Concussion (Mild Traumatic Brain Injury)

Overview

A concussion is a type of mild traumatic brain injury (mTBI) caused by a sudden blow, jolt, or shaking of the head that disrupts normal brain function. The brain moves within the skull, leading to temporary neurological changes without necessarily causing structural damage visible on standard imaging studies.^[1][2] Most concussions resolve within a few weeks, but some individuals experience persistent symptoms (post‑concussion syndrome).

Symptoms Checklist

Symptoms may appear immediately or develop over hours to days. Use the checklist below to monitor yourself or someone else after a head injury.

• Headache (new or worsening)
• Dizziness or loss of balance
• Nausea or vomiting
• Blurred or double vision
• Sensitivity to light or noise
• Feeling “foggy,” confused, or having trouble concentrating
• Memory problems (especially for events just before/after the injury)
• Sleep disturbances (insomnia or excessive sleepiness)
• Emotional changes (irritability, sadness, anxiety)
• Ringing in the ears (tinnitus)
• Loss of consciousness (even brief)

Note: Not all symptoms need to be present, and some may be subtle.^[3]

Risk Factors

• Age: Adolescents and young adults (15‑24 yr) have the highest incidence due to sports and recreational activities.
• Gender: Males are slightly more likely to sustain a concussion, though females may experience more severe or prolonged symptoms.
• Previous concussion: History of prior concussions increases susceptibility and may lengthen recovery.
• Contact sports: Football, soccer, rugby, ice hockey, lacrosse, and wrestling.
• Occupational hazards: Military service, construction, law‑enforcement, and other jobs with fall or blast risk.
• Alcohol or drug use: Impairs protective reflexes and may increase injury severity.

Diagnosis

Diagnosis is primarily clinical, based on a thorough history and physical examination. The following tools are commonly used:

1. Glasgow Coma Scale (GCS): Assesses level of consciousness; most concussions score 13‑15.
2. Sideline/Office Assessment Tools:
   • SCAT‑5 (Sport Concussion Assessment Tool – 5th edition)
   • Child SCAT5 for athletes < 12 yr
   • ImPACT (Immediate Post‑Concussion Assessment and Cognitive Testing)
3. Neurological exam: Checks pupil response, cranial nerves, motor strength, coordination, and gait.
4. Imaging (when indicated):
   • CT scan – to rule out intracranial hemorrhage if red‑flag symptoms are present.
   • MRI – rarely needed for uncomplicated concussion but may be ordered for persistent symptoms.

Red‑flag signs that prompt immediate imaging include worsening headache, vomiting, seizures, focal neurological deficits, or a decreasing level of consciousness.^[4][5]

Treatment Options

Medical Management

• Observation: Most patients are observed for 24‑48 hours for symptom progression.
• Pain control: Acetaminophen is preferred; avoid NSAIDs (e.g., ibuprofen) in the first 24 hrs if intracranial bleed is a concern.
• Medication for specific symptoms: Antiemetics for nausea, sleep aids (short‑term) for insomnia, or vestibular therapy for dizziness.
• Neuropsychological evaluation: For persistent cognitive complaints.

Home & Self‑Care Strategies

• Physical and cognitive rest for 24‑48 hrs (limit screen time, reading, and strenuous activity).
• Gradual return to light activity as symptoms improve (often called “stepwise return-to-play” or “return-to-learn”).
• Stay hydrated and maintain a regular sleep schedule.
• Avoid alcohol, drugs, and activities with a high risk of re‑injury until cleared.

Prevention

• Protective equipment: Properly fitted helmets for cycling, skiing, skateboarding, and contact sports.
• Rule enforcement: Adherence to sport‑specific concussion protocols and safe‑play rules.
• Strength & conditioning: Neck‑strengthening exercises can reduce head acceleration during impacts.
• Education: Teaching athletes, coaches, parents, and workers to recognize concussion signs and to report them promptly.
• Environmental safety: Use of non‑slip flooring, handrails, and fall‑prevention measures at home and workplace.

Living With Concussion (Mild Traumatic Brain Injury)

Even after the acute phase, many people benefit from strategies that support recovery and prevent setbacks.

• Gradual return‑to‑learn: Start with short, low‑intensity study sessions; increase duration as tolerated.
• Vestibular & balance therapy: Physical therapist‑guided exercises can speed resolution of dizziness.
• Cognitive pacing: Break tasks into 10‑15 minute blocks with frequent breaks.
• Stress management: Mindfulness, breathing exercises, and gentle yoga can help with mood changes.
• Follow‑up appointments: Keep scheduled visits with your primary care provider or concussion specialist.
• Support network: Communicate with family, teachers, or employers about needed accommodations.

When to Seek Emergency Care

Call 911 or go to the nearest emergency department if any of the following occur after a head injury:

• Loss of consciousness lasting > 30 seconds or a seizure.
• Worsening or severe headache that does not improve with medication.
• Repeated vomiting or nausea.
• Clear fluid or blood draining from the ears or nose.
• Increasing confusion, agitation, or slurred speech.
• Weakness, numbness, or loss of coordination in arms or legs.
• Unequal pupil size or abnormal eye movements.
• Any symptom that rapidly worsens or is concerning to you or a caregiver.

Medical Disclaimer: This guide is for informational purposes only and does not substitute professional medical advice, diagnosis, or treatment. Always consult a qualified health‑care provider for personalized care. The content reflects current knowledge as of 2026 and may not include the latest research.

References

1. Mayo Clinic. Concussion. https://www.mayoclinic.org/diseases-conditions/concussion/
2. Centers for Disease Control and Prevention (CDC). Traumatic Brain Injury. https://www.cdc.gov/traumaticbraininjury/
3. National Institutes of Health (NIH). Concussion. https://www.ninds.nih.gov/Disorders/All-Disorders/Concussion-Information-Page
4. Cleveland Clinic. When to Seek Emergency Care for a Concussion. https://my.clevelandclinic.org/health/diseases/17271-concussion
5. Johns Hopkins Medicine. Concussion Diagnosis and Management. https://www.hopkinsmedicine.org/health/conditions-and-diseases/concussion