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Activities to Avoid After a Concussion

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Approximately 80 percent of concussions resolve over seven to 14 days, with an average of 10 days. It's what you do, or don't do, in those days that impact your recovery process.

The recovery from concussion in children generally occurs over a longer time period than in adults. On an average, concussed high school athletes take twice as long to recover (10 - 14 days) than college and professional athletes (3 - 7 days) and preadolescent children may take even longer to recover.

The activities to specifically avoid include:

  • watching television
  • using a computer/tablet
  • video gaming
  • listening to music on headphones
  • doing homework
  • using the telephone

Lori Sheridan, Concussion Health Awareness and Management Program (CHAMP) coordinator at Beaumont, explained that concussions, "temporarily interferes with the way your brain works and can affect memory, judgment, reflexes, speech, balance, coordination and sleep patterns."

While recovering, rest and time are the only proven remedies that work to heal concussion. While most concussed patients are able to return to school or work within 7 - 14 days, 15 percent may have symptoms lasting up to one year. Rest is especially important as cognitive demands can worsen symptoms or delay recovery. The first few days of recovery should not include technology, loud noises, bright lights

While your body may feel ready for social and physical activity, both should be avoided for the days immediately following a concussion diagnosis.

So, how do you know when you're fully recovered and ready to resume normal activities?

Sheridan said, "While a concussed person’s physical symptoms may subside, their brain’s cognitive ability to stay focused, comprehend, remember and make decisions may still be affected. This is why it’s necessary for both professional and student athletes to be cleared by a physician trained in concussion before returning to play."

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To diagnose a concussion, your healthcare professional evaluates your symptoms and reviews your medical history. You may need tests that help diagnose a concussion. Tests may include a neurological exam, cognitive testing and imaging tests.

Neurological exam

Your healthcare professional asks detailed questions about your injury and then performs a neurological exam. This evaluation includes checking your:

  • Strength and sensation.
  • Coordination.

Cognitive testing

Your healthcare professional may conduct several tests to evaluate your thinking skills, also known as cognitive skills. Testing may evaluate several factors, including your:

  • Concentration.
  • Ability to recall information.

Imaging tests

Brain imaging may be recommended for some people who have had a concussion. Imaging may be done in people with symptoms such as bad headaches, seizures, repeated vomiting or symptoms that are becoming worse. Imaging tests may determine whether the injury has caused bleeding or swelling in the skull.

A computerized tomography (CT) scan of the head is the standard test in adults to assess the brain right after injury. A CT scan uses a series of X-rays to obtain cross-sectional images of the skull and brain.

For children with a suspected concussion, CT scans are used only if specific criteria are met, such as the type of injury or signs of a skull fracture. This is to limit radiation exposure in young children.

Magnetic resonance imaging (MRI) may be used to identify changes in your brain or to diagnose complications that may occur after a concussion. An MRI uses powerful magnets and radio waves to produce detailed images of your brain.

Observation

After a diagnosis of a concussion, you or your child may need to be hospitalized overnight for observation.

Or your healthcare professional may agree that you or your child can be observed at home. Have someone stay with you and check on you for at least 24 hours to ensure that your symptoms aren't getting worse.

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There are steps you can take to help your brain heal and speed recovery.

Physical and mental rest

In the first couple of days after a concussion, relative rest allows your brain to recover. Healthcare professionals recommend that you physically and mentally rest during this time. However, complete rest, such as lying in a dark room without any stimuli, does not help recovery and is not recommended.

In the first 48 hours, limit activities that require a lot of concentration if those activities makes your symptoms worse. This includes playing video games, watching TV, doing schoolwork, reading, texting or using a computer.

Don't do physical activities that increase your symptoms. This may include general physical exertion, sports or any vigorous movements. Don't do these activities until they no longer provoke your symptoms.

After a period of relative rest, gradually increase daily activities if you can tolerate them without triggering symptoms. You can start both physical and mental activities at levels that do not cause a major worsening of symptoms.

Light exercise and physical activity as tolerated starting a couple of days after injury have been shown to speed recovery. Activities might include riding a stationary bike or light jogging. But don't engage in any activities that have a high risk of another head impact until you are fully recovered.

Your healthcare professional may recommend that you have shortened school days or workdays. You may need to take breaks during the day, or have modified or reduced school workloads or work assignments as you recover.

Your healthcare professional also may recommend different therapies. You may need rehabilitation for symptoms related to vision, balance, or thinking and memory.

Returning to routine activity

As your symptoms improve, you may gradually add more activities that involve thinking. You may do more schoolwork or work assignments, or increase your time spent at school or work.

Some physical activity can help speed brain recovery. Specific return to physical activity sport protocols may be suggested by your healthcare professional. These typically involve specific levels of physical activity to make sure you return to activity safely. Don't resume contact sports until you are symptom-free and cleared by your healthcare professional.

Pain relief

Headaches may occur in the days or weeks after a concussion. To manage pain, ask your healthcare professional if it's safe to take a pain reliever such as acetaminophen (Tylenol, others). Don't take other pain relievers such as ibuprofen (Advil, Motrin IB, others) and aspirin. These medicines may increase the risk of bleeding.

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Preparing for your appointment

It's important for anyone who has a head injury to be evaluated by a healthcare professional, even if emergency care isn't required.

If your child has received a head injury that concerns you, call your child's healthcare professional right away. Depending on the symptoms, your healthcare professional may recommend that your child get medical care right away.

Here's some information to help you get ready for and make the most of your medical appointment.

What you can do

  • Be aware of any pre-appointment restrictions or instructions. The most important thing for you to do while waiting for your appointment is not to do activities that cause or worsen symptoms. Don't play sports or do vigorous physical activities. Minimize stressful or prolonged mental tasks. At the time you make the appointment, ask what steps you or your child need to take to encourage recovery or prevent another injury. Experts recommend that athletes not return to play until they have been medically evaluated.
  • List any symptoms you or your child has been experiencing and how long they've been occurring.
  • List key medical information, such as other medical conditions for which you or your child is being treated. Include any history of head injuries. Also write down the names of any medicines, vitamins, supplements or other natural remedies you or your child is taking.
  • Take a family member or friend along. Sometimes it can be hard to remember all the information provided to you during an appointment. Someone who comes with you may recall something that you missed or forgot.
  • Write down questions to ask your healthcare professional.

For a concussion, some basic questions to ask include:

  • Do I have a concussion?
  • What kinds of tests are needed?
  • What treatment approach do you recommend?
  • How soon will symptoms begin to improve?
  • What is the risk of future concussions?
  • What is the risk of long-term complications?
  • When will it be safe to return to competitive sports?
  • When will it be safe to resume vigorous exercise?
  • Is it safe to return to school or work?
  • Is it safe to drive a car or operate power equipment?
  • I have other medical conditions. How can they be managed together?
  • Should I see a specialist? What will that cost, and will my insurance cover a visit to a specialist? You may need to call your insurance provider for some of these answers.
  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend?

