Concussion Care: Signs & Symptoms to Watch
November 1, 2022
When you experience a blow to the head, knowing whether you've suffered a concussion isn't always clear cut.
Head injuries have a range of physical, psychological and intellectual effects — and only a small number of people lose consciousness.
"It's critical for parents, coaches, players and trainers to recognize the potential signs and symptoms of a concussion," says Jeffrey Kutcher, M.D., a sports neurologist who treats athletes at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology. "The basic rule is that a concussion can affect any aspect of brain function."
Signs of Concussion
The Latin root of the word "concussion" means "to shake violently" — which makes sense. Concussions happen when there's a combination of movement and impact. So, any injury that involves a hit to the head — a fall, collision or hard hit by a heavy object — could cause one. So could a hit to the body that causes the head to move quickly.
"But every brain injury is different," Dr. Kutcher says. "Some symptoms show up right away while others develop gradually over days."
Here are common concussion symptoms to watch for — both immediately following a head injury and in the hours and days after:
Physical Concussion Symptoms
- Changes in sleep patterns
- Difficulty with balance
- Dizziness or lightheadedness
- Fatigue
- Headache
- Light sensitivity
- Nausea
- Numbness or tingling
- Sensitivity to sound
- Visual problems
- Vomiting
Emotional Concussion Symptoms
- Anxiety
- Depression
- Irritability
- Mood swings
Cognitive Concussion Symptoms
- Confusion
- Difficulty concentrating
- Feeling "slow" or "foggy"
- Memory problems
Diagnosing Concussion: Getting It Right
One reason concussions are frequently misdiagnosed is because they're assessed on the field or courtside during game play or practice. Coaches, trainers and parents often make lightning fast decisions about whether symptoms, such as headache, nausea and light sensitivity, are signs of concussion.
"Unfortunately, it’s more complicated than completing a concussion checklist. Everyone — and every concussion — is different. So, observers shouldn’t be diagnosing a head injury on the spot, but rather making a triage decision for safety. They should leave the diagnosis to the medical professionals," Dr. Kutcher says. In fact, those in-the-moment assessments are wrong about half of the time.
People should focus instead on getting immediate, emergency care for anyone who displays the following signs and symptoms right after a hit:
- Difficulty walking
- Weakness on one or both sides
- Not waking up
- Repeated vomiting
- Persistent confusion
- Seizures
- Unconsciousness
No matter how hard (or lightly) you think you've been hit, it's important to take head injury symptoms seriously. Even a seemingly minor blow could have a major impact. A complete evaluation by a medical professional will not only determine whether you have a concussion, it can also identify more serious, or even life-threatening, concerns.
"In every case, medical professionals are better equipped to assess the extent of the damage if you have a comprehensive baseline evaluation on file," Dr. Kutcher says. This thorough evaluation with a sports neurologist, including a complete family and neurological history, can act as a critical point of reference when trainers and medical professionals are trying to diagnose or manage a concussion.
Dr. Jeffrey Kutcher is a sports neurologist and the medical director of the Henry Ford Kutcher Clinic for Concussion and Sports Neurology.
Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan.
Visit henryford.com/sports or call (313) 972-4216 for an appointment within 24 business hours.
Macomb Lutheran North Standout on Mend After Knee Injury
October 3, 2023
Macomb Lutheran North freshman Emiliana Manzo has already achieved a long list of accomplishments, including a 3.8 grade-point average while juggling two sports she loves.
As a point guard, she led her basketball team to an undefeated season in its division. She is also a center attacking midfielder, sometimes playing forward, on the 2009 Nationals Girls Academy Blue soccer team, ranked No. 1 in Michigan and 14th in the country.
In June of 2022, Emiliana hit a detour on her sports journey when she was participating in a club soccer national championship in Oceanside, Calif. With a few seconds left in the game and her team up 2-1, she ran 20 yards full speed to get to the ball. Hyperextending her left knee, she felt two pops. It was the first time she experienced an injury.
