A concussion is a mild traumatic brain injury (mTBI) that occurs when a jolt or blow to the head or body causes the brain to move rapidly inside the skull, temporarily disrupting normal brain function. This injury can lead to a variety of physical, cognitive, and emotional symptoms. Following any head impact, medical evaluation is necessary to assess the injury and rule out more severe injuries, even if symptoms appear mild or do not surface immediately.
Immediate Care: When to Go to the Emergency Room
The Emergency Room (ER) is the appropriate destination when specific “red flag” symptoms are present, as these signs may indicate a serious, life-threatening injury like a brain hemorrhage or skull fracture. These circumstances require immediate access to advanced diagnostic imaging, such as a CT scan, and specialized neurological assessments that are consistently available only in a hospital ER setting.
A person should go to the ER immediately if they experience a loss of consciousness lasting more than a few moments or if they have a severe headache that rapidly worsens and does not go away. Other serious signs include repeated vomiting, which is distinct from a single instance of nausea, and the onset of convulsions or seizures.
Immediate emergency care is also warranted for any changes in consciousness, such as significant drowsiness, the inability to be awakened, or increasing confusion, agitation, or slurred speech. Physical signs like weakness or numbness in the limbs, unequal pupil size, or clear fluid draining from the ears or nose also indicate a potentially severe injury requiring urgent, high-level intervention.
Deciding Between Urgent Care and Primary Care
For suspected concussions without any red flag symptoms, the decision often lies between an Urgent Care center or a Primary Care Physician (PCP). Urgent Care is well-suited for timely evaluation, typically within the first 24 to 48 hours, when the injury is acute but stable and a PCP is unavailable. These centers are equipped to perform basic neurological exams, assess cognitive function, and screen for severe symptoms.
Urgent Care provides a faster, more cost-effective option than the ER for non-life-threatening symptoms such as mild headache, temporary dizziness, or sensitivity to light. While they can provide an initial diagnosis and management plan, their focus is generally on acute stabilization and ruling out emergencies, and they may not have the capacity for extensive follow-up care.
A Primary Care Physician is an appropriate choice if the symptoms are mild, stable, and the injury occurred a few days prior. The PCP can offer an assessment within the context of the patient’s full medical history and establish a foundation for ongoing monitoring. If a patient needs immediate care and their PCP cannot offer a prompt appointment, Urgent Care serves as an effective bridge for initial assessment and care.
Specialized Evaluation and Long-Term Management
After the initial diagnosis in an acute setting, specialized care may be necessary if symptoms persist beyond the expected recovery time of a few weeks. This specialized evaluation focuses on persistent symptoms after concussion. Symptoms lasting longer than four weeks often warrant a referral to a dedicated concussion clinic or a specialist.
These specialized facilities often involve a multidisciplinary team approach to address complex and varied symptoms. A neurologist or a sports medicine physician specializing in brain injuries may oversee the overall management plan. The team may include:
- Physical therapists, who provide cervicovestibular therapy for issues like neck pain, balance, and dizziness.
- Neuro-optometrists, who can address vision problems.
- Psychologists or psychiatrists trained in concussion care, who help manage emotional and cognitive changes like anxiety and memory issues.