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Signs and Symptoms of Concussion

Miriam A. Carroll-Alfano, MS, CCC-SLP

March 1, 2016

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Question

What are the signs and symptoms of concussion?

Answer

When describing signs and symptoms of a condition, it is important to remember that a sign is usually something that is observed by other people, whereas a symptom is something that is reported by the patient.

There is a lot of variability in how signs and symptoms are reported for concussion.  Some sources will list “signs and symptoms;” some will just say “symptoms.” Categorization is also variable. For instance, the CDC uses four categories of signs and symptoms: affective or emotional or mood-related symptoms; somatic or physical symptoms; sleep disturbances; and cognitive symptoms. The National Institutes of Health (NIH) and the American Academy of Neurology do not really categorize the symptoms. They give lists of symptoms and signs.  I like to categorize signs and symptoms into physical symptoms, cognitive symptoms, and behavioral symptoms.

Physical Signs and Symptoms - First, there is chronic pain; headache is the most common symptom reported for concussion. Dizziness is also a common symptom reported for concussion. Other symptoms include: lethargy or having a lack of energy; fatigue or having reduced stamina or endurance; nausea; vomiting; any kind of visual disturbances, including blurred vision, double vision or sensitivity to light; tinnitus; and sleep disturbances, including excessive sleeping or having difficulty falling asleep.

Cognitive Signs and Symptoms - These can include: memory impairment; attention or concentration difficulties; perceptual disturbances, which would be difficulty taking in sensory information and interpreting it; communication disorders, particularly speech disorders such as change in articulation or acquired stuttering; poor executive functioning; disorientation; and word retrieval difficulty. Among the cognitive symptoms, memory impairment is most commonly reported.

Behavioral Signs and Symptoms - Some of these include: depression; irritability and anger; disinhibition, the inability to control emotions and behavior; emotional lability; and increased anxiety. Depression is the most commonly reported behavioral symptom.

Miriam Carroll-Alfano is a medical speech-language pathologist with over 15 years of experience in hospital, acute rehabilitation, outpatient and skilled nursing facilities.  She has been a clinical faculty member at Saint Xavier University for 8 years supervising students in the clinic and teaching courses in adult neurogenic disorders including traumatic brain injury, stroke and dysphagia.  She is the developer and coordinator of the university’s Concussion Education Program and annually provides concussion training to all university athletes.


miriam a carroll alfano

Miriam A. Carroll-Alfano, MS, CCC-SLP

Miriam Carroll-Alfano is a medical speech-language pathologist with over 15 years of experience in hospital, acute rehabilitation, outpatient and skilled nursing facilities.  She has been a clinical faculty member at Saint Xavier University for 8 years supervising students in the clinic and teaching courses in adult neurogenic disorders including traumatic brain injury, stroke and dysphagia.  She is the developer and coordinator of the university’s Concussion Education Program and annually provides concussion training to all university athletes.  Miriam is currently working on her doctorate in Interdisciplinary Health Science at Western Michigan  University.  Her research interests include: concussion education and policy, assessment and treatment of concussion. 


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