicle crashes, and sports and recreational activities.
MYTH: If the person was not hit in the head or did not lose consciousness, they do not have a concussion.
FACT: A blow to the head is not the only way an individual can sustain a concussion—a concussion may be caused by a direct blow to the head, face, neck, or a blow elsewhere on the body with an ‘impulsive’ force transmitted to the head. Concussions occur from blows to different parts of the body of varying magnitude. A relatively minor impact may result in a concussion, while a high-magnitude hit may not. There is therefore no way to know for certain whether a particular blow will lead to a concussion.
NOTE: Most concussions DO NOT include a loss of consciousness. Loss of consciousness occurs in less than 10% of diagnosed concussions.
The types of activities that can cause a concussion include falls, collisions with people or objects, and motor vehicle crashes. Concussions can happen at home, school, or work; or during sports or recreational activities. If there is a history of concussion, even a minor hit to the head or body can trigger symptoms.
MYTH: The person is not showing any signs or symptoms of a concussion.
FACT: Signs and symptoms of a concussion can be delayed for several hours or even a few days following an incident.
NOTE: Following a potential concussion causing event, the individual should be observed for signs and symptoms for 48 hours before assuming that a concussion has not occurred.
The following is a list of signs and symptoms consistent with a concussion. If any of these signs or symptoms are present, medical attention should be sought.
Signs and Symptoms of a Concussion in an Infant or Toddler
Concussion signs and symptoms to watch for in an infant/toddler include:
- Crankiness and irritability (beyond their usual)
- Cannot be comforted or excessive crying
- Sudden changes in nursing, eating, sleeping or playing patterns
- Loss of balance, unsteady walking (more so than normal)
- Lack of interest in favourite toys or activities
- Listlessness or tiring easily
- Loss of ability to carry on with newly acquired skills (across any social and emotional, language, physical development domains).
Seek medical attention if the individual is showing behavior that is unusual for them or concerning.
Any head injury needs to be taken seriously. Most concussions, managed appropriately, resolve without complications. On some occasions, concussion injuries can be more serious and can result in long-term disabilities.
The real danger of most concussions occur when the injury is not recognized or is managed incorrectly. Returning to full activity too soon may result in more severe symptoms or long-term problems. As well, returning to high risk activities (contact sports, dangerous job duties) before full recovery and medical clearance can put the individual at risk of sustaining another concussion with more severe symptoms and a longer recovery period.
Second Impact Syndrome is a rare but typically fatal injury that may result if an individual sustains another concussion before their brain has healed.
MYTH: Concussions aren’t a big deal, and an individual with a concussion or a suspected concussion doesn’t need to go to the Emergency Room.
FACT: If the person shows any of the Red Flag Symptoms call 911 IMMEDIATELY.
- Neck pain or tenderness
- Double vision
- Weakness or tingling/burning in arms or legs
- Severe or increasing headache
- Seizure or convulsion
- Loss of consciousness
- Deteriorating conscious state
- Increasingly restless, agitated, or combative
Refer to the red flag symptoms on the sidebar. If there are no Red Flag symptoms:
- Notify an emergency contact person, parent or guardian
- Do not leave the person alone
- Continue to monitor for Red Flag and signs of a concussion
- Do not let the person return to the activity or sport
- Do not give the person any immediate medication
- Do not let the person leave alone
- Do not let the person drive or ride a bike
MYTH: A person with a potential concussion can return to sport, play, or normal activity the same day.
FACT: If a person has a suspected concussion, they should NOT return to sport or activity and should be seen by a medical professional and/or monitored for delayed symptoms for 48 hours.
A person with a suspected concussion should not be left alone initially. The person should NOT BE woken up, but should be monitored throughout the night for anything out of the ordinary. Only wake the person if you have concerns about the person’s breathing, changes in skin colour, or how they are sleeping. Call 911 if the person is slow to wake or shows any of the Red Flag symptoms. If sleeping normally, let them sleep to allow the brain to rest. Sleep is an important part of the recovery process.