In addition to the questions that you've prepared, don't hesitate to ask questions that come up during your appointment.

What to expect from your doctor

Being ready to answer your healthcare professional's questions may reserve time to go over any points you want to talk about in-depth.

You or your child should be prepared to answer the following questions about the injury and related symptoms:

  • Do you play contact sports?
  • How did you get this injury?
  • What symptoms did you experience immediately after the injury?
  • Do you remember what happened right before and after the injury?
  • Did you lose consciousness after the injury?
  • Did you have seizures?
  • Have you experienced nausea or vomiting since the injury?
  • Have you had a headache? How soon after the injury did it start?
  • Have you noticed any trouble with physical coordination since the injury?
  • Have you had any issues with memory or concentration since the injury?
  • Have you noticed any sensitivity or changes with your vision and hearing?
  • Have you had any mood changes, including irritability, anxiety or depression?
  • Have you felt sluggish or easily fatigued since the injury?
  • Are you having trouble sleeping or waking from sleep?
  • Have you noticed changes in your sense of smell or taste?
  • Do you have any dizziness?
  • What other symptoms are you concerned about?
  • Have you had any previous head injuries?

What you can do in the meantime

Before your appointment, don't do activities that increase your symptoms and risk another head injury. This includes not playing sports or activities that require vigorous movements.

Gradually resume your usual daily activities, including screen time, as you're able to tolerate them without worsening symptoms.

If you have a headache, acetaminophen (Tylenol, others) may ease the pain. Don't take other pain relievers such as aspirin or ibuprofen (Advil, Motrin IB, others) if you suspect you've had a concussion. These may increase the risk of bleeding.

  • Evans RW, et al. Acute mild traumatic brain injury (concussion) in adults. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2023.
  • Herring S, et al. Selected issues in sport-related concussion (SRC/mild traumatic brain injury) for the team physician: A consensus statement. British Journal of Sports Medicine. 2021; doi:10.1136/bjsports-2021-104235.
  • Mild TBI and concussion. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/concussion/index.html. Accessed Nov. 13, 2023.
  • Symptoms of mild TBI and concussion. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/concussion/symptoms.html. Accessed Nov. 13, 2023.
  • Lumba-Brown A, et al. Centers for Disease Control and Prevention guideline on the diagnosis and management of mild traumatic brain injury among children. JAMA Pediatrics. 2018; doi:10.1001/jamapediatrics.2018.2853.
  • Meehan WP, et al. Concussion in children and adolescents: Management. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2023.
  • Eapen BC, et al., eds. Concussion: Assessment, Management and Rehabilitation. Elsevier; 2020. https://www.clinicalkey.com. Accessed Nov. 13, 2023.
  • Patricios JS, et al. Consensus statement on concussion in sport: The 6th International Conference on Concussion in Sport – Amsterdam, October 2022. British Journal of Sports Medicine. 2023; doi:10.1136/bjsports-2023-106898.
  • Leddy JJ, et al. Management of concussion and persistent post-concussive symptoms for neurologists. Current Neurology and Neuroscience Reports. 2021; doi:10.1007/s11910-021-01160-9.
  • Leddy JJ, et al. Rest and exercise early after sport-related concussion: A systematic review and meta-analysis. British Journal of Sports Medicine. 2023; doi:10.1136/bjsports-2022-106676.
  • Silverberg ND, et al. The American Congress of Rehabilitation Medicine diagnostic criteria for mild traumatic brain injury. Archives of Physical Medicine and Rehabilitation. 2023; doi:10.1016/j.apmr.2023.03.036.
  • De Luigi AJ, et al. Consensus statement: An evidence-based review of exercise, rehabilitation, rest and return to activity protocols for the treatment of concussion and mild traumatic brain injury. PM&R. 2023; doi:10.1002/pmrj.13070.
  • Traumatic brain injury (TBI). National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury-tbi#. Accessed Nov. 13, 2023.
  • Winn HR, ed. Sport-related concussion. In: Youmans and Winn Neurological Surgery. 8th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed Nov. 13, 2023.
  • Meehan WP, et al. Concussion in children and adolescents: Clinical manifestations and diagnosis. https://www.uptodate.com/contents/search. Accessed Nov. 13, 2023.
  • Ferri FF. Postconcussion syndrome. In: Ferri's Clinical Advisor 2024. Elsevier; 2024. https://www.clinicalkey.com. Accessed Nov. 15, 2023.
  • Nonsteroidal anti-inflammatory agents. Facts & Comparisons eAnswers. https://fco.factsandcomparisons.com. Accessed Nov. 15, 2023.
  • Nauman EA, et al. Mitigating the consequences of subconcussive head injuries. Annual Review of Biomedical Engineering. 2020; doi:10.1146/annurev-bioeng-091219-053447.
  • Koerte IK, et al. Diffusion imaging of sport-related repetitive head impacts — A systematic review. Neuropsychology Reviews. 2023; doi:10.1007/s11065-022-09566-z.
  • Ami TR. Allscripts EPSi. Mayo Clinic. Nov. 14, 2023.
  • Traumatic brain injury and concussion: Prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/prevention.html. Accessed Nov. 15, 2023.
  • International Headache Society. The International Classification of Headache Disorders, 3rd ed. Cephalalgia. 2018; doi:10.1177/0333102417738202.
  • Driscoll SW (expert opinion). Mayo Clinic. Dec. 4, 2023.
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Post-Concussion Syndrome

12 ways to spend your time during a concussion.

can you do homework with a concussion

When I sustained a concussion, I stayed home for four months. My symptoms hindered my ability to go to school, exercise, play sports, go in the car, and read. However, throughout my concussion, I was able to and enjoyed doing the things below. Every concussion is different, but I hope some of the things on this list will help relieve your boredom or inspire other ideas for how to spend your time. I would like to thank all of my family and friends who introduced me to these different ideas that allowed me to improve my health and grow as a person. I would also like to especially thank my family for putting up with the hours of UNO, Texas Holdem and complaining.

1. Audiobooks

During the first month of my concussion, I was unable to do much of anything. Since reading books strained my eyes and head, I listened to the Harry Potter books . This was a good choice for me because I had already read them numerous times, so I could easily comprehend them.

2. Magic Sand

For the first month of my concussion, I had severe light and sound sensitivities, along with nausea, balance difficulties, and debilitating headaches. I slept for most of the day, listened to audiobooks, and played with kinetic sand (a lot). Playing with the magic sand was calming, and the texture was very stimulating to my concussed brain. I played with the sand throughout my recovery, whenever I needed to rest my brain and relax. I highly recommend it!

