The following are the major conditions or complications that may be contributed to by commotio cerebri (concussion):
Factors affecting health status and leading to health care utilization (Z00-Z99).
- Suicide (suicide; threefold higher))
Circulatory system (I00-I99)
- Apoplexy (stroke) – two weeks after head or neck trauma in patients younger than 50 years in 0.04%; in 37% of cases, the apoplexy occurred on the day of the accident, with a quarter of cases having unremarkable angiography of the cerebral vessels (visualization of arteries and veins using contrast medium) after the accident.
Ears – mastoid process (H60-H95).
- Vestibular dysfunction/vestibular dysfunction and balance problems due to repetitive subcommotio caused by head ball play.
Psyche – Nervous System (F00-F99; G00-G99).
- Dementia following mild traumatic brain injury (TBI ≡ commotio cerebri):
- Mild TBI without loss of consciousness: 2.36-fold higher risk.
- Mild TBI with loss of consciousness: 2.51-fold higher risk
- Moderate to severe TBI: 3.77-fold higher risk.
- Insomnia (sleep disturbances)
- Brain disorders
- Parkinson’s disease – for mild concussions, the risk was increased by 56% (hazard ratio 1.56; 1.35-1.80)
- “Second impact syndrome” (SIS) – suffering a second trauma before the effects of the first have fully subsided; in this context, minor trauma can quickly lead to malignant cerebral edema (brain swelling); therefore, strict adherence to the guideline: no more same-day competition (“no return to play the same day”)
Symptoms and abnormal clinical and laboratory findings not classified elsewhere (R00-R99).
- Cephalgia (headache)
- Suicidality (suicidal tendencies).
- Vertigo (dizziness)
As a rule, commotio cerebri heals without consequences.
Prognostic factors for prolonged (delayed) recovery
- Primary presence of significant headache
- Presence of amnesia (memory loss)
- Weakness or fatigue
- Pathological neurological examination
Additional notes
One study demonstrated that children who had a concussion and showed abnormalities in terms of vestibular dysfunction (vestibulo-ocular reflex dysfunction or tandem gait abnormalities) during the initial examination took longer to return to school (mean 59 versus 6 days). This group achieved complete symptom freedom much later than children without vestibular dysfunction after trauma (106 versus 29 days). Furthermore, the children with vestibular symptoms also performed worse on neurologic tests and took a longer period of time to overcome their cognitive impairments.
