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Everything You Need To Know About Different Types of Concussions

Updated: May 3, 2023

Jul 27, 2022 3:05:35 PM

Did you know that a concussion is a traumatic brain injury? Known as a mild traumatic brain injury (mTBI), a concussion happens after a significant head injury.

Head injuries can lead to a multitude of symptoms. And doctors and specialists use these symptoms to differentiate between the different types of concussions.

The different types of concussions may seem trivial to you. But categorizing concussions helps doctors predict symptom trajectories. And these predictions can help individualize patient treatments and even improve outcomes.

Are you trying to understand how experts classify types of concussion injuries? Then keep reading our guide because this one is for you!

How Do Doctors Categorize the Types of Concussions?

Not all doctors diagnose concussions using the same methods. Some specialists use emerging concussion tests like the Rivermead Post-concussion Symptoms Questionnaire (RPQ).

In general, though, doctors use a patient's immediate, short-term, and mid-term symptoms to determine the type of concussion. Here are some different concussion test methods doctors use to do just that.

By Symptomatology

Symptomatology is a big word meaning all the symptoms that come along with a specific medical condition. In this case, symptomatology refers to the mid-term symptoms that come along with concussions.

Doctors have not always classified concussion types based on the associated symptoms. But there is an emerging effort among concussion specialists and researchers to make it the primary method of diagnosing head injury subtypes.

Man Holding His Head In Pain

There are six different types of concussions when you categorize them by symptoms. We will talk more about these subtypes in a moment. But first, we want to describe some other methods used to categorize concussions.

By Severity

The classic method of diagnosing concussions is by grade. "Grade" is a medical term that refers to a condition's severity. Doctors typically distinguish Grade 1, Grade 2, and Grade 3 concussions using the following guide:

  • Grade 1 (Mild Concussion): The patient's symptoms last 15 minutes or less, and the patient does not lose consciousness

  • Grade 2 (Moderate Concussion): The patient's symptoms last more than 15 minutes, and the patient does not lose consciousness

  • Grade 3 (Severe Concussion): The patient's symptoms last more or less than 15 minutes, and the patient does lose consciousness

Loss of balance and vision are also taken under consideration when ranking the severity of a patient's head injury. Also, in some cases, a doctor may use the GCS to supplement these findings.

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Using the GCS

The GCS is also known as the Glasgow Coma Scale. Even though the word Coma is in the title, some doctors also use it to rank the severity of traumatic brain injuries, including concussions.

Doctors determine the severity of a TBI based on the following responses:

  • The ability to open the eyes

  • The ability to respond to a question

  • The ability to move on command

A doctor will score each of these responses on a scale of 1 (no response) to 4, 5, or 6 (strong response). The doctor will then add up the patient's scores and give him or her a GCS rating from 3 to 15.

Scoring a 3 to 8 on the Glasgow Coma Scale indicates a severe brain injury. A score of 9 to 12 may indicate a moderate brain injury. And scores of 13 to 15 may indicate a mild brain injury or concussion.

Six Concussion Subtypes Based on Post-Injury Symptoms

We mentioned that doctors sometimes classify concussions based on the patient's mid-term symptoms. But what does that mean exactly? Doctors look at symptoms that show up within one week of the injury and initial diagnosis.

Based on the symptoms they observe, doctors can then classify the concussion as one of the subtypes. Experts used to distinguish between four subtypes: physical, cognitive, emotional, and sleep/fatigue.

Today, researchers have combined the sleep/fatigue subtype with the cognitive subtype. Also, they have added more subtypes to the list. And other subtypes are under consideration by concussion researchers and may one day be added to this list.

Boy Sleeping In Class

Here are the six subtypes doctors categorize concussions into today.

1. Cognitive

Cognitive refers to the brain. So, this concussion subtype comes with symptoms having to do with the brain. These cognitive symptoms include the following:

  • Fatigue

  • Low energy

  • Headaches with non-specified causes

  • Trouble focusing

Sometimes, doctors call this the cognitive-fatigue subtype. That is because insomnia and other sleep disruptions are common in patients with this type of concussion.

Memory loss, difficulty with multitasking, and learning disabilities may also come along with the cognitive concussion subtype.

In rare cases, a concussion patient might experience concussive convulsions. Concussive convulsions typically occur directly after head injury. Still, some doctors use this concussion symptom to classify the cognitive subtype.