If no signs or symptoms appear within the first 48 hours, the person can return to normal activities but should be monitored for several days. If no signs or symptoms appear, chances are that no concussion was sustained. If unsure, please see your medical professional for clearance.
Depending on the circumstance, the emergency contact person, parent, or guardian should take the person to a medical professional and/or monitored for delayed symptoms for 48 hours.
If you are going to see your medical professional, the following forms may be useful:
Questions to Ask Your Doctor
Concussion Incident Report
The Concussion Incident Report was developed to help you document a potential concussion-causing incident. It outlines how to respond to a potential concussion at the time of the incident, and provides important information on caring for the person at home.
NOTE: It is important to know that any advice or directions given to the person at the time of incident may not be remembered. The Concussion Incident Report is an important communication tool for sharing information from the scene of the incident.
MYTH: Complete recovery from a concussion only takes 2 to 3 days.
FACT: Children and youth tend to experience a longer recovery period than adults. It typically takes 2 to 4 weeks to recover from concussion. However, 15 to 30 percent will continue to experience persistent symptoms beyond this period. Persistent symptoms have the potential to cause long-term difficulties.
If there is no improvement or symptoms are worsening 4-12 weeks after a concussion, physician referral to an interdisciplinary clinic is recommended.
MYTH: A person needs to stay in bed and rest for at least a week to recover from a concussion.
FACT: The recovery process for concussion begins with resting the brain for up to 2 days, followed by a gradual and well-managed return to activity. This is best done in collaboration with key individuals in the person’s life such as health care providers, family members (parent/partner/caregiver), friends, employers, teachers and school staff, coaches, etc.
Recovery from concussion spans the home and work/school/sport settings. It starts immediately following the concussion causing incident and ends when the individual has gradually returned to normal activities including work, school, and physical activity.
A concussion can have a significant impact on an individual’s physical, cognitive, and emotional functioning. The recovery process involves balancing activity levels so that they do not do too much or too little. It is a fluctuating process where the person can be doing well one day but not the next. Having had a previous concussion increases the chance an individual will have a delayed recovery.
The recovery period may be negatively influenced by many factors including:
- Previous concussions
- History of headaches or migraines
- Learning disabilities
- Mental health issues
- Use of drugs or alcohol
- Returning to activities too soon
- Lack of family or social supports
- Participating in a high-risk sport / activity
Symptoms should decrease over the course of time. Follow-up with a medical professional if you are worried that the person is not improving or that symptoms are prolonged.
The Recovery Process
The first and most important step in an individual’s recovery from a concussion is REST for a maximum of 2 days. The person will need both physical and cognitive rest after sustaining a concussion to allow the brain to heal. The goal is to not trigger or worsen symptoms.
After 48 hours:
Physical exertion should be limited to those daily life activities that do not result in an increased heart rate or breaking a sweat. Restrict: physically strenuous work, exercise, sports, running, biking, rough play etc.
Cognitive activity should be limited, minimizing activities that require concentration and learning. Restrict: work or school work, reading, electronics (computers, smartphones, video games, TV), musical instruments, loud music, etc.
Once symptoms start to improve, the individual should begin to increase activities in a step-wise process to return to regular levels of activity, including work, school, and sports . Symptoms should decrease over time, but some symptoms may return, worsen, or new symptoms may appear as new activity levels are introduced. If this happens, return to a lower level of activity that does not affect or bring on new symptoms. If you are worried that the individual is not improving, follow-up with a licensed medical professional, such as a physician or nurse practitioner.
It is important that the person has successfully returned to work or school before fully returning to sports or physical activities. Returning to full activity too soon may result in more severe symptoms or long-term problems.
For more information, please review the following resources:
Social interactions are important in preventing social isolation, depression, and anxiety. Some suggestions of low-level social interactions include short conversations on the phone with friends and family, meeting someone for coffee or a short visit.