3. Listening to Music

I would listen to what my family would refer to as my “chill playlist,” which consisted of calm and quiet songs at a low volume. This helped calm me, especially when I was having a bad headache .

4. Silly Putty

Silly Putty was good for rebuilding my strength, and also proved to be soothing.

5. Podcasts

Following my concussion, my convergence insufficiency (double vision) became worse, so reading became difficult and caused severe headaches. As a result, I began listening to podcasts, including The Daily and Hidden Brain , because they were intellectually stimulating without causing headaches.

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In the second month following my concussion, I was able to use screens. I would watch TV shows that did not require too much focus, including “The Good Place,” “Hart of Dixie,” and “Master Chef Junior.” It took very little to entertain me.

7. Card Games

As I got better, and my energy level improved I would convince my family members to play games such as Texas Holdem , UNO and Scrabble . This required me to stay focused for long periods, and to practice thinking ahead.

8. Cooking/Baking

As I regained strength in my third and fourth months after my concussion, I was feeling well enough to start cooking and baking. It started with simply making my own breakfast, but later on, I would attempt to follow recipes and make more complex dishes. Doing activities that I would do prior to my concussion helped me feel more like myself, which was essential to me returning back to my normal lifestyle.

9. Mini Projects

About a month after my concussion, my brother wanted to create a youtube channel called, “Cooking with Parth.” The first and only video he made explained how to make pancakes, and I videotaped him. Now, this was not as simple as it may seem, as it took over 10 takes and a lot of pancake batter. One time, he forgot the butter, another I didn’t realize I never pressed record, but by the end, we had created a video explaining how to make a pancake. While this doesn’t seem like anything special, or extraordinary, it was. In order to do this, I had to have the coordination to videotape, to follow him around the kitchen, and to multitask. That day I made improvements; sure, it wasn’t standing on one foot, but it was a step in the right direction.

10. Arts and Crafts

I would draw and do coloring pages. This helped me rebuild my mind and body connections. It helped with the recovery of my eyes and my double vision. Most importantly, it made me happy, and whenever I would finish something, I would feel accomplished.

For my 11th birthday, my aunt and uncle had bought me a robot to build. However, I never had enough time to put it together. Now, I find myself with so much time that I do not know how to spend it. I decided to invite one of my friends from school to construct it with me. This was a great activity because I was doing it with someone else, and they could help me with the things I found to be challenging.

12. Escape Room

As I got better, I would invite one to two friends over to hangout. During this time we would do a board game version of the escape room . You would have an hour to escape the room and would open clues whenever the box beeped. This was perfect, because it felt like a normal social experience, without leaving my house and being in an environment that was overstimulating.

If you want for tips and tricks like this visit  calmingmystorm.com  or follow @calming.my.storm on Instagram. 

What activities helped you while recovering from a concussion?

We want to hear your story. Become a Mighty contributor .

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My name is Aanya Patel. I suffered a severe TBI in eighth grade, which has left me with migraines with auras, and post-concussion syndrome. My experience has inspired me to started Calming My Storm, a nonprofit organization, that works to support people with concussion and migraines through expert interviews and advice, educational resources, and personal narratives. Critical to our mission is bringing awareness and education to disparities around TBI in women specifically. For more information, visit calmingmystorm.com or follow our Instagram @calming.my.storm.

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Phoenix Concussion Recovery

Accommodations for school and work

Recommendations for school & work.

Research shows recovery is most efficient when patients learn to:

  • Manage the demands of their day
  • Avoid the negative impacts of isolation
  • Re-establish a consistent daily schedule with appropriate accommodations
  • Manage energy expenditure

Patients do better if they are able to decrease visual exertion early on post injury.  This includes homework, reading, and screen time.  Early accommodations for school can be very successful to get the student back to school and avoid the negative impacts of isolation.  For more information, reference the charts below on the Return to Learn Protocol .

For those returning to work, we often recommend part-time, low level / low risk work with periodic short breaks in a quiet environment away from screens and crowds.  Scroll down for more detailed information.

For those who cannot avoid the computer at work, set a timer every 30-60 minutes to take a break utilizing the following strategies:

  • Complete light stretching
  • Sit and take 5 deep breaths with eyes closed

Do your best to avoid screens whenever it is not essential.  Utilization of a blue light filter or blue blocker lenses may help you get through your work day.

Try alternating half days and days off to recover early on.  Progress to full days and half days alternating until you can finally return to work full time.  Your doctor will be crucial in your return to work as his or her recommendations will help support your specific needs in the workplace.

Scroll down to learn more about work, school and college accommodations!

Listen to our recent Podcast with Concussion Talk to have an audio review of possible accommodations!

School Accommodations

Research shows getting the kids in the building is the #1 priority.  We recommend 2-4 days of rest if needed but getting the kids back to school with accommodations to control symptoms ASAP.

  • Start with 1/2 days and progress to full days as tolerated.
  • Add essential homework in 30minute increments once the student is able to complete 1/2 days with limited symptoms and is ready to start the progression to full days.
  • WAIT for testing until the student is able to tolerate full days of school with limited rest / accommodations!  It is not reasonable to test a student who can barely tolerate being in the classroom!
  • Use incomplete, pass/fail grades vs letters, or allow the student to make up the work over school breaks / summer break.
  • Adding too much work back in too quickly will only increase the student’s stress and likely his/her symptoms .
  • Use sunglasses, brimmed hats, or blue light filters to decrease visual stress.
  • Use ear plugs to decrease sound.
  • Allow the student to put down his/her head or leave the classroom to sit in the hallway for 5-10mins when symptoms increase.
  • Allow the student to leave 5 mins early or late to avoid the hallways between classes.  These are times of the day that have the most noise and can be the most overwhelming to the concussed individual.
  • We often request 1-2 friends be allowed to join to avoid feelings of isolation!
  • Audio books – have access to textbooks / reading assignments on audio and read along or simply listen to decrease visual overload.
  • Front row – you can just get to class early, or have this as a written accommodation.  Sitting near the front will help with distractions.
  • NO – PE, Recess or Sports until you are cleared by your provider!  Check out our Return to Life & Sport exercise progression to help get you back to your favorite activities.  You do NOT need to be 100% in school to exercise but you DO need to be 100% in school to participate in sports!
  • Add blue blockers to the computer screen via a blue light filter (adhesive screen attachment or download a program to take over your computer monitor) or blue light lenses – we often recommend EyeKepper computer lenses from Amazon.

Work Accommodations

  • 5-15 minute breaks every hour
  • Use sick leave or vacation days for a few extra days of rest early on!  This often can make all the difference.
  • If your employer is accommodating – decrease shifts to 4-6 hours or alternate full and half days.
  • Add blue blockers to screen via a blue light filter (adhesive screen attachment or download a program to take over your computer monitor) or blue light lenses – we often recommend EyeKepper computer lenses from Amazon.
  • Use ear plugs/ear buds, a brimmed hat, or sunglasses to decrease the severity of light and noise in your environment.
  • If your injury is severe – explore your options for temporary or even long term disability with your provider.  Some individuals will require a change of their roles and responsibilities or a new field all together.  These decisions should not take place immediately and should handled between you, your family, and your providers.

