Concussions are the “silent epidemic”, a condition that can result and lifetime physical, cognitive, emotional, and behavioral impairments.  A high percentage of concussion victims do not seek medical treatment. (One study revealed the almost 90% of adults would not go to the emergency room if they thought they had a concussion. In another study, 65% of athletes who suffered concussions did not recognize their injury.  Many who did realize the injury made the decision not to report it because they wanted to continue playing.)

Even when concussion victims do seek medical attention, a high percentage are overlooked or misdiagnosed. One study reported that as many as 86% of concussion injuries were not diagnosed in the hospital emergency department.

Many concussion victims remain silent about their condition because of embarrassment and denial.  They just don’t want to admit that they have a concussion and think that the symptoms will go away on their own.  The section on treatment provides more information about the value to early diagnosis and treatment.

In other cases, the concussion will remain “silent” because it is overshadowed by physical injuries that demand immediate attention.  Concussion symptoms can be hidden by shock and pain medications.

Concussion symptoms may not be noticeable because they are not distinctly different from other medical conditions.  Many other conditions can produce headaches, blurred vision, nausea and vomiting, dizziness, and other typical concussion symptoms.

Many of the symptoms of a concussion are not immediately apparent, with a delayed onset of days, weeks, months and even years later. (See section on delayed onset.)

There are no reliable “biomarkers” or screening tests of concussion injuries that can allow the medical doctor who is challenged with task of diagnosing a concussion.  There are no known imaging tests (Xrays, MRIs or CT scans), no well-respected blood tests or vision testing to objectively “rule in” or “rule out” a concussion.  MRI scans are not helpful.  CT scans can only sort out the severe cases with brain bleeding (hematomae).  At present, the most reliable test is that of a pathology examination after death. With concussion injuries, there are typically no visible signs of injury-no bleeding, broken bones, or other outward indications.