Although they are usually mild and aren’t a major cause for concern, concussions can be quite scary. The brain, which is made of soft tissue, is surrounded by fluid and contained within a hard case—your skull. When you are injured, especially forcefully, it’s possible for your brain to smash into the wall of your skull, leading to bruising or potentially even bleeding. When this happens, your brain can stop functioning for a period of time. That is a concussion.
Concussions are fairly common (even Rachel has had one). The World Heath Organization Collaborating Centre Task Force on Mild Traumatic Brain Injury estimated that in the general population, concussions occur in more than six out of every thousand people. However, most concussions are mild and require no treatment.
Many people believe, and have been told again and again, that it is important to keep someone who has had a concussion awake. There is a mistaken belief that someone who falls asleep after sustaining a concussion might fall into a coma and not wake up again. The origins of this myth are not well understood, but likely have to do with what’s called the “lucid interval” experienced after some very severe head injuries. After a bad head injury, there can be some slow bleeding. Once the initial shock of the injury has worn off, a patient with a head bleed can appear normal for a period of time (the lucid interval) while the bleeding continues. Once enough bleeding occurs, the brain is compressed, and emergency surgery may become necessary.
However, as scary as this sounds, bleeding occurs in a very, very small number of head injuries. Mild concussions usually resolve quickly, without any effects whatsoever. In fact, physicians believe that athletes can return to a game within fifteen to twenty minutes after a very mild concussion. There is no reason to believe that bleeding occurs as a result of these injuries, and therefore, no concern that these people need to be watched closely. Those with more concerning symptoms, such as worsening headaches, nausea, confusion, trouble walking or talking, vomiting, or even seizures, should seek immediate medical attention. Any of these symptoms would mean you need to go to the hospital for evaluation.
The bottom line is that if you have a concussion that is deemed mild enough to warrant no medical attention or no treatment after evaluation, then the risk of bleeding is probably negligible, and there is no reason that you can’t go to sleep.