Every year about one million people are rushed to the emergency room with head injuries, according to the National Institute of Neurological Disorders and Stroke (NINDS). Head injuries are also referred to as traumatic brain injuries (TBIs). The most common TBIs are concussions, which are the most minor as well.

A concussion results from a blow to the head, and may be accompanied by a loss of consciousness, or not. While you can suffer one from playing a sport, the most likely causes are car accidents and falls. In the past, scientists weren't certain how much damage concussions caused. But new research from the Albert Einstein College of Medicine of Yeshiva University indicates that they result in structural damage to brain tissue and alter mental processes.

In the study, which was published in the journal Radiology, researchers revealed that a brain scanning technique called diffusion tensor imaging (DTI) could diagnose concussions and assess the effectiveness of treatments.

"DTI has been used to look at other brain disorders, but this is the first study to focus on concussions," said Michael Lipton, M.D., associate director of the Gruss Magnetic Resonance Research Center (MRRC) at Einstein and lead author of the study. "It proved to be a powerful tool for detecting the subtle brain damage that we found to be associated with concussions."

In many cases a concussion doesn't cause long-term damage, but up to 30 percent of people can develop a permanent impairment, usually evident in a personality change or cognitive problems such as being unable to plan an event.

Symptoms of a Concussion

According to the American Association of Family Physicians (AAFP) the main symptoms you may experience are:

  • headache
  • dizziness
  • vision problems
  • loss of balance
  • ringing in the ears
  • confusion
  • impaired concentration
  • nausea
  • memory loss

Other concussion symptoms include impaired balance, speech, reflexes, judgment, and muscle coordination. You should also watch out for stiff neck, convulsions, repeated vomiting, and unusual sleepiness.

Diagnosis of Concussions

According to the Einstein researchers, currently concussions are diagnosed primarily on a patient's accident history, and clinical tests for symptoms such as headache, dizziness and behavioral abnormalities. But these tests are limited and do not give doctors insight into who suffers the most serious side effects and who will have a speedy recovery. They suggest that DTI scanning can help to fill this need.

In their study, MRIs and CT scans failed to show the extent of damage revealed from neurological tests that assessed executive function, which is usually damaged when you suffer a concussion. However, DTI, which detects subtle alterations in the brain by measuring the diffusion of water in the white matter, was able to identify abnormal brain regions in 15 of the concussion patients. Furthermore, major areas of structural damage in patients correlated to low scores on tests of executive function.

"The problems in functioning caused by concussions often don't become evident until weeks or months after the injury, suggesting that the brain pathology may actually expand over time," notes Lipton. "By detecting brain injury early with DTI and then initiating cognitive rehabilitation therapies for those patients, we may be able to limit the effects of concussions."

Treatment for a Concussion

Even if you suffer a mild concussion, it should be taken seriously, advises the American Association of Neurological Surgeons (AANS). Rest is the main treatment for concussion. You may also need to take acetaminophen if you have a headache - but only do so on the advice of your doctor. Head pain caused by concussions is usually resistant to stronger narcotic-based medications, states the AANS.

If a concussion while playing a sport causes you to lose consciousness or your memory, you should lay low for one to two weeks - a second concussion shortly after an initial one can be deadly.

How to Reduce the Risk of a Concussion

In some cases, concussions can be avoided. Follow these recommendations from NINDS.

  • Wear protective head gear when playing sports
  • Don't dive into water less than nine feet deep or into above-ground pools
  • Quit playing a sport if you're ill or very fatigued
  • Stick to even, smooth surfaces when skateboarding
  • Wear your seatbelt
  • Don't drink and drive
  • Remove hazards in your home that may cause you to fall and install handrails or grab bars.


Albert Einstein College of Medicine press release, "Strong link found between concussions and brain tissue injury."

Radiology, Published online June, 2009. "Diffusion tensor imaging implicates prefrontal axonal injury in executive dysfunction following mild traumatic brain injury." Michael Lipton et al.