The clinical presentation of a concussion varies greatly, from significant changes in balance to less obvious changes such as sleep disturbances. Clinical, neurological, behavioural, physical, and/or cognitive symptoms may present. It is important to note that symptoms can appear instantly at the time of the incident, or some minutes or hours after the event.
The 2017 consensus statement lists the following signs and symptoms of a concussion:
- Symptoms—somatic (eg, headache), cognitive (eg, feeling like in a fog) and/or emotional symptoms (eg, lability)
- Physical signs (eg, loss of consciousness, LOC). Although published findings in concussion describe LOC associated with specific, early cognitive deficits, it has not been noted as a measure of injury severity and amnesia); A variety of immediate motor phenomena (eg, tonic posturing) or convulsive movements may accompany a concussion. Although dramatic, these clinical features are generally benign and require no specific management beyond the standard treatment of the underlying concussive injury.
- Balance impairment (eg, gait unsteadiness). A systematic review(2020) suggests a positive correlation between concussion injury and gait deviation in patients individuals who have suffered a concussion[3]
- Behavioural changes (eg, irritability)
- Cognitive impairment (eg, slowed reaction times)
- Sleep/wake disturbance (eg, somnolence, drowsiness).
However, this list is not exhaustive, and the following additional signs and symptoms have been cited elsewhere in the literature:
- Chronic headaches,
- Dizziness and vertigo
- Difficulty concentrating
- Word-finding problems
- Depression
- Impulsiveness
(DeKosky et al.. 2010) The existence of only one of these symptoms is enough for a concussion to be suspected.
It is important to note, however, that these symptoms and signs also happen to be non-specific to concussion, so their presence simply prompts the inclusion of concussion in a differential diagnosis for further evaluation, but the symptom is not itself diagnostic of concussion.
Working with our client to set achievable goals and improve there resilience our physiotherapists help and support our patients with concussion syndrome.