In this day and age, when so much literature, research, and media is out there on the issues surrounding a concussion, it becomes important to truly define the injury in a manner that everyone can understand from the physician to the athlete.
Having said that, Task Force Concussion believes that there is still a good deal of misinformation and myth out there on concussions. So, let’s start with what concussions are not. Then once we have dismissed all the inaccurate information around concussion we can establish the proper framework for the true definition of concussion.
- Concussions are not just a simple “Ding” or “Bell Ringer“, they are in-fact a mild Traumatic Brain Injury or mTBI (McCroy et al, 2017; Broglio et al, 2014) and there are very dangerous potential side-effects associated to this injury including death or severe changes in quality of life.
- Loss of Consciousness (LOC) is not required for a concussion, LOC only occurs in about 10% of concussions and is considered a “Red Flag” for immediate Emergency Referral (Broglio et al, 2014).
- Concussions only occur from hits to the head. In reality, a concussion can be sustained from a hit to the head or body as long as it causes translation of force to the head. Concussions can also be caused by car accidents and explosions (McCroy et al, 2017; Broglio et al, 2014).
- Helmets and/or mouthguards can prevent concussions in sport. This is just not true, the research has shown that neither helmets nor mouthguards have been show to prevent the brain from being shaken inside the skull (McCroy et al, 2017; Broglio et al, 2014).
- Concussions can be seen on imaging such as MRI, Radiograph (X-ray), CT Scan. Concussions are a metabolic injury to the brain due to microscopic damage to axons and because of this they are not visible on any diagnostic imaging (McCroy et al, 2017).
Now, that we have addressed some of the major myths surrounding concussion let’s look at the true definition of concussion.
As 2016 came to an end the 5th International Conference on Sports Concussion was held in Berlin, Germany. This conference has been held every 4 years since 2000 and the findings and published consensus statement of this International Conference tend to guide the direction of research as well as the various governing bodies’ respective position statements on concussion and treatment. The 5th International Consensus Statement re-evaluated the definition of concussion from its predecessor conference, and the 5th defined concussion as follows:
“Sport related concussion is a traumatic brain injury induced by biomechanical forces. Several common features that may be utilised in clinically defining the nature of a concussive head injury include:
►► SRC may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.
►► SRC typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, signs and symptoms evolve over a number of minutes to hours.
►► SRC may result in neuropathological changes, but the acute clinical signs and symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.
►► SRC results in a range of clinical signs and symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive features typically follows a sequential course. However, in some cases symptoms may be prolonged. (McCroy et al, 2017)“
Being aware of what a concussion truly is and being familiar with the above symptoms will help you to identify concussions and know when it’s time to seek out treatment.
In the case of any of the following “Red Flags” immediately seek out an emergency room as there may be a worse injury present than a concussion. While some of these may not seem as obvious as others, it is always important to play it safe when it comes to the brain, after all you only get one life and one brain! Now, we at Task Force Concussion hope that this definition and dispelling of myths has been helpful in developing your awareness as to what truly defines a concussion or mTBI.
Broglio, S.P., Cantu, R.C., Gioia, G.A., Guskiewicz, K.M., Kutcher, J., Palm, M., and Valovich McLeod, T.C. (2014). National athletic trainers’ association position statement: Management of sport concussion. Journal of Athletic Training, 49(2), 245-265.
McCroy, P., Meeuwisse, W., Dvorak, J., Aubry, M., Bailes, J., Broglio, S., …, and Vos, P.E. (2017). Consensus statement on concussion in sport– the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 0, 1-10.