How Do I Check for a Concussion?

Reviewed on 2/3/2022
Rendering of a male skeleton with a concussion
Concussion symptoms that require immediate medical attention include drowsiness or inability to wake up, severe or worsening headache that does not go away, one pupil larger than the other, convulsions or seizures, vomiting more than three times, weakness or numbness in part of the body, slurred speech, decreased coordination, difficulty walking or talking, changes in vision, loss of bladder or bowel control, unusual behavior (increased confusion, restlessness, or agitation), and loss of consciousness.

A concussion is a traumatic brain injury caused by bumps, blows, jolts, or impact to the head, or by hits to the body that causes the head and brain to move around quickly. 

Common causes of concussions include:

  • Motor vehicle accidents
  • Sports injuries or hits
  • Bicycling accidents
  • Falls
  • Beatings or other kinds of physical abuse

If any of the above happen to you or someone you know, you can check for a concussion by observing if certain symptoms occur. If you experience any kind of impact to the head or body and suspect you may have a concussion, it’s a good idea to be checked out by a doctor. 

Signs and symptoms of a concussion that can occur minutes to hours after injury may include:

  • Confusion
  • Headache
  • Dizziness 
  • Memory problems/memory loss 
  • Nausea or vomiting
  • Balance problems
  • Tiredness
  • Crankiness, irritability, or unusual behavior
  • Changes in day-to-day functioning
  • Eye pain and/or eye fatigue
  • Neck pain or stiffness
  • Dropping things
  • Bumping into things
  • Impaired depth perception (having difficulty seeing the distance between two items)

Signs and symptoms of a concussion that can occur hours to days after injury may include:

  • Changes in sleep patterns
  • Inattention
  • Mood or behavior changes
  • Problems walking or talking
  • Vision changes
  • Sensitivity to noise or light

If you suspect you may have a concussion, someone should stay with you for at least 24 hours to monitor you for new or worsening symptoms. 

A person with you should call a doctor right away if they notice dangerous signs and symptoms of a concussion such as:

  • Drowsiness or inability to wake up
  • Severe or worsening headache that does not go away
  • One pupil larger than the other
  • Convulsions or seizures
  • Vomiting more than 3 times
  • Weakness or numbness in part of the body
  • Slurred speech
  • Decreased coordination
  • Difficulty walking or talking
  • Changes in vision 
  • Loss of bladder or bowel control
  • Unusual behavior, increased confusion, restlessness, or agitation
  • Loss of consciousness, even briefly

How Is a Concussion Diagnosed?

A concussion is diagnosed with a patient history in which possible memory loss is assessed, neurological assessment, and mental status testing. 

A neurologic examination includes assessment of:

  • Nerve function
  • Limb strength 
  • Coordination 
  • Gait

Mental status testing may include assessment of: 

Other tools used to evaluate a concussion include: 

  • Standardized Assessment of Concussion (SAC) 
  • Post-Concussion Symptom Scale and Graded Symptom Checklist
  • Sport Concussion Assessment Tool (SCAT5) which includes 
  • Westmead post-traumatic amnesia scale (WPTAS) 

Imaging tests used to diagnose the extent of a head injury that can lead to a concussion include: 

SLIDESHOW

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What Is the Treatment for a Concussion?

A mild concussion may not need treatment. Most concussions will go away on their own over time. 

A mild concussion may last only hours to 7 to 10 days. More severe concussions may last weeks to months. Persistent symptoms are called “post-concussion syndrome.”

Home treatment for a mild concussion includes:

  • Rest the body and brain
    • Get plenty of sleep
    • Avoid activities that need concentration or a lot of attention 
    • Avoid too much physical activity 
  • Avoid alcohol while symptoms are still present
  • Over-the-counter (OTC) pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)

Post-concussion syndrome, also called persistent post-concussion symptoms, refers to symptoms of a concussion (traumatic brain injury) that last longer than the normal expected time frame for recovery.

Treatment for post-concussion syndrome may involve a combination of modalities. The goal of treatment is to relieve symptoms of post-concussion syndrome. 

Treatments endorsed by the 5th International Consensus on Concussion include: 

Individualized aerobic exercise program (also called graduated exercise therapy, or graded exercise therapy) for patients whose symptoms are associated with autonomic nervous system dysfunction (such as problems with blood pressure and breathing)

Physical therapy program in patients with neck (cervical spine) or vestibular dysfunction

Cognitive behavioral therapy (CBT) to learn to cope with chronic mood or behavioral issues

Additional treatments for post-concussion syndrome may include:

  • Vision therapy
  • Vestibular therapy 
  • Medications used to treat symptoms such as:
  • Light therapy (photobiomodulation) 
  • CBD/medical marijuana
  • Craniosacral therapy
  • Massage therapy
  • Hormone therapy 

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Reviewed on 2/3/2022
References
Image Source: iStock Images

https://www.uptodate.com/contents/concussion-in-adults-the-basics?search=concussion&source=search_result&selectedTitle=1~81&usage_type=default&display_rank=1

https://www.cdc.gov/headsup/basics/concussion_whatis.html

https://www.uptodate.com/contents/head-injury-in-children-and-adolescents-the-basics?search=concussion&source=search_result&selectedTitle=5~81&usage_type=default&display_rank=5

https://www.uwsp.edu/stuhealth/Documents/Other/Head%20Injury%20-%20Concussion.pdf

https://www.cdc.gov/concussion/headsup/clinicians/resource_center/complications_of_concussion.html

https://www.concussionalliance.org/treatments

https://www.hackensackmeridianhealth.org/en/HealthU/2021/07/14/how-to-test-if-you-have-a-concussion