It is not difficult to recognize a severe concussion, as these injuries present with signs and symptoms lasting significantly longer than mild and moderate concussions. The athlete will often experience more signs and symptoms than described in the previous two levels, and blurred vision, nausea, and tinnitus are more likely to be present. Most experts agree that a concussion resulting in prolonged LOC should be classified as a severe concussion. Some authors1,9 classify brief LOC (including momentary blackout) as a severe concussion instead of the more widely accepted moderate classification. The severe concussion may also involve post-traumatic amnesia lasting longer than 24 hours, as well as some retrograde amnesia (memory loss of events occurring prior to injury). In addition, neuromuscular coordination is markedly compromised, with severe mental confusion, tinnitus, and dizziness. Again, despite the emphasis often placed on LOC and amnesia, it is important to consider the duration of all signs and symptoms when classifying the injury. Serial observations (repeated assessments) for signs and symptoms should be conducted in an attempt to identify progressive underlying brain damage.
Management of the three types of concussive injuries is not all that different, as rest and serial evaluations are the standard of care. In the event of prolonged LOC (severe concussion), the athlete should be evaluated by a physician, with consideration given to neuroimaging of the brain. No athlete should return to participation while still experiencing symptoms. More specific assessment guidelines are presented in the section on management in this chapter.
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Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.