In acute phase the patient is still experiencing the symptoms. The phase can lasts more than a week. During this phase the concussed brain requires mental and physical rest to recover from the injury.
All brain processes that are affected by a concussion. People suffering from concussion should avoid texting, computer use, video games, television, driving, loud music and music through headphones because all of these activities make the brain work harder to process information and can exacerbate symptoms and slow the recovery process.
People with concussions should get sustained from sternous exercises.
The patient feels physical improvement such as headaches and postconcussion neurocognitive test scores has been improved. During the period the person might slow amount of recovery .
The patient should not think in excess and should avoid getting stressed.
Concussion symptoms might differ from person to person. Few patient might recover within a week. And other few might takes atleast a month or longer to get relieve from the symptoms.
No two concussions are exactly the same, so individualized treatment is necessary. Developing brains are highly variable, so the symptoms experienced by one person may be completely different from another. Some patients will take longer to recover from a concussion for various reasons. Therefore, each concussion is managed on an individual basis.
Concussion of the brain results in impaired neurotransmission, loss of regulation of ions, deregulation of energy use and cellular metabolism and a reduction in cerebral blood flow.
Excitatory neurotransmitters such as glutamate serves to stimulate the nerve cells which are released in excessive amounts. The cellular excitation causes neurons to fire excessively. This creates an imbalance of ions such as potassium and calcium across the cell membranes of neurons (a process like excitatory toxicity).
The cerebral blood flow is reduced. The reduction in blood flow is not as severe as in ischaemia. The cells tends to get reduced glucose which might result in the energy crisis.
The activity of the mitochondria is reduced which causes cells to rely on anaerobic metabolism to produce energy, increasing levels of the byproduct lactate.
For a period of minutes to days after concussion the brain is suspected to intracranial pressure, blood flow and anorexia. During this process a large number of neurons might get died.
Concussion damage result in diffuse damage to the tissues, it does not cause the damage to the localized area.
The pathology of a concussion seems to start with mechanical stress and stretching forces disrupting the cell membrane of nerve cells through "mechanoporation".This results in potassium outflow from within the cell into the extracellular space with the subsequent release of excitatory neurotransmitters including glutamate which leads to enhanced potassium extrusion, in turn resulting in sustained depolarization, impaired nerve activity and potential nerve damage. In an effort to restore ion balance, the sodium-potassium ion pumps increase activity, which results in excessive ATP (Adenosine Triphosphate) consumption and glucose utilization, quickly depleting glucose stores within the cells.