A concussion is a mild form of traumatic brain injury (TBI) resulting from a blow or jolt to the head or body, causing the brain to move rapidly inside the skull. This mechanical force temporarily disrupts the brain’s normal chemical and functional processes, resulting in physical, cognitive, and emotional symptoms. While the term “mild” refers to the injury’s severity, the consequences can be significant. Initial care typically begins with an emergency room visit or a primary care physician. Most people recover fully within a few days to two weeks, but the decision to consult a neurology specialist depends on the nature and duration of symptoms. Knowing when to seek urgent care versus specialist follow-up is important for proper management and recovery.
Acute Symptoms Warranting Immediate Consultation
Symptoms immediately following a head injury suggest a more severe issue, such as a brain hemorrhage or swelling, requiring emergency medical attention. These necessitate an immediate trip to the emergency room, not a scheduled appointment with a neurologist. Urgent warning signs include a severe or worsening headache that does not improve with rest, repeated vomiting, seizures or convulsions, and slurred speech. Other signs include being unable to wake up, increasing confusion, or becoming progressively drowsy and unresponsive. Immediate medical evaluation is necessary if a person experiences new weakness or numbness in their limbs, or if their pupils are noticeably unequal in size. These indicate structural damage that needs urgent imaging and intervention.
When Persistent Symptoms Require Specialist Follow-Up
Most concussions resolve completely within 10 to 14 days for adults. Symptoms that linger beyond this expected recovery window, persisting for weeks or months, suggest the development of persistent post-concussive symptoms. At this stage, a neurologist or concussion specialist is the appropriate next step for comprehensive evaluation and management. Persistent symptoms requiring specialist referral include:
- Chronic headaches or migraines that do not respond to typical over-the-counter medication.
- Cognitive issues, such as a persistent “foggy” feeling, difficulty concentrating, or problems with short-term memory.
- Ongoing balance problems, dizziness, or a heightened sensitivity to light and noise.
- Disturbances in sleep patterns, such as insomnia or excessive daytime sleepiness, and notable mood changes like increased irritability, anxiety, or sadness.
A neurologist helps rule out other possible causes and establishes a structured plan for recovery. Patients with pre-existing conditions like migraines, ADHD, or mood disorders may benefit from an earlier neurological evaluation.
Tools and Strategies Used by Neurologists
A neurological consultation for a persistent concussion begins with a detailed clinical history, focusing on the injury event and the evolution of symptoms. The neurologist performs a comprehensive neurological examination to objectively assess various brain functions. This exam typically includes checking balance, reflexes, coordination, eye movements, and cognitive function to identify specific areas of impairment. Advanced imaging, such as a CT scan or MRI, is primarily utilized to rule out structural injuries like bleeding or a tumor, rather than to diagnose the concussion itself. A concussion is a functional injury, meaning standard imaging often appears normal, but the scans are important to exclude more severe conditions. The neurologist’s treatment strategy focuses on targeted rehabilitation and symptom management. Treatment plans involve structured rest followed by a gradual return to activity, guided by symptom tolerance. Neurologists frequently provide referrals for specialized therapies, such as vestibular therapy for dizziness and balance issues, or cognitive therapy for concentration and memory problems. They may also manage symptoms through prescription medication for persistent headaches or sleep disturbances.