College Accommodations - Long Term

If your goals include college, you have options to help yourself achieve success!  If you are currently enrolled and require early / temporary accommodations, please refer to our school accommodations.  This section is for those of you who may require permanent accommodations to successfully earn your degree.

  • Visit with your College/University’s Disability Resource Center .  They will have applications/forms for you and your providers to complete.  Portions of your medical record may be required depending on your situation.
  • Extra time – you can had time and a half or double time if approved by your school i.e., if the class has 60 minutes, you would receive 90 minutes to decrease the effects of stress and anxiety.
  • Quiet location – you can take your test at the Resource center or another location on campus as determined by your accommodations.  Perhaps you only require ear plugs and can successfully take your test in the classroom with the rest of the students – this may be coordinated between yourself and your professor.
  • Audio – you may be able to have your test read to you.  This can decrease the negative effects of reading.
  • Record lectures – you can audio record your lectures if approved by the professor or in your accommodations.  This will help with studying later and allow you to decrease the stress of keeping up in class!
  • Smart Pen – These are available through some Resource centers, grants, or for purchase through electronics stores.  A smart pen can record your writings to the computer electronically and can also record the teacher’s lecture through the device.  It can compile your written notes and the lecture into one document through the computer program.  These are an expensive but incredible option if needed!

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FOX and Friends

21 Simple Do’s and Don’ts After Suffering a Concussion

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After being diagnosed with a traumatic brain injury (TBI), it can be difficult to know what to do next. We’ve compiled a list of easy-to-remember tips on what to do and not to do during the recovery phase.

What You Should Do

Get plenty of rest and avoid strenuous activity. Instead, practice low energy output. The brain needs time to focus on healing itself, and it can only do that with plenty of relaxation and a calm environment.

Make sure to get a good night’s sleep and take naps throughout the day, if necessary. You should get at least eight hours of sleep each night. The darker and quieter the room, the better your sleep will be.

A proper diet and high-quality nutrition will play an important role in your TBI recovery. We’ve provided a guide on the amount and type of nutrients you need for a healthier lifestyle.

Make sure to drink lots of water. Approximately 60% of the human body consists of water. The brain and heart are 73% water. If these organs are dehydrated, it can cause many problems, including headaches, organ issues, joint pain, and much more. The better hydrated you are, the better your body can flush out the harmful toxins that have accumulated in the brain since the injury.

Resist the urge to look at your smartphone, tablet, laptop, or computer screen. Digital screens can cause strain on the eyes and the mind. If you need to look at your phone or want to play video games, take frequent breaks to rest your brain and turn off the devices if you start feeling any pain or symptoms.

Get help from family members or friends when you need it. They can help you remember what directions to follow, what appointments are coming up and assist with any tasks you struggle to complete on your own.

What You Shouldn’t Do

7. avoid high-risk activities that might result in another traumatic brain injury.

Suffering a second TBI on top of one that has not fully healed can be extremely dangerous. Second impact syndrome (SIS) occurs when two traumatic brain injuries (concussions) happen in a relatively short period, and the second concussion is inflicted before the first one has fully healed.

SIS can cause rapid and severe swelling, and the brain may lose its ability to self-regulate pressure and blood volume. As the brain swells, it can press against the skull resulting in decreased blood flow. When the blood flow is disrupted it can cause severe disability or even death.

8. Do not play sports or exercise.

Unless an activity has been approved by your treating physician it is better to wait until you have made a full recovery.

9. Do not drive unless it has been approved by the treating physician.

This is especially important if you have been prescribed any medication. If possible, you should take some time off of work or study until you feel better.

10. Avoid alcohol.

11. avoid caffeine..

Sometimes patients will want to use caffeine to eliminate the cognitive fatigue or “brain fog” that often comes with a TBI. Caffeine in small amounts may be safe after a TBI, but excessive caffeine consumption could slow down the recovery process. Caffeine is a vasoconstrictor, which means it constricts the blood vessels in the brain, reducing blood flow. Without enough cerebral blood flow, the brain cannot get the vital nutrients it needs to repair itself.

12. Avoid stimulants or energy drinks.

13. avoid junk food..

Instead, consume healthy, energy-rich foods. These include blueberries, bananas, broccoli, fatty fish, and nuts.

14. Avoid sugar, carbohydrates, and dairy products.

At a minimum, reduce their intake.

15. Avoid taking Ibuprofen or Tylenol.

Don't take other medications unless it is recommended by a doctor familiar with your condition.

16. Avoid stressful circumstances and over-stimulation of the mind.

Loud music, crowds, or lots of guests can overwhelm a TBI victim. Emotionally, you may have trouble processing events and conversations. Physically, you may not be able to process noises and sounds very well. Calm, quiet environments will allow your mind to relax and focus.

17. Avoid being on the computer or smartphone.

18. avoid being on social media sites., 19. avoid prolonged conversations on the phone., 20. don’t let your caregivers do everything for you..

This is tough, especially when you are struggling to complete a small task. But sometimes this struggle may be the key to your recovery. You may need to do these difficult things to help retrain your brain to work on problem-solving. Even if you’re slow to answer a question, your helpers should resist the urge to jump in and answer. Remind them that their priority is to support you, not do everything for you.

21. But also don’t overdo it.

Some symptoms may come and go throughout your recovery. Expect to have some good days and some bad days. Most concussion victims take several weeks before they feel back to “normal.” However, their return to normal activities may cause their symptoms to return. Please don’t strain or force yourself if an activity becomes too much to handle. Make sure to notify your treating physician regarding your current condition and any recurring symptoms.

Atlanta Brain Injury Lawyer

Gary Martin Hays & Associates specializes in traumatic brain injuries and concussions cases caused by auto accidents, work accidents, and negligence. We understand the devastating consequences injured victims face and can quickly get them in touch with neurologists and concussion specialists.

If you have questions about your case, give our Georgia personal injury lawyers a call today for a free evaluation.

Don’t delay. Any type of injury to the brain can have serious, long-term consequences. You deserve experienced and professional legal help if your TBI was caused by events outside of your control.

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10 Common Activities to Avoid When Recovering from a Concussion

It’s common knowledge that “rest” is the initial staple of the recovery process after a concussion to help your brain heal. However, there are additional restrictions that might not occur to you which we recommend at the Cantu Concussion Center . The following activities have a high potential for re-injury or an exacerbation in symptoms and should be restricted until the person has completely recovered from their concussion and all symptoms have fully resolved. It is especially important for parents of a concussed child to make sure these restrictions are adhered to.

