Types of Cerebral Concussion

Types of cerebral concussions. Top row: For didactic reasons, possible definition of the most severe form of classic concussion with a maximum unconsciousness (black) of 15 minutes, followed by a maximum clouding of consciousness (gray) of one hour. Not only in adults (grades 1 to 3), but in children, too different degrees of concussions may occur; nevertheless, they may escape the observation in infants and toddlers, in contrast to adult athletes in whom they are more or less recognizable (for instance short term state of confusion with inattention, lack of concentration, incapacity to process informations, and to perform successive tasks). The four lower rows illustrate different forms of atypical concussion which are mainly observed in childhood: An observed or not obvious initial unconsciousness is followed immediately or after a symptom-free interval (white) by clouding of consciousness and/or by transient neurological signs for more than one hour, which disappear spontaneously 12 to 24 hours later without sequels. Examples are the amaurosis fugax (the child has been blind for some time), or distinct fluctuations of the state of consciousness as demonstrated in the following four pictures of the face of the same patient.