A concussion is medically defined as a mild traumatic brain injury (mTBI), caused by a jolt, blow, or bump to the head or body that makes the brain move rapidly within the skull. This physical event temporarily disrupts the brain’s normal neurological function, leading to a cascade of chemical changes. Although classified as “mild” because the effects are typically short-lived and recovery is expected, all brain injuries demand immediate attention. The actions taken in the initial 24 to 48 hours following the event are crucial and significantly influence the speed and completeness of recovery.
Prioritize Professional Medical Evaluation
The first and most critical action is obtaining a professional medical assessment, which should occur within the first 24 hours of a suspected injury. A trained healthcare clinician must diagnose the injury and, more importantly, rule out more severe and life-threatening conditions. The immediate concern is to exclude structural brain injuries, such as an intracranial hematoma, which is bleeding within the skull that can place dangerous pressure on brain tissue.
A medical evaluation will typically include a detailed neurological exam and cognitive testing to check memory and concentration. Imaging tests, like a computerized tomography (CT) scan, may be ordered to definitively check for signs of bleeding or swelling in the brain, especially if “red flag” symptoms are present. Even if symptoms appear mild or resolve quickly, a professional diagnosis provides a safe foundation for the rest of the recovery process.
Implementing Immediate Physical and Cognitive Rest
The second and third actions focus on giving the injured brain the rest it needs, which is divided into physical and cognitive components in the first one to two days. This acute period requires a state of “relative rest,” meaning you should not be completely isolated in a dark room, but all strenuous activity must cease.
Absolute Physical Rest
Physical rest involves strictly avoiding any activity that increases heart rate or blood flow to the brain, which can worsen symptoms and delay recovery. This includes sports, heavy lifting, and any vigorous activity that could cause the head to be jostled. Even quick head movements, such as those that occur during cleaning or rough play, should be minimized in the immediate aftermath of the injury. Early light physical activity, such as walking, can be introduced after the first 48 hours as tolerated, but only if it does not significantly exacerbate symptoms.
Strict Cognitive Rest
Cognitive rest is equally important and means limiting the mental energy required to process stimuli. The brain needs a break from activities that demand concentration, memory, or complex thought. You must significantly reduce screen time on phones, computers, and televisions, as the light and mental processing required can overstimulate the recovering brain. Other mentally taxing tasks, such as reading a book, studying, engaging in intense conversations, or solving complex problems, should also be avoided.
Vigilant Symptom Monitoring and Safe Management
The final three actions involve actively monitoring your condition and safely managing common symptoms. Continuous monitoring for specific “red flag” symptoms is essential, as these indicate a potentially life-threatening complication, such as a worsening bleed or swelling.
Monitoring for Red Flag Symptoms
If a person experiences a headache that steadily worsens, repeated vomiting, slurred speech, or weakness/numbness in the limbs, they require an immediate return to the emergency room. Unequal pupil size, seizures, or an inability to be awakened from sleep are also urgent warning signs that necessitate emergency medical care. These signs often point to pressure building inside the skull and cannot be ignored.
Safe Pain Management
Post-concussion headaches are common, and you should use acetaminophen, commonly known as Tylenol, as directed for relief. It is absolutely necessary to strictly avoid nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), and aspirin in the initial 48 hours. These medications can interfere with blood clotting and pose a risk of increasing or worsening any potential internal bleeding following the injury.
Prioritizing Sleep and Rest
The final action is to prioritize sleep, which is when the brain performs much of its repair work. Contrary to older beliefs, it is safe and highly beneficial for a person with a concussion to sleep, provided a medical professional has cleared them of any severe injury. Sleep is a restorative state that allows the brain to heal without the demands of wakefulness. A responsible adult should remain with the person for the first night, performing periodic checks to ensure they can be easily awakened and are not showing any of the dangerous red flag symptoms. Simple sleep hygiene practices, like avoiding stimulating activities and bright light close to bedtime, support the healing process.