Suppose the high school football coach contacts a teen’s parents to report their son got knocked out for a couple of minutes during a vehicle accident on the way home from a football game. A car lightly clipped the back of the team bus. The coach believes the boy is fine but advises the parents they may want him to see a doctor.

The concerned parents take their son to the hospital emergency room. The ER physician conducts a few balance and coordination tests. Smiling, the physician says the boy only sustained a mild concussion. He does not believe the young man needs a CT scan but will order one if they wish. The relieved parents thank the doctor, forgo the scan and return home. A few days later, their son complains of headaches, and his words sound slurred.

Mechanisms of injury

Generally, people believe that most concussions are mild and will resolve within a brief time. Some neurologists and neurosurgeons question whether the use of the vague word “concussion” minimizes what is, in fact, a traumatic brain injury. TBIs result from an impact to the head, causing the brain to jolt against the rigid skull. If the head bump seems gentle, a significant injury is unlikely—but not impossible.

Many concussions to teens occur in sports, with football players coming in first, followed by cheerleaders in second place. These two sports carry the highest risk to students for brain injuries that range from mild to those that cause paralysis or death. When students do not receive enough time—usually several weeks—for the first concussion to heal, they are in danger of serious brain complications, including rare cases of sudden death from brain swelling, if they receive a second concussion. There is a cumulative effect.

Concussions are not necessarily harmless

People who are in mild motor vehicle accidents often fail to appreciate that they may have sustained a serious TBI. It is critical for anyone in an accident to get an immediate medical assessment, preferably at a higher level medical center or hospital. The head can whip back and forth in an accident with enough speed to cause TBIs, even without impact to the skull. Accident victims may want to ask the doctor what signs or symptoms to watch for and what to do if their symptoms grow worse.

Those who believe they suffered no injury in a car accident may not notice symptoms for as long as a few hours up to several days later. A small brain bleed is not noticeable until enough blood accumulates to cause serious problems. Anyone in a motor vehicle accident should exchange insurance information from the person who hit them because TBIs—even with delayed symptoms—can result in expensive medical treatments or brain surgery. The person may face a long-term injury that involves extensive medical treatment, rehabilitation and loss of the ability to work.

No matter how mild an accident may seem, it can be a good idea to consult a legal professional early on about how to proceed in case a “mild” concussion turns into a serious and expensive TBI.