A concussion is an injury to the brain that temporarily alters normal brain function. Most often, treatment for a concussion is rest and time, but in the very rare instance that internal bleeding occurs, surgery is necessary.

The brain floats within the skull, surrounded by cerebrospinal fluid, which cushions it from the light bounces of everyday movement. However, the fluid may not be able to absorb the force of a sudden hard blow or a quick stop, either of which can result in a traumatic brain injury. Traumatic brain injuries can range from mild to severe; a concussion is the mildest form.

Although not usually life-threatening, a concussion causes at least a temporary loss of brain function and can have serious effects. Most people with mild injuries recover completely, but it’s important to seek medical attention and to allow enough time for the healing process. Rarely—in about 5 percent of instances—a concussion can result in a hemorrhage, leading to an intracranial hematoma and requiring immediate treatment.


Symptoms may not occur immediately after injury, instead perhaps taking several days or even weeks to become evident. Although losing consciousness is a common sign of a concussion, it is possible to have a concussion without being completely knocked out.

Possible symptoms include:

  • Difficulty thinking or concentrating
  • Changes in sleep patterns, such as sleeping more or less than usual
  • Changes in mood or behavior
  • Headache
  • Nausea
  • Vomiting
  • Fatigue
  • Vertigo
  • Increased sensitivity to light and noise
  • Visual disturbances, such as blurry vision or diplopia

Adults or children who have the following symptoms should be taken immediately to the emergency:

  • Persistent, worsening headache
  • Continued vomiting or nausea
  • Seizure
  • Loss of consciousness
  • Amnesia regarding the event that caused the head injury
  • Worsening state of confusion
  • Slurred speech

A child with a concussion who refuses to eat or cries excessively should be taken immediately to the emergency room.


A neurological examination is performed to identify changes in brain function and mental status. This exam consists of evaluating sense of smell, motor function, swallowing, hearing, sensation, eye movements, balance and coordination.

Also, the Glasgow coma scale, which is a 15-item scoring system, is used to measure an individual's level of consciousness. The score is then used to identify whether an injury was mild, moderate or severe.

Concussions have high scores, as they are the mildest traumatic brain injury.

Imaging tests, such as computed tomography (CT) scan or magnetic resonance imaging (MRI) sean, may be ordered to view the brain and identify intracranial hematoma or other brain injury. These imaging scans themselves cannot lead to a diagnosis of concussion but can identify bleeding.

Risk Factors

A concussion is caused by a sudden hard blow to the head or jerking of the body. Possible causes include a fall, a motor vehicle accident and being struck by an object. Vigorously shaking an infant or young child can cause a concussion or worse.

Factors that increase a person’s risk for getting a concussion include:

  • Playing contact sports, such as football, soccer or hockey
  • Being military personnel involved in combat
  • Having had a concussion previously


At Columbia, our neurosurgeons use the latest surgical advances and techniques to treat concussions, providing the best possible results.

For most patients. surgery is not needed. lnstead patients are instructed to rest—physically and mentally—until fully recovered. The key to recovering fully after a concussion is preventing additional injury to the head. An additional hit to the head, particularly before the brain has recovered, can cause further damage.

Some steps you can take to prevent concussion include the following:

  • Don’t drive when you are under the influence of alcohol or drugs.
  • Always wear a seatbelt while in a vehicle.
  • Wear a helmet while on a bicycle, motorcycle or horseback. Also wear a helmet during contact sports, using skates or a skateboard, or when batting while playing baseball or softball.
  • Take precautions to avoid falls around your home.

In the rare instance that an intracranial hematoma occurs, surgical intervention is needed. Surgery involves temporarily removing a section of skull bone, a procedure called a craniotomy, and evacuating the buildup of blood.