A concussion can cause emotional or behavioural changes. It is normal to be anxious, irritable, angry, or depressed after sustaining a concussion. The person may worry about school, work, or social isolation and being away from their peers. Offer encouragement and support as the person works through the graduated stages of return to activity.
Depression can be a long-term consequence of concussion. The person may feel depressed due to a loss of place at work, school, on a team, or in a social group. Depression in some children and youth can be the result of physical changes in their brain associated with the injury itself.
Seek medical attention or counselling for support in dealing with emotional or behavioural difficulties.
FACT: Although not all concussions can be prevented, there are steps you can take to decrease the risk of sustaining one or reducing the severity of a potential concussion.
Educate: Learn more about concussions
Educating yourself is the first step in preventing concussions and reducing associated risks in yourself and others. You can further educate yourself by taking the CATT training and visiting the Resources section, where you will find concussion information, including videos, reports, handouts, and articles.
Promote: Responsibility & Fair play
Behaviour and attitude have a major impact on concussion causing incidents. Be responsible for your own actions and inaction to protect yourself and others from concussion. You can encourage fair play in sport by modelling respect and sportsmanship in the presence of others.
Equipment: Ensure you use the appropriate equipment for the activity
Using proper equipment for the activity is paramount. Remember for work sites – hardhats and for sport and recreational activities – helmets DO NOT prevent concussions. Hardhats, helmets and mouth-guards are vital pieces of equipment that protect from serious skull and dental injuries, but they do not prevent the brain from moving around when there is an impact to the head.
Ensuring that you have the required equipment for work, sport or activity, that it is in good condition and fits correctly, could decrease the severity of a head injury, such as a skull fracture.
Note: Current research is focusing on helmet modifications to reduce rotational forces on the brain; however, these products are still undergoing testing and not readily available at this time
Encourage: Support concussion reporting
People will often hide symptoms of concussion because they don’t want to fall behind or disappoint their employers, colleagues, teachers, parents, coaches, and/or teammates. Supporting a positive environment for reporting concussion symptoms sooner can make the biggest difference in preventing more serious concussion outcomes and associated risks.
Awareness: Educating yourself and others
Learning about concussions helps to understand how serious a concussion can be. It also provides the tools to recognize and report a concussion if suspected. An informed person is more likely to follow the guidelines during the recovery process.
Safe work environments: Strategies to decrease the likelihood of concussions
Creating a culture of reporting incidents, supporting injured workers, conducting workplace risk assessments, and providing concussion prevention training are key to ensuring a safe work environment. Avoiding slips, trips, and falls is easier if walkways and work spaces are free of clutter, cords, puddles and other hazards and using appropriate signage and stepstools/ ladders if needed. Exercise caution when working from heights and wear proper safety footwear. Strategies to prevent hits to the head include; ensuring shelves and work areas are clean and organized to avoid falling objects, the appropriate use of signage on low hanging obstacles and stacking heaviest objects on or close to ground. Strategies to prevent motor vehicle crashes include reducing driver hours and implementing a distracted driving policy.
Violence prevention: Strategies to decrease the likelihood of concussions
Having policies for those working directly with people who have a history of violence, substance abuse or gang involvement and providing training for recognizing and managing hostile and assault behaviors is important. Personal safety can also be enhanced by addressing physical environments like those with inadequate lighting and barriers that block sight lines and escape routes. Adjusting staffing levels, providing means of emergency communication and exercising vigilance.
Red Flag Symptoms
If someone shows any of the following Red Flag Symptoms, call 911 immediately.
Neck pain or Tenderness
Weakness or tingling/burning in arms/legs
Severe or increasing headache
Seizure or convulsion
Loss of consciousness
Deteriorating conscious state
Increasingly restless, agitated, or combative
For a brief summary of the information on this page, print our What You Need to Know About Concussion fact sheet (PDF).