Concussions: What to know, from warning signs to recovery

Concussion research focuses primarily on male athletes, possibly hurting women

From sports headlines to high-profile injuries, we've all heard of concussions — but how much do we really know about them?

A concussion is "an injury to the brain that results in temporary loss of normal brain function," according to the American Association of Neurological Surgeons.

"Concussions can be caused by direct trauma to the head, such as from falling, getting hit or being in an accident," the association's website notes, adding they can also occur after a rapid "acceleration-deceleration of the head," such as in whiplash or blast injuries.

But there's still a lot we don't know about this type of injury, experts say.

A CBS News investigation that aired this week, for example, examined a gender gap in concussion research that may be leaving female athletes without the care they need.

To better understand the basics of concussions, we gathered expert info on what you should know:

What are the signs of a concussion?

Concussion is a clinical diagnosis, meaning there is "not one test that says this was definitely a concussion," says Dr. Daniel Torres, a neurologist at Lenox Hill Hospital in New York. 

Instead, physicians have to get a clear story of what actually happened to the person and then do a detailed assessment of their functioning, he explains. 

According to the American Academy of Neurology, signs and symptoms include:

  • Headaches 
  • Sensitivity to light and sound
  • Changes to reaction time, balance and coordination
  • Changes in memory, judgment, speech and sleep
  • Loss of consciousness  

How do you treat concussions?

"The good news is that the concussion isn't a progressive disease," Torres says. "It's not like getting an infection, where if you don't take antibiotics, you're going to get more sick without treating the infection." 

The recovery process may look different for each individual, but may include options such as:

  • Medications for problems like headache and pain
  • Vitamins that can be helpful in managing post-traumatic headaches
  • Physical therapy to rehabilitate neck injuries or balance problems
  • Therapy to help with emotional issues after an injury

More research is emerging on the importance of sleep, exercise and meditation after a brain injury as well, he notes.

"A big part of their treatment, also, is the evaluation with someone like me, where they're gaining a much clearer understanding of what has happened in their case," Torres adds. "When they can understand it better, that can help them start to manage the symptoms better as well, because they can sort of figure out what they're trying to cope with and recover from."

Are there other risk factors?

One risk factor is having a previous concussion, Dr. Nidhi Kumar told CBS New York

"Your brain is more vulnerable. In fact, 7-10 days after concussion is when the brain is most fragile," she adds.

Gender can also play a role. 

"Girls have less developed neck muscles," Kumar explains, meaning forces gets transmitted to the brain easier.  

Cognitive neuroscientist Dr. Chris D'Lauro co-authored a study last year in the British Journal of Sports Medicine that found "women are more likely to receive a concussion than male athletes playing the same sport."

"Your daughter is more likely to get a concussion playing soccer than your son is," D'Lauro told the CBS News investigation.  

And of course, sports can pose a risk factor. Hockey, football, basketball and soccer are among the sports we see concussions most, Kumar says. 

Repetitive concussions in childhood can also put you at risk for issues in adulthood.

"Cognitive difficulties like difficulties with memory, concentration, emotions, depression, anxiety, even impulse control," she explains.

What should you do if you or a loved one suffers a head injury?

Kumar advises following the saying, "when in doubt, sit them out" if you're a parent or a coach of a child who gets hit.

"A little person that gets a big hit needs to be taken very seriously. And for about 50% of players, they won't have symptoms for 24 hours," she says, adding many of these instances are "pre-concussive events," meaning it's not a concussion but a precursor to one. "And if you continue to play, you can develop a full-blown concussion."

If a hit occurs with warning signs like loss of consciousness, facial trauma, headache, dizziness, fogginess, "you're done playing for the day (and) need to seek medical attention," Kumar says.

Torres says clear red flags to head to the emergency room include: 

  • having a seizure at the time of the injury
  • inability to stop vomiting
  • signs of stroke including inability to move one side of their body or slurred speech
  • losing consciousness for more than a few seconds 
  • getting much worse after seemingly getting better

"The number one rule is, if you think you might need to go to the ER, you should just go to the ER, because it is very important to listen to our intuition," he adds. "If someone is concerned and feels like anything is getting worse - just go. No one should feel bad if they go to the ER and they're told everything's fine. That's a good thing."

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