What’s the Difference Between a Concussion and a Contusion?

Two terms often pop up when it comes to head injuries: concussions and contusions. Although the two sound similar, they refer to different types of injuries with distinct symptoms and characteristics. It’s important to understand these differences, especially if you or someone you love has suffered a head injury.

What is a concussion?

A concussion is a type of mild traumatic brain injury (TBI) that happens when a blow or jolt to the head causes the brain to rapidly move back and forth. The Mayo Clinic describes a concussion as follows:

Concussions usually are caused by an impact to the head or body that is associated with a change in brain function. Not everyone who experiences a blow to the body or head has a concussion.

Concussions typically don’t involve structural damage to the brain that can be seen on imaging tests like CT scans or MRIs.

What are the symptoms of a concussion?

Concussion symptoms can vary widely and may not appear immediately after the initial injury. Concussion symptoms can include:

• Headache, dizziness, nausea, vomiting, blurred vision, sensitivity to light or noise, and balance problems.
• Confusion, difficulty concentrating, memory problems, and feeling mentally “foggy.”
• Irritability, sadness, nervousness, and mood swings.
• Sleeping more or less than usual, trouble falling asleep, or insomnia.

It’s important to remember that loss of consciousness doesn’t always happen with a concussion. In fact, many people with concussions never lose consciousness.

What is a contusion?

A contusion, generally, is a bruise. When it comes to the brain, a cerebral contusion means the brain tissue has been bruised. This can happen when the small blood vessels in the brain are damaged from a direct impact, leading to bleeding and swelling within the brain. Unlike concussions, contusions can often be seen through imaging tests like CT scans and MRIs, as they involve structural damage to the brain tissue.

What are the symptoms of a contusion?

The symptoms of a brain contusion can vary depending on the severity and location of the injury. However, they may include:

• Headache, dizziness, nausea, vomiting, and loss of consciousness.
• Difficulty with coordination and movement, weakness or numbness in parts of the body, difficulty speaking or understanding speech, and changes in vision.
• Confusion, difficulty concentrating, memory problems, and changes in behavior or personality.

Severe contusions can lead to significant neurological deficits and can be life-threatening if not treated promptly.

What are the differences between concussions and contusions?

While both concussions and contusions result from head trauma, they have distinct differences.

• For example, a concussion involves a temporary disruption of brain function without structural damage. Contusions involve actual bruising and structural damage to the brain tissues.
• Concussions don’t typically appear on standard imaging tests. Contusions can often be seen on these tests like CT scans or MRIs.
• Concussions are generally considered to be mild TBIs (though symptoms can still be serious). Contusions can range from mild to severe and might require surgical intervention.
• Concussions often include headaches, dizziness, and cognitive disturbances without localized neurological issues. Contusions, on the other hand, may present with more localized neurological symptoms, like weakness in a specific limb or difficulty speaking, depending on the area of the brain affected.

What are the causes and risk factors for concussions and contusions?

Both concussions and contusions are typically caused by a direct blow to the head or a sudden acceleration-deceleration movement, such as in:

• Motor vehicle accidents: Collisions can cause the head to strike objects or experience rapid movement changes.
• Falls: These are especially common in older adults and young children.
• Sports injuries: Contact sports like football, hockey, and boxing carry higher risks.
• Physical assaults: Including blows to the head during altercations.

Certain factors can increase the risk of sustaining these injuries, including not wearing appropriate safety gear during activities, engaging in high-risk behaviors, and having a history of previous head injuries.

How do doctors diagnose concussions and contusions?

Diagnosing concussions and contusions involves a combination of medical history, physical examination, and, when necessary, imaging studies.

The clinical evaluation for a concussion includes an assessment of symptoms, cognitive function, and neurological status. Imaging is not typically required unless there are red flags and symptoms suggesting a more severe injury.

The clinical evaluation for a cerebral contusion is similar to that of concussions, but with a focus on localized neurological deficits. CT scans or MRIs can be used to identify the location and extent of the bruising.

What is the treatment for concussions and contusions?

Doctors treat concussions and contusions differently based on the severity of the injury.

Concussion

Both physical and cognitive rest are vital to allow the brain to heal. Avoid activities that require intense concentration, like screen time and reading, during the initial recovery period. Patients should slowly return to normal activities, making sure that symptoms don’t worsen.

Over-the-counter pain relievers like acetaminophen can help, but NSAIDs (like ibuprofen) should be initially avoided due to the risks of increased bleeding.

It’s important to be alert for worsening symptoms, like severe headaches, vomiting, confusion, or loss of consciousness, which could indicate a more serious brain injury.

Most mild concussions resolve within a few weeks, but some symptoms, particularly cognitive or emotional ones, may linger for months (a condition known as post-concussion syndrome).

Contusion

Because cerebral contusions involve structural damage to the brain, they often require closer monitoring and medical intervention. Severe cases may require hospitalization to observe for swelling, increased intracranial pressure, or worsening symptoms. In cases where the contusion leads to significant brain swelling or bleeding, a neurosurgeon may be needed to perform a procedure to relieve pressure on the brain.

If neurological deficits occur, rehabilitation like physical therapy, occupational therapy, or speech therapy may be necessary to help the patient recover lost functions.

Recovery varies widely depending on the severity. Mild contusions may resolve within weeks, while severe contusions can take months or even years to recover. Some patients may experience long-term complications.

What are the potential complications of concussions and contusions?

Concussions and contusions can present with a variety of complications.

With post-concussion syndrome, symptoms of a concussion can persist for weeks or months, affecting the patient’s daily life. Patients may suffer second impact syndrome, which is a rare but dangerous condition where a second concussion happens before the first has healed, leading to rapid and severe brain swelling.

With contusions, there is the risk of seizures, as brain bruising can increase the risk of post-traumatic epilepsy. Depending on the location of the contusion, individuals may struggle with memory, speech, or motor coordination. In severe cases, swelling can lead to increased pressure within the skull, requiring emergency medical intervention.

If you or a loved one has suffered a concussion or contusion due to someone else’s negligence, such as in a car accident, workplace injury, or slip and fall, you may have legal options. Brain injuries can lead to costly medical bills, lost wages, and long-term rehabilitation needs. Consulting with an experienced personal injury attorney can help you understand your rights and pursue compensation for your losses.

At Pat Maloney Accident & Injury Attorney, we work to help victims of traumatic brain injuries seek justice. If you or a loved one has suffered a concussion or brain contusion due to negligence, contact us today. Call our offices or complete our contact form to schedule a free consultation.