Advice for people who have been concussed

This leaflet gives advice on dealing with problems that may result from a mild head injury.

For most people, a concussion is a minor event that has no lasting side effects. However, in some cases the effects can last several weeks or longer.

The first two weeks

It will probably take a couple of weeks before you feel you are completely ‘back to normal.’ Here are some symptoms that you may experience during this time, together with some advice on how to deal with them:

Tiredness

Your brain will seem to have less energy. After even a little effort, you may feel exhausted. When you feel tired, your brain is telling you that you need to rest — listen to it. If you struggle on, you will only make yourself even more tired and less able to cope.

Poor concentration

You will be less able to concentrate. If there’s something you must do, start when you have had a sleep and are feeling refreshed. Stop as soon as your attention begins to fade. If you have not finished, rest and continue later.

Forgetting things

You may become forgetful. A concussion can affect your memory. Do not be alarmed, as it will get better. Make a note of important things you want to remember.

Irritability

You may get annoyed or lose your temper more easily. Don’t be alarmed. This is a result of your head injury. Try to notice when it starts to happen, and turn away, go out of the room and take time out. Find ways to relax, and use up your aggression by taking exercise or hitting a punch-bag.

Sensitivity to noise

Putting up with noise needs brain energy, and people find it difficult after they have been concussed. Children playing, a loud radio, or machinery at work may be unbearable. The only remedy is to avoid the noise – ask the family to turn the volume down, get the grandparents to take the children for a day or two, or buy some ear protectors.

Dizziness

You may experience a feeling of unreality or floating, similar to dizziness. This is because a concussion sometimes upsets the balance organs in the ears. You may also notice that a sudden movement of your head can give you vertigo, so that the world seems to spin round and make you feel dizzy. Do not be alarmed – both these symptoms settle down in time.

Clumsiness

You may find that you bump into people in the street, or drop the dishes when you’re drying them. This is because your brain is reacting more slowly than usual.

Avoid situations that might be dangerous, and take special care when crossing the street. You should not drive until you are fully recovered.

Eye problems

You may find that bright light bothers you and that it helps to wear sunglasses, even indoors. Sight is sometimes a little blurred, either because the eyes are not focusing well, or because they are not lining up correctly. Again these symptoms should not last, but get expert advice if things don’t improve.

Headaches

You will probably suffer from headaches. In the early stages, this is because of the bruising from the injury. Later the headaches are often due to tiredness or stress, if you are asking your brain to do more than it is comfortable with. Headache pills may not be effective. Take plenty of rest. If the headaches are severe and do not go away, you should see your doctor.

What to do if the symptoms do not go away

For about one person in ten, the symptoms of a head injury last longer than two weeks. If your symptoms have lasted for more than two or three weeks, or are particularly severe, you should seek professional help.

Get the help you need

Your GP should be able to organize a team of professionals to help manage your treatment. This may include a doctor, psychologist, occupational therapist, and social worker. You may also be referred to a neurologist or a neuropsychologist to check for any complications. Tests will be done to assess your concentration, memory, and brain function. These tests will help guide your treatment, and act as a baseline to measure progress.

Manage your symptoms

You may feel anxious and depressed that the symptoms have not gone. A member of the team can advise you, and help with relaxation exercises to manage stress.

It can also be useful to meet with other people with the same problems, and in many places there will be support groups that you could join.

You may be able to go regularly to the hospital or clinic to get help following your program of treatment. It can be useful to discuss problems with the occupational therapist or another counsellor, and sometimes home visits can be arranged. If there are compensation or legal consequences of your injury, make sure you get help dealing with them as soon as possible.

Pace your recovery

With the advice of your team, plan a daily routine of things to do, both brain work and physical. Give yourself enough to do to make you feel that you have achieved something, without making you too tired. Pace yourself and rest when you are tired. You must never get so tired that you do not feel fresh again after a night’s rest.

As you get better, gradually step up the amount you do, making sure that you can cope with what you are doing before you make a change.

As you can find you can do more and more, consider starting work again. Return to work in easy stages, working just half a day, and then increasing the time at work slowly.

Help people to understand

Most people do not understand the effects of concussion. Your family, friends, workmates, or an employer may think you are being lazy or difficult deliberately. It is important that they know the symptoms are real and directly due to the accident. Showing them this information may help.

Children — pre-school and primary school

This is the time when the brain has most learning to do, and a head injury can have a definite effect on a child’s progress. Family and teachers may not realize this. If there is any suggestion that after a head injury, even a mild one, your child is not progressing as well as they should, you should get expert help.

School and university

A head injury can also have a serious impact on students at school and university, for example at a critical time, such as the run-up to an exam. If there is a suggestion that they are having unexpected difficulty, then ask for expert advice, usually through your GP.

Older people

Older people often need more help overcoming the symptoms of a head injury.

People who work on their own

Homemakers and people with their own businesses often feel that they cannot stop working and may ignore the effects of a head injury. This can cause problems to mount up, leaving them more stressed until a crisis occurs. Family and friends need to persuade them to accept help, reduce their work load, and get expert advice.

Sports injuries — when to play again

Concussion is quite common in some sports, and there may be pressure to play down its effects. It is dangerous to risk a second concussion within a fortnight of the first one. Some sports bodies have strict rules about this and it is irresponsible not to follow them.

More than one head injury

Each head injury, even mild concussion, results in a slight long term reduction of the capacity of the brain. The reserve of brain power that we all have will compensate for the loss after one or two injuries, but if there are more the loss will start to show – in slow thinking, poor memory, and change of character. Those who have had more than one injury should think carefully before exposing themselves to repeated risks, such as those of football and boxing.