“Mild” Traumatic Brain Injury: Still Very Serious!

Article Categories: Diseases and Conditions & Mental Health

At some point, every nurse gets asked about concussions. Maybe you’re at your son’s baseball game when a child falls off the bleachers. Or a neighbor wonders if she should see a doctor because she’s having headaches after her recent fender-bender. Or a CNA on your shift is studying for an exam and needs help listing the symptoms.

We all remember, “Don’t let them go to sleep.” But what else should we keep in mind about mild Traumatic Brain Injury (TBI), or a concussion, as it’s also called?

• A concussion is considered mild if the person has a loss of consciousness or appears confused or stunned for less than thirty minutes. However, the effects can be lingering.
• A concussion is the most common type of TBI. 90% do not involve a loss of consciousness.
• It is not always apparent at the time of injury. Symptoms may develop days or even weeks after the event.
• MRI and CAT scans may be normal, but the person will show cognitive problems. Others may notice changes before the injured person does.
• Although a concussion can be “mild,” over 15% of people will still have symptoms a year later.
• Children and teens may not identify their symptoms. They often just say that they “don’t feel right.” Parents should be observant after a fall or blow to the head.

Unless you work in neurology, you may not remember all the symptoms of a TBI. Some can be subtle or not associated with a concussion.

Immediate Symptoms:

• Loss of consciousness, even if for a few seconds
• Amnesia about what happened just before and after the event
• Dazed and unsure about what happened
• Dizziness
• Nausea, with or without vomiting
• Blurred or double vision
• Ringing in the ears
• Difficulty with balance
• Headache

Neurological Symptoms:

• Sleep problems and/or insomnia
• Ongoing fatigue
• Sensitivity to light and/or noise

Cognitive Symptoms:

• Memory loss
• Inability to concentrate or pay attention
• Poor problem solving or decision making
• Slowed thinking and/or understanding

Psychosocial Symptoms:

• Impatience or irritability
• Feeling withdrawn or socially isolated
• Becoming socially inappropriate

The Centers for Disease Control and Prevention (CDC) has a “HEADS UP” campaign to promote awareness about concussions, as well as all types of brain injuries. The campaign includes signs of medical emergency. Anyone should call 9-1-1 as soon as any of these are apparent:

• One pupil becomes bigger than the other
• Extreme drowsiness and inability to wake the person
• Slurred or very slow speech
• Repeated episodes of nausea and vomiting
• Seizures or seizure-like twitching
• Increased confusion, agitation, or restlessness
• Headache that gets worse or does not go away

Of course, as a nurse, you can provide information, but not diagnose. But you are seen as a medical expert by others in the community, so brushing up on your knowledge about concussions can be important in encouraging people to seek treatment and to understand the importance of watching someone after even a “mild” head injury.