A concussion is a mild traumatic brain injury (mTBI) that results from a blow or jolt to the head or body, causing the brain to move rapidly within the skull. This sudden movement can temporarily disrupt normal brain function, leading to a range of physical, cognitive, and emotional symptoms. While concussions are generally not life-threatening, they should never be dismissed as a minor bump. Following any suspected head injury, seeking a professional medical evaluation is necessary to rule out more severe injuries and to establish an appropriate management plan for recovery.
Immediate Care Settings for Acute Symptoms
Immediate evaluation following a suspected head injury requires a trip to an emergency department (ER) or an urgent care center. The ER is the appropriate destination when experiencing “red flag” symptoms that may indicate a more severe traumatic brain injury or internal bleeding. Warning signs include loss of consciousness lasting longer than 30 seconds, persistent or worsening headache, repeated vomiting or nausea, or the onset of seizures. Other severe signs are slurred speech, significant confusion, weakness or numbness in the limbs, or pupils of unequal size.
Urgent care centers offer a suitable alternative for individuals who are symptomatic but stable and lack severe red flag signs. This setting provides prompt assessment for symptoms like a mild headache, dizziness, or brief confusion, especially if the person did not lose consciousness or experience rapid symptom deterioration. Both the ER and urgent care focus on initial triage, stabilization, and ruling out acute structural brain injuries. This often involves neurological exams and potentially a CT scan if warranted.
Non-Emergency Primary and Specialty Providers
For stable symptoms not requiring emergency intervention, a primary care physician (PCP), pediatrician, or family doctor is the first point of contact for diagnosis and monitoring. These providers use standardized assessment tools to evaluate symptoms, cognitive function, and balance. They provide initial advice on physical and cognitive rest, manage symptoms, and create a return-to-school or return-to-work strategy.
If recovery is delayed or if the patient has a history of prior concussions, the PCP may refer them to a medical specialist. Sports medicine physicians and neurologists are often involved, especially for athletes or those with complex symptom profiles. A neurologist addresses specific neurological concerns, while a sports medicine physician specializes in the safe return to physical activity and competition. This evaluation establishes a baseline of post-injury function for comparison throughout recovery.
Comprehensive Concussion Clinics and Rehabilitation Centers
For patients whose symptoms persist or who exhibit complex symptom clusters, specialized concussion clinics offer multidisciplinary, targeted care. These centers move beyond general rest recommendations by identifying the specific root causes of persistent symptoms, which may involve the vestibular, ocular, or cardiovascular systems. They employ a team approach, often including physical therapists, occupational therapists, and neuropsychologists, to create a holistic treatment plan.
Specialized services frequently include:
- Neurocognitive testing, such as the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), to objectively measure deficits in memory, reaction time, and processing speed.
- Vestibular therapy for dizziness and balance issues.
- Vision therapy to address visual disturbances and eye-tracking problems common after a concussion.
- Graded exertion assessments to determine a safe return to activity by monitoring heart rate and symptom provocation.
Initial Screening in School and Athletic Environments
Immediate assessment and safety protocols are often first implemented by non-physician personnel in settings like sports fields or school hallways. Certified Athletic Trainers (ATCs) are trained to conduct on-site evaluations using tools like the Sport Concussion Assessment Tool (SCAT) to identify a suspected injury. Their primary function is to immediately remove an athlete from play if a concussion is suspected, preventing the risk of a “second impact” injury.
School nurses and other trained staff play a crucial role in identifying symptoms in non-athletic settings, such as during class or recess. They monitor for signs like confusion, difficulty concentrating, or a dazed appearance and ensure the student is safely removed from cognitive demands. These initial screenings are not a medical diagnosis; they are a protocol to identify the need for a formal evaluation by a licensed healthcare provider. Staff then facilitates the referral for medical clearance before the student returns to full academic or physical activity.