Concussions are classified into several types.

Written by Ma Xian Shi
General Surgery
Updated on May 26, 2025
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Concussion is the mildest form of brain injury, characterized by transient brain dysfunction without visible neuropathological changes, although microscopic examination can reveal disordered neural structures. Generally, there are two types of concussions. The mild form manifests immediately after the injury with transient disturbances in consciousness and mental clarity, often lasting a few seconds to minutes, usually not exceeding half an hour. Upon waking, the individual cannot recall the incident, a condition known as retrograde amnesia. The second type, the severe form, involves more significant disturbances in consciousness that last longer, accompanied by symptoms such as pallor, cool and moist limbs, sweating, decreased blood pressure, slowed heart rate, slowed breathing, and the loss of various physiological reflexes. However, as consciousness is regained, these symptoms gradually normalize, followed by headaches, nausea, vomiting, and other symptoms. With time and treatment, improvement typically occurs.

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How is a concussion diagnosed?

Concussion diagnosis usually includes, first, a history of head trauma; second, after a head CT scan, no significant substantive changes are observed, but the patient has experienced a transient loss of consciousness, typically not exceeding half an hour. Third, there is approximated amnesia where the patient cannot recall the incident. Some may show symptoms such as decreased blood pressure and pale complexion, while others can experience dizziness, headache, nausea, loss of appetite, insomnia, memory deterioration, and lack of concentration among a series of clinical presentations. Diagnosis of concussion can be confirmed through medical history, supplementary examinations, and clinical symptoms.

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Symptoms of concussion

Concussion is the mildest form of traumatic brain injury. The symptoms of concussion primarily include: first, a brief period of clouded consciousness shortly after the injury, typically lasting from a few seconds to a few minutes, generally not exceeding half an hour; second, retrograde amnesia, where the patient cannot clearly recall the events during the injury, but memory of events prior to the injury remains clear; third, common symptoms such as headache, dizziness, nausea, vomiting, poor sleep, and decreased memory; fourth, the patient's cranial examination reveals no significant abnormalities, and lumbar puncture cerebrospinal fluid color and tests are normal.

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Concussions are classified into several types.

Concussions are usually categorized into several levels based on the severity of their clinical symptoms. Generally, the higher the level, the more pronounced the symptoms in patients. They can generally be divided into five levels. Patients with a level one concussion may experience mild consciousness disturbances, but these are short-lived and generally do not leave noticeable residual effects. Patients with a level two concussion might experience slight headaches and dizziness, accompanied by vertigo. Patients with a level three concussion show evident retrograde amnesia. Patients with a level four concussion experience mild disturbances in consciousness, manifesting as states of drowsiness, stupor, or coma. Patients with a level five concussion present with clear clinical symptoms, characterized by recurrent headaches, dizziness, nausea, and vomiting.

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General Surgery
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What should be done for a concussion?

Patients with concussion generally experience fear and anxiety, so it is important to keep them calm and avoid disturbing them as much as possible. Some psychological communication with the patient can help maintain a calm state of mind. Secondly, closely observe the patient's general condition and changes in consciousness to prevent delayed intracranial hemorrhage. Thirdly, administer symptomatic medication as needed, such as pain relievers and sleep aids for symptoms like headache and insomnia. Fourthly, use medications that promote the recovery of nerve cells for treatment.

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Written by Li Jin Quan
General Surgery
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How to diagnose a concussion

Typically, patients with concussions do not show organic changes on head CT scans; their primary clinical symptoms include temporary disturbances in consciousness after the injury and short-term memory loss. Some patients also experience varying degrees of headache, dizziness, nausea, vomiting, blindness, impaired memory, or lack of concentration, among other clinical symptoms. Generally, the essential tests include: first, a head CT scan; second, an electroencephalogram (EEG); third, cerebrospinal fluid examination.