Concussion Care: Signs & Symptoms to Watch

October 27, 2020

Henry Ford Health System

When you experience a blow to the head, knowing whether you've suffered a concussion isn't always clear cut.

Head injuries have a range of physical, psychological and intellectual effects — and only a small number of people lose consciousness.

"It's critical for parents, coaches, players and trainers to recognize the potential signs and symptoms of a concussion," says Jeffrey Kutcher, M.D., a sports neurologist who treats athletes at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology. "The basic rule is that a concussion can affect any aspect of brain function."

Signs of Concussion

The Latin root of the word "concussion" means "to shake violently" — which makes sense. Concussions happen when there's a combination of movement and impact. So, any injury that involves a hit to the head — a fall, collision or hard hit by a heavy object — could cause one. So could a hit to the body that causes the head to move quickly.

"But every brain injury is different," Dr. Kutcher says. "Some symptoms show up right away while others develop gradually over days."

Here are common concussion symptoms to watch for — both immediately following a head injury and in the hours and days after:

Physical Concussion Symptoms

  • Changes in sleep patterns
  • Difficulty with balance
  • Dizziness or lightheadedness
  • Fatigue
  • Headache
  • Light sensitivity
  • Nausea
  • Numbness or tingling
  • Sensitivity to sound
  • Visual problems
  • Vomiting

Emotional Concussion Symptoms

  • Anxiety
  • Depression
  • Irritability
  • Mood swings

Cognitive Concussion Symptoms

  • Confusion
  • Difficulty concentrating
  • Feeling "slow" or "foggy"
  • Memory problems

Diagnosing Concussion: Getting It Right

One reason concussions are frequently misdiagnosed is because they're assessed on the field or courtside during game play or practice. Coaches, trainers and parents often make lightning fast decisions about whether symptoms, such as headache, nausea and light sensitivity, are signs of concussion.

"Unfortunately, it’s more complicated than completing a concussion checklist. Everyone — and every concussion — is different. So, observers shouldn’t be diagnosing a head injury on the spot, but rather making a triage decision for safety. They should leave the diagnosis to the medical professionals," Dr. Kutcher says. In fact, those in-the-moment assessments are wrong about half of the time.

People should focus instead on getting immediate, emergency care for anyone who displays the following signs and symptoms right after a hit:

  • Difficulty walking
  • Weakness on one or both sides
  • Not waking up
  • Repeated vomiting
  • Persistent confusion
  • Seizures
  • Unconsciousness

No matter how hard (or lightly) you think you've been hit, it's important to take head injury symptoms seriously. Even a seemingly minor blow could have a major impact. A complete evaluation by a medical professional will not only determine whether you have a concussion, it can also identify more serious, or even life-threatening, concerns.

"In every case, medical professionals are better equipped to assess the extent of the damage if you have a comprehensive baseline evaluation on file," Dr. Kutcher says. This thorough evaluation with a sports neurologist, including a complete family and neurological history, can act as a critical point of reference when trainers and medical professionals are trying to diagnose or manage a concussion.

Dr. Jeffrey Kutcher is a sports neurologist and the medical director of the Henry Ford Kutcher Clinic for Concussion and Sports Neurology.

Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan.

Visit henryford.com/sports or call (313) 972-4216 for an appointment within 24 business hours.

NFHS Voice: Find Answers at Youth Level

November 13, 2019

By Karissa Niehoff
NFHS Executive Director

Are there long-term solutions to increasing the number of participants in high school sports and improving parental behavior at high school contests? The answer to both questions might start at the youth sports level.

The NFHS hosted a first-ever meeting of about 25 leaders of National Governing Bodies and the U.S. Olympic & Paralympic Committee last week to discuss common concerns and opportunities to align and work together.

Within the youth areas of these organizations, the issues are familiar ones to high school leaders – decline in participation, parent behavior, coaches education and minimizing the injury risk. Clearly, however, reaching parents with appropriate educational messages on sportsmanship, injury risk and the values of participation is a top priority for leaders at all levels – youth, middle school and high school sports.

Recently, the NFHS formed a Middle School Committee in an effort to build interest in education-based sports at that level and to share the proper messages with parents before their kids reach high school. However, as we learned last week, middle school may even be too late!

Those educational messages will be enhanced if the process starts in out-of-school youth sports. If messages about the values of multi-sport participation, playing for the love of the game, and limiting contact in sports like football are consistently shared and demonstrated at the youth level, the education-based concept should be firmly in place by the time students reach high school. 

Coaches education is another common concern. While the NFHS has created an outstanding online education program for interscholastic coaches through the NFHS Learning Center (www.NFHSLearn.com), there is no standard requirement to coach at the youth level. There should be some type of required certification for anyone to walk onto a field or court to coach. And while knowledge about teaching the proper tackling form in football or the proper defensive positioning in basketball is important, those are not the most important prerequisites for coaching.

Similar to the NFHS’ online Fundamentals of Coaching course, youth coaches should be required to take courses that help them learn how to coach the kids more so than the sport. And since many of the coaches at this level are parents of players on the team, these individuals – and all youth parents – should be presented materials similar to what is presented at preseason meetings at the high school level. This would include, among other things, the non-negotiable requirement to positively support their child while letting the coaches coach, and the officials officiate.

Lofty goals, for sure, without a collective governing organization over youth sports. However, these concepts can be endorsed and promoted within the youth areas of sport-specific NGBs. These fundamentals of education-based athletics are essential for the 2-3 percent who play sports beyond high school as well as the majority who apply the values learned in high school sports in their chosen careers.

The skills will eventually fade – even for those individuals who play sports beyond high school – but the values learned from playing sports, beginning at the youth sports level, will last a lifetime.

Dr. Karissa L. Niehoff is in her second year as executive director of the National Federation of State High School Associations (NFHS) in Indianapolis, Indiana. She is the first female to head the national leadership organization for high school athletics and performing arts activities and the sixth full-time executive director of the NFHS, which celebrated its 100th year of service during the 2018-19 school year. She previously was executive director of the Connecticut Association of Schools-Connecticut Interscholastic Athletic Conference for seven years.