A concussion is a mild form of traumatic brain injury (TBI) that occurs when a bump, blow, or jolt to the head, or a rapid movement of the body, causes the brain to move quickly inside the skull. This sudden motion can temporarily disrupt the brain’s normal function, leading to a variety of symptoms that are often confusing to those affected. Making the correct decision about when and where to seek medical care is a critical first step toward a safe recovery. This guide outlines the different levels of concern regarding symptoms and the subsequent medical evaluation process.
Recognizing Common Concussion Symptoms
Symptoms following a head injury can manifest across physical, cognitive, and emotional domains, and they may appear immediately or develop hours to days later. A headache is the most frequently reported symptom, often accompanied by physical complaints such as dizziness, balance problems, or nausea. Some individuals also experience sensitivity to light or noise, blurred vision, or a feeling of being dazed or “not right”.
Cognitive changes are also typical and include difficulty concentrating, feeling mentally “foggy,” or having trouble remembering new information. People may notice their reaction time is slower or that they struggle with organization. Emotional or mood changes, such as increased irritability, anxiety, or sadness, can also signal a concussion.
Sleep disturbances are common, which may involve sleeping more or less than usual, or having trouble falling asleep. While these symptoms indicate a probable concussion and warrant an evaluation by a healthcare provider, they do not automatically require an emergency room visit if they are not rapidly worsening. The presence of any of these signs means all physical and cognitive activity should immediately stop to prevent further injury.
Emergency Signs Requiring Immediate Attention
Certain “red flag” symptoms can signal a more severe brain injury, such as bleeding or swelling, and require an immediate trip to the emergency room or a call to 911. The most concerning of these is any loss of consciousness, particularly if it lasts for more than a minute. A headache that becomes severe or progressively worse over time is a serious warning sign.
Repeated vomiting or persistent nausea is an indicator of increased pressure within the skull. Any sign of neurological deterioration, such as slurred speech, weakness, or numbness in the arms or legs, demands emergency care. Seizures or convulsions, which present as uncontrollable shaking, are also high-risk symptoms.
If an individual cannot be awakened from sleep, exhibits severe confusion, or displays unusual behavior like agitation or an inability to recognize people or places, seek emergency help right away. Other urgent signs include pupils of unequal size or clear fluid or blood draining from the ears or nose. These symptoms suggest a potential structural injury to the brain that requires rapid assessment and intervention.
What Happens During a Medical Evaluation
A medical evaluation begins with the healthcare professional gathering a detailed history of the injury, including the mechanism of impact and the timeline of symptoms. The doctor will perform a neurological exam to check basic functions, including vision, hearing, strength, sensation, balance, and coordination. This exam helps determine if there is any focal deficit that might suggest a specific area of the brain is affected.
Cognitive testing is a standard part of the assessment, where the provider evaluates memory, concentration, and ability to recall information. These tests often involve answering questions about orientation or repeating a series of words or numbers. The diagnosis of a concussion is primarily a clinical one, based on the patient’s reported symptoms and the findings from the physical and cognitive exams.
Brain imaging, such as a Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI), is not typically used to diagnose a concussion itself. A concussion involves microscopic chemical changes that are not visible on standard imaging. Imaging is reserved for cases where severe “red flag” symptoms are present to rule out structural injuries like skull fractures, brain bleeds, or significant swelling. A CT scan is generally the first choice for acute trauma because it is fast and effective at identifying internal bleeding.
Guidelines for Recovery and Return to Activity
Recovery from a concussion requires patience and a structured, gradual return to normal life. The initial management involves a short period of rest, typically 24 to 48 hours, encompassing both physical and cognitive activities. During this time, activities that increase symptoms, such as screen time, complex tasks, or strenuous exercise, should be limited.
Following this initial rest, the focus shifts to a gradual return to activities, ensuring that symptoms do not worsen. A stepwise approach is used for returning to school, work, and sports, with each stage lasting a minimum of 24 hours. If any activity causes symptoms to return or intensify, the individual must drop back to the previous, tolerated stage of activity.
For athletes, this progression involves moving from light aerobic activity to sport-specific exercise, then to non-contact training, and finally to full-contact practice, only proceeding with medical clearance. Monitoring for post-concussion syndrome is important, as this involves symptoms that persist for weeks or months beyond the expected recovery time. A healthcare provider’s guidance throughout this process is necessary to ensure a safe and complete recovery before returning to full activity.