Concussion After a Blow to the Head: Symptoms, Rest and Warning Signs

What it involves

MedlinePlus describes a concussion as a type of brain injury involving a short loss of normal brain function. It happens when a hit to the head or body makes the head and brain move rapidly back and forth. It is sometimes called a mild brain injury, but MedlinePlus stresses that concussions can still be serious.

Who this is for

• Adults who hit their head in a fall, a car accident or a sport and feel dazed, dizzy or foggy
• Patients with a headache, nausea or ringing in the ears that started after an injury, even days later
• People still not feeling like themselves two or three weeks after a head injury
• Anyone who wants to know which symptoms mean going to the ER instead of waiting for an appointment

What to expect

• Questions about how the injury happened and what you remember before and after it
• A neurological exam that checks vision, balance, coordination and reflexes, plus a look at memory and thinking
• A referral for a CT scan or MRI when symptoms are worrisome, since scans check for bleeding, inflammation or a skull fracture
• A plan for rest, a gradual return to normal activity and follow-up visits

Symptoms, including late ones

MedlinePlus says symptoms may not start right away and can begin days or weeks after the injury. They include a headache or neck pain, nausea, ringing in the ears, dizziness, tiredness and feeling dazed or not your normal self for several days or weeks. Mild injuries do not always cause a blackout. The encyclopedia notes that most people never pass out, that some see all white, all black or stars, and that a person can have a mild brain injury and not realize it. Flashing lights, light sensitivity, memory loss around the injury and sleep changes are also listed.

Warning signs that mean the ER

MedlinePlus lists symptoms that call for prompt care: convulsions or seizures, drowsiness or an inability to wake up, a headache that gets worse and does not go away, weakness, numbness or decreased coordination, repeated vomiting or nausea, confusion, slurred speech and loss of consciousness. The encyclopedia adds pupils of unequal size, symptoms in just one eye, unusual eye movements and confusion that does not go away. Head injuries often come with neck or spine injuries, so take special care moving someone who is hurt.

How a head injury is examined

A provider asks about the injury, examines you and usually does a neurological exam of vision, balance, coordination and reflexes, and may evaluate memory and thinking. In some cases a CT scan or MRI looks for bleeding, inflammation or a skull fracture. Serenity By A Dr. Sareen does not list brain imaging among its in-office services, so a scan is arranged by referral or at an emergency room. The dizziness guide and the headache and migraine guide describe two of the most common after-effects.

Why rest matters

MedlinePlus calls rest very important after a concussion because it helps the brain heal. At the start you may need to limit physical activity and activities that need a lot of concentration, such as studying, computer work or video games, because they can bring symptoms back or make them worse. When your provider says it is okay, you return to normal activities slowly. The encyclopedia says both adults and children must follow their provider's instructions about when it will be possible to return to sports.

Recovery

Most people recover fully, but it can take days, weeks or months. During recovery the encyclopedia says you may be easily upset, have mood changes, have trouble with memory or concentration, mild headaches, less tolerance for noise, tiredness, dizziness or occasional blurry vision. In a small number of people symptoms do not go away, and the risk of long-term changes is higher after more than one brain injury. Contact your provider if symptoms are not improving after two or three weeks. The brain fog guide and the memory loss guide cover lingering thinking problems.

A visit or the ER

A head bump that left you with a headache, dizziness or foggy thinking but none of the warning signs above is a reason to book a visit, so the injury is examined and a recovery plan is set. Any warning sign is a reason to go to an emergency room. The sick visit, urgent care or ER guide explains how to decide where to go, and anyone who faints after an injury should read the fainting guide.

Sources

• MedlinePlus: Concussion (health topic)
• MedlinePlus: Traumatic brain injury (medical encyclopedia)