A concussion is a mild traumatic brain injury (mTBI) caused by a bump, blow, or jolt to the head or body, which causes the brain to move rapidly inside the skull. This sudden movement creates temporary chemical changes and disrupts normal brain function. While most concussions are not life-threatening, medical evaluation is necessary for proper diagnosis and monitoring, as symptoms can be delayed or subtle. Determining the right doctor depends on the severity of initial symptoms and the persistence of resulting functional deficits.
Acute Care Triage
The first step after any suspected head injury involves a quick assessment to rule out severe, life-threatening complications like brain bleeding or swelling. Certain “red flag” symptoms necessitate an immediate visit to the Emergency Room (ER) or a call to 911. These urgent signs include a headache that worsens, repeated vomiting, or any sign of a seizure or convulsion.
Other symptoms that warrant emergency attention are significant drowsiness, an inability to be awakened, slurred speech, or a noticeable difference in pupil size. Loss of consciousness, even if brief, or increasing confusion and agitation are also indicators for immediate emergency care. The primary goal in the ER is to perform advanced imaging, like a CT scan, to ensure there is no skull fracture or internal hemorrhage.
For individuals with non-life-threatening symptoms, a Primary Care Physician (PCP) or an Urgent Care center is an appropriate starting point. These settings are equipped to perform an initial neurological examination and formalize a concussion diagnosis based on reported symptoms and mechanism of injury. An Urgent Care doctor can screen for red flags and provide guidance on initial rest and symptom tracking, serving as a less expensive alternative to the ER for mild cases. The provider will then coordinate necessary follow-up care and monitor the patient’s recovery progression.
Advanced Medical Management
When concussion symptoms persist beyond the typical recovery window of a few weeks, specialized medical doctors manage the complex condition often called Post-Concussion Syndrome. Neurologists specialize in disorders of the nervous system and are consulted for complicated neurological symptoms, such as severe, lingering headaches. They conduct comprehensive examinations of motor skills, coordination, and reflexes to diagnose the extent of the functional impairment.
A Physiatrist, or a doctor of Physical Medicine and Rehabilitation, specializes in nonsurgical treatment of brain, bone, and muscle disabilities. They are excellent overseers of the recovery process. Physiatrists are instrumental in managing return-to-play or return-to-work protocols and prescribing initial targeted therapies, particularly for issues involving the vestibular system. These specialists focus on functional deficits that impair daily life and often work with therapists to create a coordinated treatment plan.
Symptom-Specific Rehabilitation
Active recovery often requires a team of non-physician specialists and therapists who address specific symptoms that interfere with function. Vestibular and Physical Therapists specialize in treating issues related to balance, dizziness, and motion sensitivity. They use targeted exercises, such as gaze stabilization, to retrain the brain to process sensory information correctly and reduce symptoms like vertigo. Physical therapists with specialized training can also address associated neck pain and cervicogenic headaches that frequently occur after a concussion.
Persistent visual disturbances, such as blurred or double vision, often require evaluation by an Ocular or Vision Therapist, typically a neuro-optometrist. These professionals address problems like convergence insufficiency through personalized vision therapy programs. Therapy involves exercises to improve eye tracking, focusing, and depth perception, which can alleviate symptoms like eye strain and light sensitivity. Untreated visual deficits can prolong recovery and impede participation in other rehabilitation therapies.
For assessment of thinking and memory problems, a Neuropsychologist is the appropriate specialist. They conduct extensive cognitive testing to evaluate processing speed, attention, and executive function, which are commonly affected by brain injury. The results guide academic and work accommodations and help determine the safe timing for returning to school or work activities. Recovery is frequently a multidisciplinary team effort, combining medical management and targeted rehabilitation to ensure the best possible functional outcome.