1. Standing in high places (ladders, roofs, furniture, beds, chairs, ski lifts, towers, cliffs, ledges). Often following a concussion, a person can experience dizziness — sometimes without warning — that can be triggered with head or eye movement.

2. Being in an area where objects are thrown. This would include sporting events where there are Frisbees, soccer balls, etc. This could also occur in class rooms or gym class with younger children or people with behavioral disabilities.

3. Jumping up and down repetitively. Quick acceleration/deceleration can be very jarring on the brain and can provoke symptoms. Examples of this would include jumping up and down on the bed, jumping on a trampoline, horseback riding, or using a pogo stick.

4. Roughhousing or wrestling. If you are not cleared to play football, you certainly should not be wrestling with your sibling! Rough play can easily intensify concussion symptoms or result in another head injury or whip lash.

5. Riding a bicycle, tricycle, motorcycle. You should not be cycling until your balance, coordination, reaction time, vision and neck flexibility is back to baseline.

6. Going on amusement rides that rapidly accelerate, decelerate or rotate. Rollercoasters and other theme park rides can be very unpleasant for someone who is in recovery from a concussion. Rides can significantly hurt an already impaired vestibular system (sensory system that detects motion and position of the head to allow for balance and compensatory movements). This could lead to dizziness, vertigo, poor balance, nausea/vomiting and headaches.

7. Skydiving, parachuting, parasailing. Refrain from these adventurous activities until you are functioning 100 percent from a cognitive standpoint. You want to be able to make fast, smart decisions before being hundreds of feet up in the air!

8. Horseback riding. Even the tamest horse should not be trusted to ride when recovering from a head injury. A quick jerk to the head or even the repetitive up and down motion when riding can significantly exacerbate headaches and neck pain.

9. Water skiing, surfing or paddle boarding. Hitting the water at a high speed can feel similar to hitting your head on a hard surface.

10. Snowboarding, skiing, snowmobiling, tubing. These activities require skilled coordination, balance, and normal reflexes to quickly change direction. Concussed patients should stay away from these winter pastimes until they have completely recovered.

Ellen McKinnon is a board-certified family nurse practitioner and Katelynn Cataldo is a board-certified adult-gerontology primary care nurse practitioner with Emerson Hospital’s Dr. Robert C. Cantu Concussion Center in Concord, Mass. To learn more, call 978-287-8250 or visit emersonhospital.org/concussion .

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6 do’s and don’ts of concussion

Published on: August 15, 2019 Last updated: September 26, 2022

As a parent or coach, knowing what to do after concussions occur is important. A CHOC pediatric neurologist offers tips on what to do.

Link: https://health.choc.org/6-dos-and-donts-of-concussion/

If your child experiences a concussion, it can be scary to think about the effects on their developing brain. The good news is, more than 85% of concussions heal well if managed properly early on.

sharief-taraman-pediatric-neurologist-choc-childrens

“Early, appropriate treatment prevents kids from having to come see me as a neurologist,” says Dr. Sharief Taraman , pediatric neurologist and director of the CHOC Concussion Program . “It’s important to do as much as we can to prevent kids from getting a concussion, prevent reinjury, and treat them as aggressively and appropriately as possible in the early intervention stages.”

Follow these do’s and don’ts for proper prevention and treatment of concussion. If your child does sustain a concussion, be sure to see your pediatrician as soon as possible.

Do protect a young brain

Athletes should be taught safe playing techniques, equipment maintenance and to follow the rules of the game. Always wear a helmet while playing contact sports like football, hockey and lacrosse, and during activities like horse riding, biking, skateboarding or snowboarding. Helmets should fit correctly and be in good condition.

Don’t miss the signs

A concussion isn’t always obvious. Watch for these signs in your child or teen, especially while they are participating in sports. Symptoms may take up to a day to appear after an incident.

  • Nausea or vomiting
  • Balance problems
  • Visual problems
  • Fatigue or drowsiness
  • Sensitivity to light or noise
  • Numbness or tingling
  • Dazed or stunned
  • Irritability
  • More emotional
  • Nervousness
  • Trouble falling asleep
  • Feeling mentally “foggy”
  • Feeling slowed down
  • Confused about recent events
  • Sleeping less or more than usual
  • Difficulty concentrating or remembering
  • Forgetful of recent information or conversations
  • Answers questions slowly or repeats questions

Seek emergency care immediately if your child or teen has experienced unconsciousness for any amount of time or has changes in alertness, convulsions or seizures, muscle weakness, persistent confusion, repeated vomiting, unequal pupils, unusual eye movements or walking problems.

Do sit on the sidelines

The most important thing your child should do if they are injured during a sports activity is to immediately stop playing. It’s crucial that they avoid more hits, jolts, shakes or bumps to the head or spine. Getting back in the game is not worth the risk. Remember, the signs of concussion aren’t always clear, so when in doubt, sit it out.

Athletes may not want to tell their coach if they had a concussion. Encourage them to come forward if they have an injury, or if they notice a teammate is injured. Young athletes should never ignore a head injury or impact to the head.

Don’t skip treatment

Even a mild concussion should be evaluated by a doctor. Get in to see your child’s pediatrician as soon as possible.

When a concussion is severe or symptoms won’t go away, talk to your doctor about a referral to the CHOC Concussion Program, which includes pediatric sports medicine specialists, neurologists, neurosurgeons, neuropsychologists and rehabilitation therapists who are all trained in concussion management.

Don’t rush recovery

Rest is important immediately following a concussion. For 24-48 hours, your child should stay home from school and get plenty of quiet time and mental rest. This includes limiting activities like:

  • Social media
  • Doing homework
  • Social interaction
  • Attending loud events

After the first 24-48 hours, light activities may help speed up recovery. Most children should be able to tolerate some school after a few days. If they need to miss more school than that, contact the school and your doctor to help intervene with short-term adjustments. Before returning to sports, be sure that symptoms have resolved and get medical clearance from your child’s doctor.

Do prevent future injury

Parents, coaches and athletes should be extra cautious to prevent future concussions. One concussion is rough enough, but additional injury is even worse. Research has shown that repeated jars to the head can have long-lasting effects on the brain. And, if a child or teen suffers a second concussion before the first concussion heals, they are at risk for Second Impact Syndrome, a life-threatening condition.

“The CDC has called concussions an epidemic in the United States,” Dr. Taraman says. “Kids really do get into trouble if a concussion is not recognized, and if we don’t take the proper steps to get them better and avoid those second injuries, which can be catastrophic.”

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Skip the Homework If You've Got a Concussion

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Kids need to cut back on mental exertion, as well as physical exercise, when they’re recovering from a concussion, a new study shows.

