A head injury can cause anxiety and uncertainty, as symptoms vary widely and make it difficult to determine severity. Any event causing concern for a concussion, even a mild one, requires professional medical evaluation to ensure your safety and proper recovery. This information is intended only as a guide to help you understand the potential severity of your situation and is not a substitute for a doctor’s diagnosis or medical advice.
Defining Concussion: Mechanism and Misconceptions
A concussion is a form of mild traumatic brain injury (mTBI) that temporarily affects how the brain functions. It is caused by a bump, blow, or jolt to the head or body, resulting in the rapid movement of the brain inside the skull. This movement causes brain tissue to stretch and twist, triggering a complex cascade of chemical changes within the nerve cells. The resulting disturbance is generally functional, meaning it affects the brain’s processes rather than causing structural damage visible on standard imaging like CT or MRI scans, which are primarily used to rule out more severe injuries.
A common misconception is that a person must lose consciousness to sustain a concussion; only a small percentage of cases involve this. Another misunderstanding is the belief that a concussion is a “bruise” to the brain; instead, it is a disturbance of function related to the stretching of long nerve pathways called axons. A concussion can occur even without a direct blow to the head, such as from a whiplash injury that causes the brain to accelerate and decelerate rapidly.
Symptom Assessment: What to Look For
Concussion symptoms are widely varied and fall into physical, cognitive, and emotional/sleep-related groups. These categories help organize the diverse ways a brain injury can manifest.
Physical Symptoms
Physical symptoms often include a headache or feeling of pressure in the head, nausea, and sometimes vomiting. Other common signs are:
- Balance problems
- Dizziness
- Blurred or double vision
- Sensitivity to light and noise
Cognitive Symptoms
Cognitive symptoms affect thinking and often manifest as feeling “in a fog” or slowed down. You might experience trouble concentrating, difficulty with short-term memory, or problems retaining new information. A person may also appear dazed or confused, or repeatedly ask the same questions due to temporary amnesia.
Emotional and Sleep Symptoms
Emotional symptoms include irritability, anxiety, or feeling more emotional than usual. Changes in sleep patterns are also possible, such as sleeping much more than normal or having difficulty falling or staying asleep. Symptoms do not always appear immediately; they can be delayed, emerging hours or even days after the initial injury.
Urgent Warning Signs Requiring Immediate Care
While many concussion symptoms are temporary, certain signs indicate a potentially dangerous situation requiring immediate emergency medical attention. These urgent warning signs, often called “Red Flags,” suggest a more severe injury such as an intracranial hematoma or brain bleed. You should call emergency services or go to the nearest emergency room immediately if any of these signs are present:
- A severe or continuously worsening headache, especially if accompanied by repeated vomiting.
- Having a seizure or convulsions.
- Slurred speech, or noticeable weakness or numbness in the arms or legs.
- Any loss of consciousness, even brief, warrants an immediate evaluation.
- Changes in consciousness, such as inability to wake up, excessive drowsiness, or increasing confusion.
- Changes in the eyes, specifically pupils that are unequal in size or double vision.
These symptoms are non-negotiable criteria for emergency action. Delays in treatment for internal bleeding or swelling can have serious consequences.
Next Steps After Injury and Recovery Guidance
Assuming no urgent warning signs are present, the immediate next step after a head injury is to seek a medical evaluation within 24 to 48 hours. Initial treatment involves a brief period of relative physical and cognitive rest, typically lasting 24 to 48 hours. This means avoiding strenuous physical activity, mentally taxing work, and limiting screen time to reduce symptom exacerbation.
During this period, it is advisable to have someone check on the injured person regularly to monitor for delayed or worsening symptoms. Current guidance recommends a gradual return to light-intensity physical activity, such as walking, as tolerated by symptoms, since prolonged complete rest can delay recovery.
Recovery should progress gradually, aiming to return to normal activities without causing symptoms to flare up. For those involved in sports, a structured, medically supervised “Return-to-Play” protocol is necessary, involving step-by-step increases in activity intensity. Medical clearance is mandatory before returning to full-contact activity.