Concussion and Traumatic Brain Injury

At UT Southwestern Medical Center, we provide comprehensive patient care for concussions resulting from injuries received while playing sports, being in a household or motor vehicle accident, serving in the military, or hits to the head or body occurring in countless other scenarios.

UT Southwestern is a leader in brain research to pioneer new evaluations and treatments for brain trauma, and we have one of the nation’s premier treatment centers.

Comprehensive Evaluation and Management of Concussion

Concussion, a type of traumatic brain injury, can result from a bump, strike, or jolt to the head – or to the body – that causes the brain to bounce around or twist within the skull. This sudden movement causes stretching and tearing of connections between brain cells and creates chemical changes that alter normal brain function. 

A concussion should be taken seriously. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head that produces symptoms can require attention. 

For emergency situations, it’s important to call 911 or seek emergency care. 

UT Southwestern has the experience and expertise to treat traumatic brain injuries such as concussions. Our multidisciplinary team includes physicians, neuropsychologists, and nurses who are specialists in brain injuries, as well as physical and occupational therapists, and social workers.

Symptoms of Concussion

Signs and symptoms of concussion generally appear soon after the injury. Most people don’t lose consciousness. Symptoms a person might experience include:

• Balance problems or dizziness
• Concentration or memory problems
• Confusion
• Double or blurry vision
• Feelings of sluggishness, haziness, fogginess, or grogginess
• Headache or “pressure” in the head
• Nausea or vomiting
• Sense of “feeling not right” or “feeling down”
• Sensitivity to light
• Sensitivity to noise

People around a person with a concussion might notice that he or she:

• Appears dazed or stunned
• Answers questions slowly
• Can’t recall events prior to the hit or fall
• Forgets an instruction
• Is confused about an assignment or position
• Is unsure of the game, score, or opponent
• Loses consciousness (even briefly)
• Moves clumsily or stumbles
• Shows mood, behavior, or personality changes

When to Get Emergency Medical Attention

Call 911 or go to an emergency department right away if someone is experiencing any of the following:

• Convulsions or seizures
• One pupil larger than the other
• Drowsiness, cannot be awakened
• Headache that gets worse
• Inability to recognize people or places
• Increasing confusion, restlessness, or agitation
• Loses consciousness (even briefly)
• Repeated vomiting or nausea
• Slurred speech
• Unusual behavior
• Weakness, numbness, or decreased coordination

The full effect of the injury might not be noticeable at first. For example, in the first few minutes after the injury, someone might be just slightly confused or appear a little bit dazed. But an hour later, he or she might become confused or unable to recall what was going on before the injury. 

Repeatedly check for signs of concussion. Any worsening of concussion signs or symptoms can indicate a medical emergency. 

In rare cases, a dangerous blood clot may form on the person's brain, crowding the brain against the skull.

Content source: Courtesy of CDC’s Heads Up Program. Created through a grant to the CDC Foundation from the National Operating Committee on Standards for Athletic Equipment (NOCSAE).

Diagnosing Concussion

UT Southwestern physicians diagnose a brain injury and determine its severity by conducting several tests, which can include:

• A physical examination
• Imaging studies such as computed tomography (CT) or MRI scans of the brain
• Neuropsychological tests to evaluate the patient’s cognitive functioning, such as learning, memory, concentration, and problem solving

Treatment for Concussion

Concussion causes temporary dysfunction of brain cells and require rest for a full recovery. Patients can usually recover at home, requiring only rest and over-the-counter pain relievers. Rest is very important after a concussion because it helps the brain to heal – however, too much rest might not be good for recovery. 

Although most people recover after a concussion, how quickly they improve depends on many factors, such as:

• How healthy they were before the concussion
• The severity of the concussion
• How they take care of themselves after the injury
• Their age

When a patient’s symptoms have reduced significantly, a gradual return to activities such as work or school is recommended. 

A person with a concussion should have someone at home who can provide close monitoring so that follow-up treatment can be provided if symptoms persist or get worse. If symptoms come back or new symptoms develop, a physician should be notified right away. 

Considerations for Athletes and Student Athletes

About 10% of athletes participating in contact sports will experience a concussive brain injury. When such injuries happen, allowing time for the brain to heal is key. Whether an athlete has a concussion (or even if one is suspected), it's important to discontinue play or practice. 

Whether the athlete is participating in football, soccer, cheerleading, or any other sport, please keep in mind the following:

• No one – except for a health care professional – should try to judge the seriousness of the injury. The player should be seen by a professional experienced in evaluating concussions.
• Coaches and parents should share information they have about the student’s injury.
• Most will recover quickly and fully. However, for some athletes, some effects of the concussion can last for days, weeks, or longer.
• A repeat concussion that occurs before the brain recovers from the first one can slow recovery or increase the chances for serious complications or even death.
• Sometimes people wrongly believe that playing injured exhibits strength and courage. Some athletes might also try to hide their symptoms. Thus, diagnosis is important.
• Don’t let the athlete convince the coach that he or she is “just fine” or that he or she can “tough it out.” In fact, the saying for suspected concussion should be, “When in doubt, sit it out.”
• Playing with a concussion is dangerous, as it can damage brain cells. Pressuring injured athletes to play should be discouraged.
• Young children and teens are more likely to get a concussion and take longer to recover than adults.
• Athletes who have had a concussion are at increased risk for another concussion.
• Recognition and proper response to concussions when they first occur can help prevent further injury or even death.
• Allow the brain time to heal. This means keeping the athlete out of practice or the game the day of the injury. An athlete diagnosed with a concussion should only return to playing sports with permission from a doctor.

Research and Clinical Trials

The Texas Institute for Brain Injury and Repair at UT Southwestern is focused on a comprehensive and transformative approach to how brain injuries are prevented and treated. We draw on our depth of technology advances, innovative research, and exemplary patient care to create a unique collaboration to enhance the treatment and diagnosis of brain injuries.

Much concussion research has focused on sports-related injuries in youth and young adults, but concussions affect people of all ages and those who engage in a wide variety of activities. Researchers in the ConTex study are dedicated to furthering the field's knowledge about concussions.

Nyaz Didehbani, Ph.D., conducts concussion research through a partnership between UT Southwestern Medical Center at Frisco and Texas Health Resources. Learn more about her work and this collaboration.