Nearly 50 percent of the kids and young adults who didn’t reduce their mental strain took 100 days or more to fully recover, according to the study published in Pediatrics on Monday. Among those who cut back the most, almost all had recovered by 100 days, most within a couple of months.

While specialists had long suspected that cutting back on mental activities would shorten recovery time, this is the first study to back that recommendation up with data. The study could be especially important for treating children, whose developing brains are particularly vulnerable to concussion damage. 

For many kids it will be enough to cut back for three to five days, said study co-author Dr. William Meehan, director of the Sports Concussion Clinic at Boston Children’s Hospital. “Then you can gradually reintroduce them to cognitive activity. They should do as much as they can without exacerbating their symptoms.”

For the new study, Meehan and his colleagues followed 335 patients, aged 8 to 23, at the sports concussion clinic at Boston Children’s Hospital.

At each visit to the concussion clinic, the patients, whose average age was 15, were asked about their symptoms and also to describe how much they’d worked their brains since the last visit. The five possible choices ranged from complete cognitive rest to no cutback at all.

The new findings fall in line with animal research and imaging studies that have taught us what happens during a concussion, said David Hovda, a professor of neurosurgery and director of the Brain Injury Research Center at the University of California, Los Angeles.

When the brain is jolted hard, it experiences a sort of mini-seizure, Hovda said. “All the cells fire and the brain needs an enormous amount of fuel to equilibrate,” he explained. “The brain is then exhausted so it shuts down and becomes very quiet.”

That quiet is what the brain needs to repair itself, Hovda said. “If you activate the brain during the time it’s trying to shut itself down, it will activate, but that will make recovery much more prolonged.”

People need to realize that “it can take days to weeks for processes in the brain to mop up the mess from a concussion,” agreed Dr. Douglas Smith, a professor of neurosurgery and director of the Center for Brain Injury and Repair at the University of Pennsylvania Medical Center.

Just how much kids needs to reduce their mental activity will depend on the number and severity of symptoms, said Dr. Robert Cantu, a professor of neurology and neurosurgery at the Boston University School of Medicine and co-director of the Center for the Study of Chronic Traumatic Encephalopathy.

“You do everything based on what doesn’t aggravate the situation,” Cantu said. “If kids can do 15 to 20 minutes on the computer without aggravating their symptoms, let them. But if headaches get worse after only 5 or 10 minutes, then you need to shut this down completely. Everything needs to be tailored to the individual.”

For some kids the slightest mental exertion can worsen symptoms. “There are definitely individuals with symptoms that are so bad that the best thing to do is to take a period of months off from school,” Cantu said. “That is a small minority, however.”

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What Are the Long-Term Effects of a Concussion?

In Some Cases, Concussions Cause Long-Lasting Effects

What Is a Concussion?

Short-term effects, long-term effects, preventing long-term injury, when to see a doctor, frequently asked questions.

Concussions typically are mild traumatic brain injuries that occur after a fall or a blow to the head. In most cases, they are not life-threatening and a single concussion won't cause permanent brain damage. Although most symptoms of a concussion will resolve within a few weeks, some effects are chronic and can result in a condition called post-concussion syndrome.

This condition is characterized by symptoms that include memory and sleep problems, difficulty concentrating, and psychological effects, occurring more often in cases of repeated brain injury, making it especially concerning for competitive athletes.     

A concussion, also known as traumatic brain injury (TBI) , is the result of trauma to the brain due to force applied to the head. The sudden jerking motions of the head and neck resulting from trauma cause the brain to twist and bounce inside the skull, immediately damaging its cells and surrounding structures. Though concussion is not as severe as other forms of TBI, and the symptoms are typically not life-threatening, except in extremely rare cases.

When you have long-term effects of a concussion—those that persist for more than three weeks—you have what’s clinically known as post-concussion syndrome (PCS). PCS is the result of inflammation, altered blood flow, and disrupted brain cell structures due to the original injury.

The common effects of a concussion typically arise minutes to hours after the blow or fall. In general, they last about two to three weeks before resolving on their own. These short-term symptoms include:

  • Nausea and vomiting
  • Loss of consciousness
  • Difficulty balancing and staying upright
  • Blurry or doubled vision
  • Ringing in the ears
  • Sensitivity to light
  • Sleep problems and fatigue

In addition, a concussion is often accompanied by neurological and psychological symptoms, such as:

  • Difficulty with comprehension or concentration
  • Depression and sadness
  • Irritability, nervousness, and anxiousness
  • The feeling of being in a “fog”
  • Memory loss and challenges with paying attention

Infants and toddlers also can experience concussions, and, given the limitations in communication of children this age, diagnosis is much more difficult. Concussion in young children is characterized by:

  • Bumps forming on the head
  • Irritability and being cranky
  • Low appetite or an unwillingness to nurse
  • Changes in sleep patterns
  • Blank stare

With infants or toddlers, it’s especially important to be vigilant about injuries. Don’t hesitate to call your pediatrician or get emergency help after a fall or suspected head injury.

The longer-term effects of concussion, which typically last after immediate symptoms have receded, arise quickly after the onset of the concussion (just like the shorter acting ones). These symptoms include:

  • Difficulty concentrating
  • Significant memory issues
  • Irritability and changes in personality
  • Light and noise sensitivity
  • Disturbed sleep patterns
  • Depression , anxiety, and other psychological issues
  • Changes in smell and taste sensation

Most people who experience a concussion won’t have long-term symptoms, but the chances of developing them increase if you have had a concussion or another type of TBI in the past. One severe condition—an inflammation of the brain called chronic traumatic encephalopathy (CTE)—is associated with repeated head impacts of sufficient force (which may not reach the level of a concussion).  

Can concussion be fatal?

Though occurrences are extremely rare, certain concussions can cause death. Of particular concern are bleeding in the brain or swelling (cerebral edema ), especially within the first 24–48 hours. If untreated, these cases can be fatal, which is why careful monitoring is required immediately after a head trauma.  

The key to preventing long-term problems and post-concussion syndrome is timely and proper care. Even if you (or a loved one) don’t require emergency care, the best thing you can do is to get medical attention within one to two days of the accident or fall.

Ways to prevent concussion include:

  • Always wear your safety belt when traveling in a vehicle.
  • When cycling or playing certain sports, wear an appropriate helmet.
  • Use handrails when walking on stairs.
  • Install safety gates by stairs for young children and toddlers.
  • Add grab bars and nonslip mats in the bathroom.
  • Improve lighting in the home and remove trip hazards.
  • Strengthen neck muscles to help stabilize your head if in a fall.

