A concussion is a form of traumatic brain injury (TBI) caused by a sudden bump, blow, or jolt to the head—or even a hit to the body—that forces the brain to move rapidly back and forth inside the skull. This abrupt movement can cause the brain to bounce, twist, or stretch, leading to chemical changes and potential damage to brain cells.
Written by
Angel Rigueras
Pain Management Specialist
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Written by
Angel Rigueras
Pain Management Specialist
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Concussions are complex injuries with far-reaching effects. They can trigger a wide range of symptoms, including physical challenges (headaches, dizziness), cognitive impairments (memory loss, difficulty concentrating), sleep disturbances, and mood changes (anxiety, depression). Populations at higher risk include children, the elderly, and athletes in high-impact sports such as soccer, boxing, and football. However, it’s important to remember that anyone, regardless of age or lifestyle, can sustain a concussion, whether from a car accident, a fall, or another unexpected event.
In this article, we’ll explore the causes, symptoms, and risks of concussions, along with effective treatment and recovery strategies. Understanding concussions is crucial for minimizing long-term complications and promoting a safe recovery. Let’s explore how to protect your brain health and what to do if you or someone you know experiences this common but serious injury.
Recent clinical studies have revealed a troubling connection between traumatic brain injuries and long-term health issues. Beyond the immediate neurological effects, concussions are linked to chronic chronic medical conditions and behavioral health issues. For patients under 40 years old, the risk of developing post-concussion comorbidities, such as depression or anxiety, is particularly high. Repeated mild TBIs, such as those experienced by military veterans and professional athletes, have been associated with chronic, multi-system health problems and even increased mortality rates.
Behavioral health, a term defined by the American Medical Association (AMA), encompasses mental health and substance use disorders, as well as life stressors and stress-related physical symptoms. Behavioral health care emphasizes prevention, diagnosis, and treatment within a patient-centered approach that considers the whole person. Effective integration of behavioral health involves collaboration between primary care physicians, psychiatrists, mental health clinicians, and families to provide comprehensive and coordinated care.
For individuals recovering from a concussion, behavioral health care is essential. Many patients experience significant emotional challenges, including anxiety, depression, and even suicidal thoughts. These mood-related consequences of a TBI can be just as debilitating as the physical symptoms, making it critical to address the mind as well as the body during recovery.
At UOC, we emphasize the importance of behavioral health integration in treating patients who have sustained a concussion. By prioritizing whole-person care and addressing both the neurological and emotional aftermath of TBIs, we can improve outcomes and support individuals on their journey to recovery.
Traumatic Brain Injury (TBI), including concussions, is a highly heterogeneous injury, meaning it affects individuals in diverse ways. To better assess and treat patients, clinical researchers have proposed a model consisting of six distinct clinical subtypes or profiles:
While this framework helps guide assessment and treatment, there are significant challenges in applying it to real-world cases. Patients may present with a single, well-defined clinical profile, but it is common for individuals to exhibit overlapping symptoms from multiple profiles. This complexity underscores the need for personalized, multidisciplinary care to address the unique needs of each patient.
This patient profile is primarily characterized by significant cognitive challenges and pronounced fatigue, especially during or after engaging in mental activities. Common symptoms include difficulty concentrating, memory problems, mental fog, and feelings of being mentally slow. Patients often report low energy levels and struggle to maintain mental endurance.
For example, athletes recovering from a Sport-Related Concussion (SRC) frequently experience transient cognitive decline, making it difficult to process information or perform at their usual mental capacity. In addition to cognitive difficulties, patients in this profile may report nonspecific headaches, worsening fatigue as the day progresses, and disruptions in their sleep patterns.
These symptoms can lead to functional impairments, making it challenging for individuals to uphold academic or occupational responsibilities. Reduced cognitive efficiency often translates into difficulties sustaining productivity, meeting deadlines, or focusing in high-demand environments.
The vestibular system is a sophisticated sensory network that helps the brain process motion, balance, and spatial orientation information. It plays a crucial role in maintaining stability and interpreting movement in the surrounding environment. When disrupted, vestibular function can result in symptoms commonly associated with motion sickness, including dizziness, lightheadedness, imbalance, nausea, and a sense of mental fogginess.
Patients with vestibular dysfunction often report difficulties in specific situations, such as:
In addition to these physical symptoms, some patients may develop anxiety or feelings of detachment and dissociation. This is because the vestibular system is closely connected to brain regions that regulate mood and emotional well-being.
The ocular profile in concussion patients is marked by post-traumatic vision impairments and related symptoms that stem from disruptions in oculomotor function. These impairments can include deficits in convergence (the ability of the eyes to work together to focus on nearby objects) and accommodative function (the ability to maintain clear vision during near-vision tasks).
Patients with this profile often report symptoms such as:
These symptoms can significantly impact both academic and occupational performance, as many daily tasks rely heavily on sustained visual focus and processing. Students, for example, may struggle with reading assignments or screen-based learning, while professionals may face challenges maintaining productivity in visually demanding work environments.
