When does a bump on the head become something more serious? It can be hard to tell. The most important thing you can do is take concussions—or any head injuries—seriously from the get-go.

WellTuned spoke with Dr. Ian Bushell, a family medicine physician and medical director for BlueCross BlueShield of Tennessee, about what we should know about concussions.

What is a concussion?

Dr. Bushell: A concussion is an injury to the brain that’s caused by direct trauma to the head, like a bump or a blow from a fall. That’s why some people also refer to concussions as traumatic brain injuries (TBIs). People over 75 have the highest number of TBI-related hospitalizations and deaths. But more than 800,000 children are treated each year in the emergency department for TBI. About 25,000 Tennesseans experience a TBI each year.

The national awareness of brain injuries has spiked recently in the wake of injuries experienced by high-profile professional athletes. The hope is that more people will now learn about concussions, and:

• how they affect your brain,
• how to recover from them, and
• how to prevent them from occurring when possible.

CDC: Facts about concussion and brain injury

What you need to know about concussions

1. It’s not always easy to recognize a concussion

It’s obvious that a person with a broken leg can’t just shake it off and return to the playing field. But it’s easier to miss, or even dismiss, a lot of the symptoms of concussion. This includes brain fogginess, memory loss, and headache, which aren’t visible to onlookers. Other common symptoms of concussion could include:

• nausea and vomiting
• ringing in the ears
• sensitivity to light
• trouble concentrating
• loss of taste or smell
• trouble falling sleep

2. You might never lose consciousness

You might lose consciousness after falling or sustaining a blow to your head, but you might not. In many cases, concussions occur without a loss of consciousness. So don’t assume that you didn’t experience a concussion because you didn’t faint or pass out.

3. The effects can unfold over time

With head injuries, sometimes the extent of the damage isn’t obvious right away. The symptoms can start out as mild, but the effects can worsen over time. The symptoms can vary and change in as little as 15 minutes—but the effects can linger for a long time afterward. However, some symptoms warrant immediate medical attention, such as:

• seizures
• slurred speech
• repeated episodes of nausea or vomiting
• inability to wake up
• loss of consciousness

4. All concussions should be evaluated by a doctor

Your brain is too important to take lightly. If you or someone you love has received an injury to the head, get it checked out by a healthcare professional. And consider seeing one with special training in diagnosing and treating concussions.

5. Rest is crucial

Most concussions require rest—both physical and mental, according to the Mayo Clinic. You need to give your brain a break from activities that require thinking and mental concentration for a few days—or possibly longer. You don’t have to confine yourself to a dark room, but you might want to forego or at least limit activities such as:

• texting
• watching videos
• playing video games
• reading novels

You should also take a break from physical activities that worsen your symptoms. Some cases may require additional treatment, such as occupational therapy and physical therapy.

6. You’re at greater risk for another concussion

Once you have one concussion, you’re at greater risk for experiencing another one. Follow all instructions from your doctor if you get a concussion to lower your risk of experiencing a second concussion. Repeated concussions have a long-lasting effect on the brain. If you experience a head injury before your brain has healed from the first one, you can develop a rare condition known as Serious Impact Syndrome. This is when the brain swells and can lead to death.

7. Your child may have to be officially cleared before they can play again

Don’t send your child back out onto the soccer field or basketball court after they get a concussion. A doctor needs to weigh in first to make sure they’re ready. Otherwise, you could be setting them up for further injury. Returning to play before symptoms fully resolve leads to the risk of additional injury.

In Tennessee, the Tennessee Secondary School Athletic Association (TSSAA) maintains a concussion policy that requires a “Concussion Return to Play Form.” A physician with concussion training has to evaluate your child, make sure it’s safe for them to return to P.E. class or sports, and sign the form. The policy also recommends that children return to play via gradual steps, starting with low levels of physical activity.

Tennessee Return to Learn/Return to Play guidelines

How to reduce the chances of getting a concussion

Dr. Bushell: Prevention is absolutely critical when it comes to concussions. A few key tips from the CDC:

• Wear helmets during activities such as skiing, skating, riding scooters and bikes, and while playing sports like football.
• Wear a seatbelt when riding in a vehicle.
• Try to avoid any direct head impact in contact sports.
• Put safety gates on stairwells in your home to reduce the chance that a small child will fall down the stairs and sustain a head injury.
• Install window guards so no one can fall out of an open window.

Older adults are also at increased risk for falling, which can lead to a head injury like a concussion. If you have an older adult living in your household, suggest that they talk to their doctor about a fall evaluation. Fall evaluations may include a review of medications that could make them dizzy—and more prone to fall—as well as a vision check. Also, loose carpets or mats need to be fixed or removed in homes that have seniors to reduce trip hazards.

More from Dr. Bushell on WellTuned.

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.