By far the most important prevention tool is careful and exact adherence to post-concussion protocols . Reinjury of the brain before it’s fully recovered greatly increases the risk of chronic symptoms, permanent damage, and post-concussion syndrome. According to these conventions, athletes must stay away from activity until:

  • Symptoms are absent during rest, physical activity, or mental tasks.
  • Daily tasks, schooling, and work can be tolerated.
  • Neurological and cognition test results post-concussion match those taken before the head injury or pass criteria set by the school or athletic board.
  • Passing results are obtained during a physical exam and balance test.
  • Full contact activity is cleared by a healthcare provider with expertise in concussion.

Caution should always be heeded with concussion. While most people will fully recover, problems can arise if the recovery period is rushed and parts of the brain that are still healing become injured again.

Given how critical it is to get timely treatment for concussions, it’s absolutely essential to know what the signs are for when to see a doctor or get emergency help following a collision or fall. For adults, the criteria are:

  • Worsening and lingering headache
  • Continued numbness, weakness, loss of coordination, convulsions , or seizures (seek immediate medical evaluation)
  • Repeated vomiting and nausea
  • Slurred speech or changes in behavior
  • One pupil dilated, while the other is not
  • Confusion, lack of recognition of faces, restlessness, and agitation
  • Loss of consciousness, excessive drowsiness, and inability to wake up

When it comes to concussion, don’t hesitate and don’t delay in getting treatment. If you believe you or a loved one has experienced a concussion, get help as soon as possible. As with many conditions, the sooner you get help, the better off you’ll be.

What are the long-term effects of concussion?

Arising anywhere from a couple of hours to days after the initial injury, they include:

  • Cognitive issues, such as difficulty with concentration or memory
  • Disrupted sleep, including trouble falling asleep, staying asleep, and feeling tired throughout the day
  • Changes in mood or personality, irritability
  • Trouble staying in balance
  • Changed senses of taste and smell
  • Depression, anxiety, and other mental health conditions

What helps prevent long-term effects of a concussion?

Verywell / Michela Buttignol

Preventing the long-term effects of a concussion starts with reducing the chance of getting a head injury in the first place. Key steps to take include:

  • Car safety: It's essential for everyone in a vehicle to use seat belts, and children should be strapped into age-appropriate car seats and booster seats.
  • Helmets: Properly wearing helmets while bicycling, skating and skateboarding, riding on motorcycles, and taking part in contact sports can reduce your chances of getting a concussion.
  • Home safety: Installing slip- and fall-prevention devices and surfaces on floors, railings, and stairs for children and adults can help prevent falls in the home.
  • Safe play spaces: Making sure playgrounds have safe material and soft surfaces can help prevent childhood concussion.

Another step is proper post-concussion management. As your brain is healing, there's an increased chance of more severe effects—or experiencing another concussion—with reinjury. This involves:

  • Not driving until cleared to do so by the doctor
  • Getting prompt medical attention
  • Not moving a person with a suspected concussion without medical help
  • Getting plenty of sleep at night as well as naps during the day
  • Remaining vigilant of symptoms throughout recovery
  • Staying away from sports-related activities until cleared to return

Can an old head injury cause problems years later?

Yes, the more times you have a concussion, the greater the chance you can develop long-term or severe symptoms. Repeated TBIs can cause chronic traumatic encephalopathy (TCE), a progressive brain condition that is diagnosed only after death. This condition is characterized by:

  • Changes in thinking, behavior, and emotions
  • Depression and anxiety
  • Personality and mood changes
  • Motor symptoms, such as with Parkinson's disease or motor neuron disease

In addition, a history of concussion increases the chance of a case becoming fatal.

Can you die from a concussion?

Yes. While chances of dying from concussion are exceedingly rare, it can happen. In some cases, bleeding and inflammation in the brain, especially if untreated, is fatal. This is why careful observation is needed for the first 24–48 hours following brain injury. Get emergency help if symptoms become more pronounced and severe.

Cleveland Clinic. Concussion: causes, symptoms, diagnosis, treatments, prevention .

University of Utah Health. Concussions: how they can affect you now and later .

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Get the facts about TBI : Traumatic Brain Injury & Concussion.

 Polinder S, Cnossen M, Real R et al. A multidimensional approach to post-concussion symptoms in mild traumatic brain injury . Front Neurol . 2018;9. doi:10.3389/fneur.2018.01113

Centers for Disease Control and Prevention. Brain injury safety tips and prevention .

Centers for Disease Control Injury Center. Managing return to activities . Heads Up.

Centers for Disease Control and Prevention. Answering questions about chronic traumatic encephalopathy (CTE) .

By Mark Gurarie Gurarie is a freelance writer and editor. He is a writing composition adjunct lecturer at George Washington University.  

About concussion

Symptoms of concussion, causes of concussion, diagnosing concussion, treating concussion, complications of concussion, preventing concussion.

Concussion is the sudden but short-lived loss of mental function that occurs after a blow or other injury to the head. It is the most common but least serious type of brain injury.

The medical term for concussion is minor traumatic brain injury.

Symptoms of concussion  include brief:

  • loss of consciousness after the head injury
  • periods of memory loss
  • disturbances in vision, such as “seeing stars” or blurry vision
  • a period of confusion, a blank expression, or a delay in answering questions immediately after the head injury

If a brain scan is carried out, concussion is only diagnosed if the scan is normal – for example, there is no bleeding or swelling of the brain.

When to seek medical help

Concussion should only be diagnosed by a health professional trained in assessing patients with head injury. They will be able to rule out serious brain injury that needs a brain scan or surgery.

You should visit your nearest accident and emergency (A&E) department if you or someone in your care has a head injury and develops the following signs and symptoms:

  • loss of consciousness, however brief
  • memory loss, such as not being able to remember what happened before or after the injury
  • persistent headaches since the injury
  • changes in behaviour, such as irritability, being easily distracted or having no interest in the outside world – this is a particularly common sign in children under five
  • drowsiness that occurs when you would normally be awake
  • loss of balance or problems walking
  • difficulties with understanding what people say
  • difficulty speaking, such as slurred speech
  • problems with reading or writing
  • vomiting since the injury
  • problems with vision, such as double vision
  • loss of power in part of the body, such as weakness in an arm or leg
  • clear fluid leaving the nose or ears (this could be cerebrospinal fluid, which surrounds the brain)
  • sudden deafness in one or both ears
  • any wound to the head or face

Anyone drunk or high on recreational drugs should go to A&E if they have a head injury as it’s easy for others around them to miss the signs of a more severe injury.

Phone 999 for an ambulance immediately if the person:

  • remains unconscious after the initial injury
  • is having a seizure or fit
  • is bleeding from one or both ears
  • has been vomiting since the injury
  • is having difficulty staying awake, speaking, or understanding what people are saying

Certain things make you more vulnerable to the effects of a head injury. These include:

  • being aged 65 or older
  • having previously had brain surgery
  • having a condition that makes you bleed more easily, such as haemophilia
  • having a condition that makes your blood more prone to clotting, such as thrombophilia
  • taking anticoagulant medication, such as warfarin or aspirin, to prevent blood clots

There are things you can do at home to help relieve concussion symptoms, including:

  • apply a cold compress to the injury to reduce swelling – a bag of frozen peas wrapped in a towel will do
  • take paracetamol to control any pain – do not use non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, as these can cause bleeding
  • avoid drinking alcohol or taking recreational drugs

Read more about how concussion is treated , including information on self care tips and when you can return to playing sport.

