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Understanding Concussions: A Q&A with Michelle L. Mellion, MD


NPNI brain imageMichelle Mellion, MD, assistant professor of neurology at the Warren Alpert Medical School of Brown University, explains what concussions are, the latest concussion research and how you can help to prevent these injuries.

What is a concussion (what causes it and what are the signs/symptoms and impact)?

Concussion is a traumatic brain injury that affects 1.6 to 3.8 million people annually. This figure is probably underestimated given that many people do not seek medical treatment because they do not recognize that they have suffered a brain injury. Most people do recover from concussions without any long lasting injury.

Concussion can occur with forceful blows to the head or body or a forceful movement causing the brain to crash into the skull or be subjected to more damaging rotational movement resulting in an alteration of brain function.

Signs of a concussion are behavior or personality changes, blank stare/dazed look, changes in balance, coordination, reaction time, delayed or slowed speech or physical responses, disorientation, loss of consciousness (this occurs in less than 10% of cases), memory loss and difficulty controlling emotions.

Symptoms of a concussion can include vision changes, dizziness, feeling foggy, groggy, drowsy, sleep problems, headaches, inability to concentrate/focus and sensitivity to light and sound.

Are they happening more often, or are we just aware of more of these types of injuries as education improves?

Concussion is an unrecognized epidemic. We are just beginning to understand the best methods for diagnosis and treatment of this potentially disabling condition. Educating the public including parents, coaches, trainers, school nurses and people involved in high risk activities is playing a huge role in the increasing the awareness of this brain injury. Earlier recognition of concussion may lead to appropriate, potentially life-saving treatment especially in those people who have already suffered a concussion and are at risk for further injury.

How can someone protect themselves or their children from concussion injuries?

It is impossible to be completely protected from a concussion. Aside from sports injuries, the most common causes of concussion in the general population are falls and motor vehicle accidents. Soldiers are exposed to potential concussions from blast injuries. People need to know the consequences of participating in high risk activities. Unfortunately, no protective equipment has been shown to decrease the risk or severity of concussion in controlled clinical trials. However, wearing appropriate equipment whether on the playing field or on the battlefield as well as using proper technique when playing contact sports could possibly reduce the likelihood of concussion.

What types of research is being conducted into concussion?

Clearly more research needs to be done in order to understand this complex and potentially debilitating traumatic brain injury. Many studies are underway looking at improving methods of diagnosis and treatment of concussion as well as longitudinal studies to understand the natural progression of the injury to the brain over time. Prevention of concussion is also being studied. Many of the ongoing clinical trials can be found at