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What Are the 3 Types of Concussions?

A boy with a head injury touching his face with his hand
Concussions are often categorized into three grades, based on severity, including whether there was a loss of consciousness and how long symptoms lasted..

A concussion is a traumatic brain injury caused by an impact to the head or body that causes the head and brain to move around quickly. 

Concussions are often categorized into three grades, based on severity: 

  • Grade I
    • Transient confusion
    • No loss of consciousness 
    • Symptoms resolve in less than 15 minutes
  • Grade II
    • Transient confusion
    • No loss of consciousness 
    • Symptoms last more than 15 minutes
  • Grade III
    • Any loss of consciousness

27 Concussion Symptoms & Emergency Signs

In addition to confusion, symptoms of a concussion that can occur minutes to hours after injury may include:

Hours to days after an injury, symptoms of a concussion may include:

  • Mood or behavior changes
  • Memory problems 
  • Sensitivity to noise or light
  • Trouble sleeping
  • Inattention
  • Problems walking or talking
  • Vision changes

If you get a concussion, someone should stay with you. You should be monitored for at least 24 hours after getting a concussion in case of new or worsening symptoms. 

A person with someone who got a concussion should call 9-1-1 right away if they notice dangerous signs and symptoms such as:

  • Loss of consciousness, even briefly
  • Drowsiness or inability to wake up
  • One pupil larger than the other
  • Slurred speech
  • Decreased coordination
  • Convulsions or seizures
  • Severe or worsening headache that does not go away
  • Weakness or numbness in part of the body
  • Vomiting more than three times
  • Difficulty walking or talking
  • Unusual behavior, increased confusion, restlessness, or agitation
  • Changes in vision 
  • Loss of bladder or bowel control

How Is a Concussion Diagnosed?

A concussion is diagnosed with a patient history, neurological assessment, and metal status testing. 

The patient history includes asking the patient to describe the incident in as much detail as possible to assess any memory loss.

Other tests and tools used to diagnose a concussion include:   

  • A neurologic examination 
  • Mental status testing 
  • Tools to evaluate a concussion include: 
  • Standardized Assessment of Concussion (SAC) 
  • Post-Concussion Symptom Scale and Graded Symptom Checklist
  • Sport Concussion Assessment Tool (SCAT5 
  • Westmead post-traumatic amnesia scale (WPTAS) 
  • Imaging tests 

What Is the Treatment for a Concussion?

A mild concussion may last only hours to 7 to 10 days and may not need treatment. Most mild concussions improve on their own over time. 

Home treatment for a mild concussion includes:

  • Rest your body and brain
  • Over-the-counter (OTC) pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)
  • Avoid alcohol when symptoms are present

More severe concussions may last weeks to months. Persistent symptoms are called “post-concussion syndrome (also called persistent post-concussion symptoms), which refers to symptoms of a concussion (traumatic brain injury) that last longer than the normal expected time frame for recovery.

Treatment for post-concussion syndrome may involve a combination of modalities to relieve symptoms of post-concussion syndrome. 

The 5th International Consensus on Concussion endorses the following treatments: 

  • Aerobic exercise program (also called graduated exercise therapy, or graded exercise therapy) for symptoms that are associated with autonomic nervous system dysfunction (such as problems with blood pressure and breathing)
  • Physical therapy program for neck (cervical spine) or vestibular dysfunction
  • Cognitive behavioral therapy (CBT) to learn to cope with chronic mood or behavioral issues

Additional treatments for post-concussion syndrome may include:

  • Vision therapy
  • Vestibular therapy 
  • Medications used to treat symptoms such as:
  • Light therapy (photobiomodulation) 
  • CBD/medical marijuana
  • Craniosacral therapy
  • Massage therapy
  • Hormone therapy 

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References
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https://www.uptodate.com/contents/concussion-in-adults-the-basics?search=concussion&source=search_result&selectedTitle=1~81&usage_type=default&display_rank=1

https://www.cdc.gov/headsup/basics/concussion_whatis.html

https://www.uptodate.com/contents/head-injury-in-children-and-adolescents-the-basics?search=concussion&source=search_result&selectedTitle=5~81&usage_type=default&display_rank=5

https://www.uwsp.edu/stuhealth/Documents/Other/Head%20Injury%20-%20Concussion.pdf

https://www.cdc.gov/concussion/headsup/clinicians/resource_center/complications_of_concussion.html

https://www.concussionalliance.org/treatments

https://www.barrowneuro.org/for-physicians-researchers/education/grand-rounds-publications-media/barrow-quarterly/volume-16-no-1-2000/grading-scale-for-cerebral-concussions/