Post-traumatic migraine is a moderate-to-severe pulsating headache that develops following head trauma. It is often accompanied by symptoms such as nausea, photosensitivity (sensitivity to light), and phonophobia (sensitivity to sound). Headache is the most commonly reported symptom after a traumatic brain injury (TBI), with many patients experiencing migraine-like symptoms within the first week of injury.
While some headaches resolve quickly, others may persist as intermittent, long-lasting discomfort. In addition to headaches, patients may experience other symptoms, including:
The presence of post-traumatic migraine can significantly impact a patient’s quality of life, particularly if symptoms persist or worsen over time. These headaches may interfere with daily activities, disrupt work or school performance, and contribute to emotional distress.
This clinical profile is associated with emotional and behavioral changes after injury. These may include symptoms of depression, anxiety, mood swings, irritability, and increased emotional sensitivity. While patients may describe these emotional shifts, they can also exhibit behavioral patterns indicative of underlying psychological distress, such as:
Other associated features may include difficulties with sleep regulation, exaggerated or inconsistent somatic complaints, and psychological alterations in the autonomic nervous system, such as heightened stress responses.
Evaluating emotional functioning after a concussion often involves a clinical interview and the use of symptom questionnaires to assess the level and nature of emotional distress. This is a critical step in understanding the interplay between mental health and physical symptoms.
However, this process is not always straightforward. Patients may struggle to recognize the influence of psychological processes on their physical symptoms, or they may resist attributing their physical discomfort to a psychological cause. This highlights the importance of compassionate, patient-centered communication to help individuals feel understood and supported.
Cervical clinical profile involves cervicogenic injury due to the neck’s role in stabilizing the head. An evaluation should be performed by a physician or physical therapist with expertise in cervical assessment.
Symptoms associated with this profile include:
Evaluation for cervical injuries should be conducted by a physician or physical therapist with expertise in cervical assessment. If a cervical modifier is identified during the diagnostic process, further evaluation by a physical medicine specialist is necessary. Treatment typically involves a rehabilitation physician and a physical therapist specializing in cervical rehabilitation.
As discussed earlier, common symptoms of traumatic brain injury (TBI), including depression, anxiety, and mood changes, are integral components of behavioral health care. Psychosocial and neurobiological factors play a critical role in explaining affective responses following a TBI or concussion.
For instance, clinical depression has been linked to structural and morphological changes in the brain’s mood-regulating centers, such as the hippocampus, amygdala, and prefrontal cortex—areas that can be directly affected by a concussion. Beyond these biological changes, emotional responses may arise from frustration over uncertain recovery timelines, isolation from sports or teammates (particularly in athletes), and a lack of social support.
Clinical studies have shown that athletes recovering from concussions or orthopedic injuries experience similar emotional symptoms, such as anxiety, with female athletes being more significantly affected than males. Furthermore, age also appears to influence the presence and duration of affective symptoms. In high school and collegiate athletes, depressive symptoms have been observed for up to 14 days post-injury. Interestingly, collegiate athletes report significantly more depressive symptoms at 14 days post-injury compared to their high school counterparts, underscoring the importance of age-specific care strategies.
These insights highlight the need for a comprehensive approach to concussion assessment. Effective evaluation should incorporate clinical interviews, symptom scales, neurocognitive testing, and screenings for balance, vestibular, and oculomotor function. When patients exhibit high scores on tools such as the Anxiety Inventory, Profile of Mood States, or Beck Depression Inventory, they should be referred to mental health practitioners for more in-depth evaluation and care.
Moreover, some patients with vestibular impairments may experience concurrent anxiety due to central vestibular dysfunction or the subjective perception of their impairments. For example, symptoms like vertigo, dizziness, or fogginess in visually or physically complex environments (e.g., school settings or while driving) can provoke significant anxiety. If this anxiety is not promptly identified and treated, it can escalate, disrupt the recovery process, and reduce the effectiveness of other treatments.
A multidisciplinary approach, emphasizing both behavioral health and physical recovery, is essential for addressing the complex needs of TBI patients. Our Behavioral Health Program integrates psychological care with physical rehabilitation, with specialists that can enhance outcomes and support our patients’ overall well-being.
Effective treatment for patients recovering from traumatic brain injury (TBI) should be personalized and guided by the results of a thorough, comprehensive assessment. Addressing specific clinical profiles ensures that interventions are tailored to meet the unique needs of each patient.
For patients experiencing subclinical mood changes, such as nervousness or sadness, discussing the underlying causes of their symptoms can be helpful. These feelings often arise from factors like being unable to play sports, participate in school or work, or concerns about the recovery timeline.
These targeted strategies help patients regain their cognitive abilities and manage fatigue effectively.
Addressing these issues early is critical for successful recovery and reintegration into normal routines.
Recovering from a TBI or concussion requires personalized care tailored to the unique challenges of each clinical profile.
If you or someone you know is experiencing symptoms, seeking prompt medical attention can make all the difference. At University Orthopedic Care, our dedicated team of board-certified healthcare professionals provides comprehensive assessments and support to guide you toward a full and healthy recovery.
Don’t wait. Prioritize your health today. Contact us at (866) 962-1744 to schedule an appointment and take the first step toward healing.
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