Many people think that a loss of consciousness is the defining feature for all concussions. But in fact, loss of consciousness is not necessary for a concussion to occur, and less than 5% of all concussions lead to a loss of consciousness, depending on the particular study. (Kluger, 2011) Here are some other tell-tale warning signs of a concussion:

Signs & symptoms of a concussion

The following symptom inventory for concussions was developed by neuropsychologist Keith Cicerone:

1. ___ Feeling dizzy

2. ___ Loss of balance

3. ___ Poor coordination or clumsiness

4. ___ Headache

5. ___ Nausea or vomiting

6. ___ Vision problems (such as seeing stars, blurred vision or trouble seeing)

7. ___ Sensitivity to light

8. ___ Hearing difficulty

9. ___ Sensitivity to noise

10. ___ Numbness or tingling in parts of the body

11. ___ Change in taste or smell

12. ___ Loss of appetite or increased appetite

13. ___ Poor concentration/easily distracted

14. ___ Forgetfulness; not being able to remember things

15. ___ Difficulty making decisions

16. ___ Slowed thinking, problems getting organized, inability to finish tasks

17. ___ Fatigue, loss of energy, easily tired

18. ___ Difficulty falling or staying asleep

19. ___ Feeling anxious or tense

20. ___ Feeling sad or depressed

21. ___ Irritability, easily annoyed

22. ___ Becomes easily overwhelmed by things

A lot of doctors will also ask patients to rate each symptom’s severity on scale of 1 to 5, but the severity of symptoms does not necessarily translate into the severity of a concussion. Severe concussions can come with subtle symptoms, and vice versa.

The most common concussion symptoms

Of the possible symptoms listed above, the first five are the most common signs of concussion. Confusion, irritability, and amnesia (an inability to remember events before or after the injury) are also red flags.

Neurological signs of concussion

There are also a few signs of neurological impairment that you can look out for:

1. __ Balance problems

2. __ Pupils that are bigger than normal or of unequal sizes

3. __ Loss of consciousness

Gender differences in concussion symptoms

Signs of a concussion can be slightly different for boys versus girls. The primary symptoms, by each gender:

Girls

• Drowsiness
• Dizziness
• Headache
• Nausea
• Sensitivity to noise
• Unsteadiness

 

Boys

• Feeling sluggish or in a fog
• Difficulty concentrating
• Memory problems

 

Delayed concussion symptoms

Symptoms of a concussion don’t always show up right away. One woman suffered a roller blading accident in which she lost control and crash-landed on the lawn. She got the wind knocked out of her and passed out, and went to the ER because her abdomen hurt and an arm was rapidly swelling.

She never hit her head, so she never thought to ask about a concussion… and neither did her doctors. The next morning she woke up to an excruciating headache, nausea, sensitivity to light, and confusion. The following day she went to see another doctor, who diagnosed her with a concussion. (Schrock-Simring, 2016)

Also keep in mind that you can’t rely on symptoms alone, especially when dealing with student athletes. Kids will often lie about symptoms because they want to continue playing, and boys, especially, may try to hide the effects because they don’t want to appear weak. “Culturally, we teach boys that they have to be tough,” says pediatrician Dawn Comstock. “They have to play through the pain.” (Gregory, 2007)

How to tell if a child has a concussion

The old “how many fingers am I holding up” ruse is bogus. The biggest indicator of a concussion is that a child feels “off” or is exhibiting the symptoms described above.

Parents and coaches can perform a physical exam and a series of cognitive tests to check for a concussion. These can include:

1. The same roadside tests done for drunken driving, such as walking toe to toe along a line or closing your eyes, tilting the head back, and touching your finger to your nose

2. Repeating sets of words in a particular order or reciting the alphabet backwards. You can also have them count backwards or in multiples (2…4…6…8… or 5…10…15…20…)

3. Hold a finger out in front of their face, move it closer and further away slowly, and ask them when they start seeing double. Most healthy people start seeing a double or blurry finger when it’s about an inch away from their nose. If they experience this effect from farther away it’s a sign they might have a concussion.

If a child can perform these tasks without any obvious impairment, there’s no need to get them to a doctor. But if the hit they took looked serious, you should have them sit out and continue to recheck them every 15 minutes or so.

Aside from that, the severity of amnesia is one indicator of the degree of injury. “If a child can’t remember the first part of the game or doesn’t remember getting home afterward, he (or she) should be evaluated for concussion,” says neurologist Jeffrey Kutcher, M.D. (Hochwald, 2013)