“I was screaming and crying and got taken off the field on a golf cart,” explains Emiliana. The trainer felt she was OK. Fortunately, she had the next day off and her knee was feeling better. The following day she played again, and 20 minutes into the game she knew there was an issue.
“Someone hit me from behind and I heard the pop again. I knew there was a problem.”
Emiliana’s father Vince Manzo said she experienced swelling, and the athletic trainer thought she may have a meniscus injury; however, she was able to continue to walk around during the championship in California before heading home.
Finding the Right Provider
Back in Michigan, Emiliana saw a few surgeons during her evaluation to seek treatment. When she met with Vasilios Bill Moutzouros, MD, chief of Sports Medicine at Henry Ford Health, she felt she met the right match.
“He treated me like an athlete and made me feel really comfortable,” she says.
Vince adds that both he and Emiliana were also appreciative of something Dr. Moutzouros said during her evaluation: “He emphasized to Emiliana that she was an athlete before this injury, and she would be an athlete after the injury.”
A detailed evaluation by Dr. Moutzouros revealed Emiliana had a complete anterior cruciate ligament (ACL) tear and medial and lateral meniscal tears. The meniscus, a C-shaped piece of tough, rubbery cartilage, acts as a shock absorber between the shinbone and the thighbone. It is one of the most common knee injuries. The ACL, one of the strong bands of tissue that help connect the thigh bone (femur) to the shinbone (tibia), is also prone to injury during sports when there are sudden stops or changes in direction.
Emiliana required physical therapy to get the swelling down and increase mobility before surgical repair.
Dr. Moutzouros reconstructed her ACL with her own patellar tendon graft and repaired her medial meniscus.
“She handled the surgery well and has been working very hard in her rehabilitation,” he says. “Her high-level soccer experience likely helped in her recovery as her range of motion and strengthening advanced so quickly.”
Understandably, Emiliana was nervous and scared when she went into surgery but expressed appreciation for the little things from Henry Ford like hearing “great music” as she was entering surgery, which gave her a sense of calm.
“That’s when I knew I picked the right doctor,” she said.
The Road to Recovery
As part of her recovery, after surgery which took place in July of 2022, Emiliana has undergone six months of physical therapy to increase mobility and strength training to get her leg strong again.
She also participated in the Return to Sport Program at the Henry Ford Center for Athletic Medicine to optimize recovery.
“We loved it,” says Vince. “It gave us peace of mind.”
Dr. Moutzouros explains that ACL prevention and rehabilitation programs are critical, especially for women because they have a four times greater risk of ACL tear than men. He says performance training post-surgery, along with an injury prevention program for those playing cutting sports, can markedly reduce the likelihood of future ACL injury.
“At Henry Ford, we work with physical therapists across the Midwest as well as our own. They do a great job in following our Henry Ford specific post-ACL reconstruction protocol,” he says. “After therapy runs its course, we strongly encourage our athletes to undergo performance training to allow a smooth transition back to sport.”
Nick Parkinson, supervisor of Athletic Training and Sports Performance at Henry Ford Health, emphasizes that the return to sport program is designed to bridge the gap between rehabilitation and returning to full activity in your chosen sport.
“Many times, insurance limits rehabilitation to regaining activities of daily living and not necessarily rebuilding the skills needed to play a sport or return to activity,” Nick says. “This program provides an affordable option to fill this need and return athletes to competition at the highest level.”
As for Emiliana, who hopes to play soccer in college and pursue a career in the medical field, she says this experience has taught her to not be afraid of injuries and treatment. She has also used the experience to volunteer for a program through the Girls Academy which serves as an advisory board to come up with ideas to help with mental and physical issues girls her age may be facing.
“For other kids who experience injuries, I’ve learned that this does not define you,” she said. “You can push through it, recover from it and be way better than you even were before.”
To find a sports medicine doctor or athletic trainer at Henry Ford, visit henryford.com/athletes.