Complications of Concussion

Writing about complications is tricky.  On the one hand it is important to make the point that if people don’t take concussion seriously there are some potentially very serious things that can happen - and on the other hand, most cases of concussion will be completely resolved within a couple of weeks and never cause any long term problems.  So when you read this do let it make you aware of some of the things that can happen but don’t let it make you believe everyone who has concussion will die if they bump their head a second time!

As before, it is always good to start with a few principles:

  • managing concussion properly leaves the victim less likely to have complications.
  • following a proper Graduated Return to Play protocol gives the best protection you can have
  • if there are persisting symptoms of concussion after 2 weeks seek further medical advice
  • multiple concussions seem to be more likely to lead to complications than single events

There is increasing awareness of issues after concussion.  There is a class action underway in the USA on behalf of American Footballers who have apparently have been damaged by multiple concussions.  This is still making its way through the American legal system.

It is easy to get lost in discussing complications of concussion - so I am going to work through by the time after the original injury when the complications may be seen.

Second Impact Syndrome

This is very rare.  Seen in young people.  May occur when a second concussion is sustained before a previous one has resolved - so maybe someone who is concussed without it being identified, gets back on & then has a second fall later in the day.  This is very rare but catastrophic - resulting in rapid swelling of the brain & death in most cases.  Please now read the last sentence of the first paragraph again!

Post Concussion Syndrome

Unusual, but occurs.  Basically seems to consist of similar symptoms to those seen in the early stages of concussion but persisting for much longer.  There are a number of different treatments that may be used depending on which of the symptoms are more troublesome.

Post traumatic seizures

Very unusual.  May come on months or years after the original injury (so it might be hard to make a connection between the two).  Treatment is with standard medication for fits.

Chronic Traumatic Encephalopathy

There are a number of different long term brain disorders which have been linked with concussion.  As they often occur 20-40 years later again it can be difficult to establish a definite link between the two.  There are various different types which have been identified - some seem to be similar to a dementia like process, others more similar to Parkinson’s disease with movement being more affected.