Once you have already experienced a concussion, no amount of prevention or awareness can change what has already happened. Now what you may want to know after suffering a concussion is what the long-term effects are?

The good news about concussions: It might ease a little worry to know that for one concussion it is rare to have any lasting long-term effects. For a month or so after a concussion, it is common to have all the symptoms from headaches to difficulty concentrating. These symptoms typically resolve themselves with a little rest. However, rare does not mean completely impossible. There are still certain cases where one might find there to be lasting effects of a concussion. In these cases, the individual should seek medical care to make sure that there isn't worse damage that had not yet been realized. When there has only been one concussion, the persisting symptoms are typically indicative of post-concussion syndrome, since every person has different variables that affect the length of their recovery.

Where the long-term effects come in: The situations in which long-term effects should be of concern are in cases of more moderate to severe traumatic brain injuries. Since a concussion classifies as a mild traumatic brain injury, it is left out of this grouping. Keep in mind, however, that multiple mild injuries can quickly become the equivalent of a more severe condition.

• Post-concussion syndrome: While this syndrome isn't necessarily long-term, it does extend the length of time that a person will experience symptoms. It could range anywhere from three months to a year, and possibly longer even though it is rare. Although this isn't a lifelong condition, it can be a very lengthy period of time to be dealing with the symptoms that come with it. Symptoms can affect the individual with physical, cognitive, and emotional changes. A year is a long time to deal with headaches, irritability, states of confusion, and all the other changes that this syndrome brings. This can affect personal relationships, work, and school capabilities, making life increasingly more difficult for a year or until symptoms fade.

• Concussions at a young age: Some studies have shown that concussions suffered at a young age can potentially lead to longer lasting effects. Brain injuries that occur during the developmental years can have long-lasting neurocognitive changes, such as memory loss, personality changes, intense aggression, and lack of inhibition. Adults and children who have a concussion are two to three times more likely to have another concussion, so this puts younger children at risk for more brain injuries during their developmental stage.

An exam checking for lasting neurocognitive changes might include these steps:

• An assessment of concentration – This can include drills involving counting backwards or stating the months of the year in reverse.

• Memory test – The physician might ask them to recall specific words after a short period of time has passed.

• Extraocular movement test – Individuals with neurological damage will experience abnormal eye movements.

• Physical test – This part of the test should include an examination of cranial nerves and an assessment of the spine. The doctor might test for tenderness, spasms, and range of motion.

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Long-term impact on athletics: With each concussion that a person suffers, their risk of getting another brain injury increases. For a young athlete, this could have a significant impact on the future of their athletics. If an individual has already suffered multiple concussions, it could be dangerous for them to continue playing contact sports. In this situation, it is not the symptoms that are long-term, but rather the consequences that are long lasting. This could be a particular impact for somebody who might have had a promising future in sports, as their athletic career is cut short by concern for their safety.

Long-term impact on academics: For somebody who suffers from post-concussion syndrome or other lasting symptoms, schoolwork can be a difficult and straining task. Headaches and trouble focusing that lasts for a year can have a significant impact on a student's ability to concentrate in school and perform well. This can slow down the student's academic track and possibly affect them long-term. In order to remain on track, they may have to work with an advisor or someone from their school to design a plan that works for them and keeps their brain's health in mind.

Other long-term impacts: Apart from the three areas of life mentioned above, a concussion can have an impact in many ways. The emotional symptoms and changes can have a stressful impact on relationships, as aggression and depression can create tension between family members or friends. This can also have occupational impacts, as it can strain relationships between coworkers and employers. Other occupational impacts include loss of skillsets due to brain injury, temporary absence and loss of income while being on bedrest to recover, or trouble concentrating on work tasks due to concussion symptoms.

What are the costs? Depending on the range of severity of the injury and the treatment it requires, the cost of traumatic brain injuries over a lifetime can vary tremendously. A simple concussion won't bring on as much financial burden as a long-lasting traumatic brain injury condition like CTE. However, the impact of the costs can also depend on whether or not the individual has insurance to help with the burden. Since medical attention is usually a critical factor to diagnosing and recovering from severe traumatic brain injuries, it is often unavoidable in these cases. Here are the few of a costs that an individual might encounter, especially if they suffer from multiple concussions or more severe traumatic brain injuries:

Rehabilitation – This certainly isn't necessary for every single concussion patient, but it may be called for depending on the individual's ability to regain their language and physical capacities. Therapists can also help patients regain cognition, behavioral, emotional, social, and occupational skills that may have been lost or damaged due to injury.³ Rehabilitation could sometimes just mean occasional physical therapy sessions to ensure that all functions are restored properly and to the best of their ability. Others with a more severe or permanent injury might find physical therapy to be a routine part of their lifestyle. This financial decision will come down to whether or not that specific individual needs therapy or rehab to cope with symptoms or regain particular skills. By otherwise rejecting rehabilitation, an individual could face future consequences at work or in relationships where they have lost certain abilities or skills.

Higher unemployment rates – For individuals suffering from longer lasting symptoms of a brain injury, they face the struggle of higher unemployment rates that exists for people with brain injuries. This can significantly impact a family's economic situation and become a financial cost all in its own. If their occupational skills are impaired by the injury, their employer may have no choice but to let them go. It can be difficult to find work consequently, which can be a significant financial burden. Without a consistent job, the individual may have no way to cover the medical bills, let alone keep food on the table easily.

Costs for just one concussion – At the very basic level of concussion injury, consider that a patient has had only one mild traumatic brain injury and is going in to get it checked out. Even if their injury is as mild as it gets, they will still encounter some costs.

• First, if they choose to go to the emergency room to get it checked out, the cost for just a check-up there can be around $1,500.

• The doctor might suggest running some scans to make sure there isn't further damage, and they're left with running the risk or running the cost. A CT scan of the head can range around $1,200, although it varies from one location to the next. An MRI of the head is easily $1,000, and could be up to 5 times that depending on the severity of the condition they are checking for.

• Even if a patient has insurance, they could face high deductible rates, meaning they could potentially have to pay $2,000-$3,000 out-of-pocket before insurance would cover the rest.

Costs for more severe brain injuries - Rehabilitation is often a key factor in caring for an individual with severe traumatic brain injury. There are different facilities and programs that may offer different prices for therapy, but here are some general prices to give an idea of what the costs might look like:

• A post-acute rehabilitation program could cost around $450,000, and this is only for a short period following the injury. It's not even considering the long-term needs of the patient, which should also be factored in to costs.⁴

• The annual living cost for supervised home placement could be around $50,000 and the annual living cost for a behavioral group home placement could be around $85,000. Depending on the needs of the individual, one of these living situations could be more suitable.

• A lifetime of tests and therapy can add up to over a million dollars in the long run, if an individual's symptoms persist. From all of the doctor's visits to the treatment programs, the costs accumulate rapidly. If the individual is unable to work due to the severity of the issue, then this can put a huge financial strain on the family members that are left to cover the costs.

• Increase awareness – The first step is to increase awareness of the prevention and treatment for traumatic brain injuries.

• Promote funding for research – In order to research better traumatic brain injury treatments, funding needs to be promoted. More funds can be accumulated if awareness is raised and improved research is promoted.

• Put the research to use – Once funds for research have been raised, steps should be taken towards implementing new methods that are low-cost and finding alternatives for families who simply can't pay the high costs.