2. Vestibular

Vestibular is a fancy word for the balance systems that exist within the inner ear, which is known as the vestibule. Vestibular symptoms are extremely common after a head injury and include:

  • Dizziness

  • Vertigo

  • Nausea

  • Brain fog

  • Detachment

  • Overstimulation

Less commonly, people with this concussion subtype may experience a loss of coordination and abnormal eye movements.

Disruptions to the vestibule are also associated with giddiness. That means patients feel lightheaded and off-balance. Often, people say they feel a spinning or swimming sensation, which are also signs of giddiness.

3. Ocular

The ocular or oculomotor concussion subtype commonly comes with eye-related symptoms. After all, the prefix ocul- comes from the Latin word oculus, which means eye.

When doctors classify someone's concussion under the ocular subtype, they look for the following symptoms:

  • Eye pressure, especially behind the eye

  • Blurred vision

  • Double vision

People with this type of concussion may also report trouble with visual learning. 65% of people are visual learners, so this symptom can be detrimental to patients' wellbeing.

Guy Rubbing His Nose And Checking His Glasses

Other more rare symptoms of this concussion subtype include reduced color and/or light sensitivity, inaccurate depth perception, and difficulties reading both digital and non-digital texts.

Patients who experience phosphenes (seeing stars) and photopsia (seeing flashing lights) directly after a head injury could be an early indicator of an ocular concussion subtype.

4. Emotional

The emotional concussion subtype affects patients' moods. Doctors may also refer to this type of concussion as the anxiety subtype since anxiety is one of the most common symptoms. Other symptoms of this subtype include:

  • Hypervigilance (always being on alert for danger)

  • Hopelessness

  • Sadness or depression

  • Feeling overwhelmed

  • Newfound phobias or fears

It is also common for patients with this concussion subtype to experience significant mood swings. That might look like someone laughing happily at one moment before quickly switching to crying sadly.

In very rare cases, concussions can lead to changes in personality. This symptom is more common the more severe the concussion. Personality changes also depend on the region of the brain where the injury occurred.

5. Physical

Doctors also call physical concussions somatic. That is because somatic refers to the body, and this concussion subtype's symptoms mainly affect the body.

Symptoms of a physical or somatic concussion are:

  • Pain

  • Nausea or vomiting

  • Loss of consciousness

  • Numbness or tingling in the toes and fingers

Some experts also call the physical concussion subtype cervical. However, this subtype differs slightly from the traditional physical concussion subtype.

That is because cervical concussions manifest pain symptoms exclusively in the upper back and neck.

6. Post-Traumatic Migraine

The post-traumatic migraine concussion subtype is perhaps the simplest to diagnose. Why? Because it only has one symptom: migraine headaches.

Migraines are reoccurring, often chronic headaches. They come with characteristic throbbing pain, usually on only one side of the head. 18% of men and 43% of women experience migraines, but migraines are not always due to an underlying brain injury.

Migraine headaches patients develop from the post-traumatic migraine type of concussion may include the following symptoms:

  • Nausea

  • Vomiting

  • Photosensitivity (sensitivity to light)

  • Phonosensitivity (sensitivity to sound)

Rarely, a migraine may also come with hearing, speaking, or vision problems. This concussion subtype could be mistaken for the vestibular subtype because migraines can sometimes lead to vertigo and loss of balance.

How Do Doctors Treat Concussions?

Concussion treatments vary based on severity, symptoms, and the patient's history with TBIs and mTBIs. Additionally, different doctors and specialists prefer different treatments for concussions.

For a moderate to severe concussion, the patient may need specialized treatment. This is especially true for patients who have a history of head injuries. Specialized treatments include surgery, rehabilitive or physical therapy, or even occupational therapy.

People with mild concussions usually do not require specialized treatment. Experts typically recommend lots of rest in the days and weeks following the injury. Mild concussion patients can also take an over-the-counter medication to deal with any symptoms of pain.

You can learn more about recovering from a concussion here.

Join a Community of TBI Survivors

Doctors classify the types of concussions based on symptoms and severity. There are three concussion subtypes based on severity: mild, moderate, and severe concussions. And there are six subtypes based on symptoms: cognitive, vestibular, ocular, emotional, physical, and post-traumatic migraine.

Are you or your loved one recovering from a concussion or TBI? Subscribe to our newsletter to get access to the free Power of Patients app, where you can track your symptoms and connect with other TBI survivors just like you.

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