Does Concussion Require Loss of Consciousness?

The following is from a current review of concussion treatment: ¹

“Concussion is a trauma-induced alteration in mental status that may or may not involve loss of consciousness. The misunderstanding that concussion requires loss of consciousness has surfaced again in recent years. More than 30 years ago, the Congress of Neurological Surgeons² concluded that head injury leading to mental status alterations without loss of consciousness is also a form of concussion. C. Miller Fisher³ also offered a clear case of amnesia from head injury without loss of consciousness, and he alluded to numerous other reports in his experience and in the literature of similar cases. Ommaya and Gennarelli⁴ created an animal model of traumatic brain injury in which three of the six grades of concussion did not involve loss of consciousness. More recent animal studies⁵ also found axonal swelling after mild traumatic brain injury in animals, further demonstrating that neuroanatomic alterations indeed occur during concussion.”

1. Kelly JP, Rosenberg JH. Diagnosis and management of concussion in sports. Neurology 1997;48:575-580.
2. Report of the Ad Hoc Committee to Study Head Injury Nomenclature. Proceedings of the Congress of Neurological Surgeons in 1964. Clinical Neurosurgery 1966;12:386-394.
3. Fisher CM. Concussion amnesia. Neurology 1966;16:826-830.
4. Ommaya AK, Gennarelli TA. Cerebral concussion and traumatic unconsciousness. Correlation of experimental and clinical observations on blunt head injuries. Brain 1974;97:633-654.
5. Povlishock JT, Lontos HA. Continuing axonal and vascular change following experimental brain trauma. Journal of the Central Nervous System Trauma 1985;2:285-298.

 

 

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