In the real world and my personal experience, unless there is concurrent substance abuse (e.g. they're not roaring drunk), the loss of consciousness for a concussion is pretty short, on the order of minutes. However, after they wake up, concussion victims can be perseverative (asking same question over and over again) and with short term memory loss (don't remember asking that same question before, nor your previous response) for minutes to hours. However, I am constantly reading fiction with people knocked out for hours with no sequelae, so I think most people would be willing to suspend their disbelief for an hour or so.
With a more severe TBI (traumatic brain injury), where there is actual bleeding in the brain and the victim has a persistent depressed level of consciousness, they may never recover fully, and if they do, it may take weeks to months to years.
Someone used to people with concussions would be resigned but patient with the very annoying repetitive questions of the concussed, explaining what happened and where the patient was and what was happening over and over again. If they were also experienced with moderate-severe TBIs (even in old timey land!) the things they would likely check to see if the patient was deteriorating (e.g. bleeding getting worse, brain getting compressed) would be: symmetry, reactiveness to light and size of pupils, patient's ability to talk and be coherent, and ability to move all their extremities on command (raise your right arm; squeeze your left hand). Depending on the medical tradition you're using, a doctor might use trepanning (cutting into the skull; we would now use the term Burr hole in the modern era) to relieve pressure from bleeding on the brain if there are lateralizing signs (eg, an asymmetry in the physical exam). They would be planning to do this immediately and urgently if the exam changed, to prevent herniation of the brain and death. They'd do it with a hand drill after cutting an incision into the scalp.
As for how it feels: I have had patients with concussions who lost consciousness have no headache and others have terrible headaches, so both are possible. Concussion symptoms often include nausea, vomiting, dizziness, and photophobia (light hurts your eyes). If they don't remember the blow or the preceding events or immediate aftermath, they may never remember it in the future.
Similar answer for the cases with no lasting damage (meaning a minor concussion; mod-severe concussions can have the above symptoms and more for days to weeks).
Often people with concussions from being struck with an object have a laceration to their scalp where they were hit that bleeds like stink and needs washing out and sewing up. Even on the forehead, the scalp can split like that, and can bleed briskly! Even if no actual laceration, you can get a real goose-egg of a hematoma or a skull fracture. That said, the bone under the forehead is some of the strongest bone in the body, so not likely in your scenario, especially if they don't have any lasting symptoms.
Does that help? Anything I can clarify more? SO thrilled to be able to use my knowledge to help fic or fannish writers :)
![[community profile]](https://www.dreamwidth.org/img/silk/identity/community.png){kind=small}
![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
branchandroot
(no subject)
Date: 2023-07-24 10:11 pm (UTC)In the real world and my personal experience, unless there is concurrent substance abuse (e.g. they're not roaring drunk), the loss of consciousness for a concussion is pretty short, on the order of minutes. However, after they wake up, concussion victims can be perseverative (asking same question over and over again) and with short term memory loss (don't remember asking that same question before, nor your previous response) for minutes to hours. However, I am constantly reading fiction with people knocked out for hours with no sequelae, so I think most people would be willing to suspend their disbelief for an hour or so.
With a more severe TBI (traumatic brain injury), where there is actual bleeding in the brain and the victim has a persistent depressed level of consciousness, they may never recover fully, and if they do, it may take weeks to months to years.
Someone used to people with concussions would be resigned but patient with the very annoying repetitive questions of the concussed, explaining what happened and where the patient was and what was happening over and over again. If they were also experienced with moderate-severe TBIs (even in old timey land!) the things they would likely check to see if the patient was deteriorating (e.g. bleeding getting worse, brain getting compressed) would be: symmetry, reactiveness to light and size of pupils, patient's ability to talk and be coherent, and ability to move all their extremities on command (raise your right arm; squeeze your left hand). Depending on the medical tradition you're using, a doctor might use trepanning (cutting into the skull; we would now use the term Burr hole in the modern era) to relieve pressure from bleeding on the brain if there are lateralizing signs (eg, an asymmetry in the physical exam). They would be planning to do this immediately and urgently if the exam changed, to prevent herniation of the brain and death. They'd do it with a hand drill after cutting an incision into the scalp.
As for how it feels: I have had patients with concussions who lost consciousness have no headache and others have terrible headaches, so both are possible. Concussion symptoms often include nausea, vomiting, dizziness, and photophobia (light hurts your eyes). If they don't remember the blow or the preceding events or immediate aftermath, they may never remember it in the future.
Similar answer for the cases with no lasting damage (meaning a minor concussion; mod-severe concussions can have the above symptoms and more for days to weeks).
Often people with concussions from being struck with an object have a laceration to their scalp where they were hit that bleeds like stink and needs washing out and sewing up. Even on the forehead, the scalp can split like that, and can bleed briskly! Even if no actual laceration, you can get a real goose-egg of a hematoma or a skull fracture. That said, the bone under the forehead is some of the strongest bone in the body, so not likely in your scenario, especially if they don't have any lasting symptoms.
Does that help? Anything I can clarify more? SO thrilled to be able to use my knowledge to help fic or fannish writers :)
[source: I am a trauma surgeon]