After experiencing concussion, careful monitoring is needed. This is usually for 48 hours.

This is because the symptoms of concussion could also be symptoms of a more serious condition, such as:

  • subdural haematoma – bleeding between the skull and the brain
  • subarachnoid haemorrhage – bleeding on the surface of the brain

While the medical term “minor traumatic brain injury” can sound serious, the actual extent of damage to the brain is usually minimal and does not cause long-term problems or complications.

There is evidence that repeated episodes of concussion could cause long-term problems with mental abilities and trigger dementia . This type of dementia is known as chronic traumatic encephalopathy (CTE).

However, this seems to only be a significant risk for professional athletes who experience repeated episodes of severe concussion, such as boxers – CTE is sometime nicknamed “boxer’s brain”.

Post-concussion syndrome (PCS) is a poorly understood condition where symptoms of concussion can last for weeks or months afterwards.

Read more information about PCS as a  complication of concussion .

Who’s at risk?

Most cases of concussion occur in children and teenagers aged 5 to 14, with the two most common causes being sporting and cycling accidents.

Falls  and motor vehicle accidents are a more common cause of concussion in older adults.

People who regularly play competitive team sports such as football and rugby have a higher risk of concussion.

Read more information about the causes of concussion  and tips on preventing concussion .

Symptoms of concussion can be mild to severe, and in some cases emergency treatment may be needed.

The most common symptoms of concussion are:

  • confusion, such as being unaware of your surroundings, a delay in answering questions, or having a blank expression 
  • loss of balance
  • feeling stunned or dazed
  • disturbances with vision, such as double vision, blurred vision or “seeing stars” or flashing lights
  • difficulties with memory

Difficulties with memory can mean:

  • you are unable to remember events that occurred before the concussion happened (this usually only affects the minutes immediately leading up to the concussion) – retrograde amnesia  
  • you are unable to remember any new information or events after the concussion happened – anterograde amnesia

Both types of memory loss usually improve within a few hours.

Less common symptoms

Less common symptoms include:

  • loss of consciousness
  • slurred speech
  • changes in behaviour, such as feeling unusually irritable
  • inappropriate emotional responses, such as suddenly bursting into laughter or tears

When to seek medical advice

As a precaution, it is recommended that you visit your nearest accident and emergency (A&E) department if you or someone in your care has a head injury resulting in concussion and then develops any of the following signs and symptoms:

  • loss of consciousness from which the person then recovers
  • amnesia (memory loss), such as not being able to remember what happened before or after the injury
  • changes in behaviour, such as irritability, being easily distracted or having no interest in the outside world – this is a particularly common sign in children under the age of five
  • drowsiness that goes on for longer than an hour when you would normally be awake
  • a large bruise or wound to the head or face
  • prolonged vision problems, such as double vision
  • reading or writing problems
  • balance problems or difficulty walking
  • clear fluid leaking from the nose or ears (this could be cerebrospinal fluid, which normally surrounds the brain)
  • a black eye with no other damage around the eye

Anyone taking warfarin should seek medical assistance after a head injury, even if they feel well. 

Anyone who is drunk or high on recreational drugs should also go to A&E if they have a head injury. It’s often easy for others around them to miss signs of a more severe head injury.

Certain things make you more vulnerable to the effects of a head injury, such as:

  • a previous history of brain surgery
  • having a condition that makes you bleed more easily, such as haemophilia, or having a condition that makes your blood more prone to clotting, such as thrombophilia
  • taking anticoagulant medication (such as warfarin ) to prevent blood clots, or taking  low-dose aspirin

When to seek emergency medical treatment

You should phone 999 for an ambulance immediately if the person:

  • is having difficulty staying awake, speaking or understanding what people are saying

Concussion occurs when a blow or impact to the head causes a sudden disruption to part of the brain known as the reticular activating system (RAS).

The RAS is located in the middle of your brain, and helps regulate your sense of awareness and consciousness. It also acts as a filter that allows you to ignore unimportant information by focusing on details you need.

For example, your RAS helps you to:

  • fall asleep and wake up as required
  • suddenly hear when your flight is being called in a noisy airport
  • notice news items that interest you when you are quickly scanning a newspaper or news website

During a head injury severe enough to cause concussion, your brain is moved out of its normal position for a short time. This rotation disrupts the electrical activities of brain cells that make up the RAS, which in turn triggers symptoms associated with concussion, such as:

  • loss of memory 
  • a brief period of unconsciousness
  • mental confusion

Increased risk

The three main causes of concussion are:

  • being involved in a road accident
  • an accidental trip or  fall
  • taking part in sporting or other recreational activities

Activities known to have a higher-than-average risk of concussion include:

  • martial arts, such as karate or judo

Most doctors would argue that the physical benefits of regularly taking part in these sports outweigh any potential risks associated with concussion.

But this is only if you (or your child) wear appropriate equipment, such as a helmet, and are supervised by a suitably trained referee, umpire or trainer with experience of diagnosing and treating concussion.

The exception to this is boxing, as most doctors – especially those who treat head injuries – have stated that the risks of serious brain injury associated with boxing are unacceptably high and the sport should be made illegal.

Because of the nature of concussion, most diagnoses are either made at an accident and emergency (A&E) department, by a paramedic at the scene of an accident, or by a trained official at a sporting event.

The person making the diagnosis will perform a careful physical examination to check if there are any noticeable signs and symptoms of a more serious brain injury, such as bleeding from the ears, while making sure breathing is unaffected.

If you are conscious, you will be questioned so your state of mind (particularly your memory) can be assessed.

Possible questions include:

  • Where are we?
  • What were you doing before the concussion?
  • Can you repeat the months of the year in reverse order?

You may be asked to try what is known as the “finger-nose-finger” test. The person running the test will hold one of their fingers in front of you. You are asked to touch their finger and then touch the tip of your nose as quickly as possible.

This test is a good way of assessing what effect the concussion has had on your balance and co-ordination.

If you are unconscious, as a precaution it is assumed that you have a serious neck or spinal injury until proved otherwise. You should therefore not be moved until a specialist brace can be fitted around your neck and spine to protect it.

Similarly, if you see a person who is unconscious, make no attempt to move them unless they are in immediate physical danger. Instead, dial 999 for an ambulance and wait with them until paramedics arrive.

Further testing

In some circumstances, further testing may be recommended if there are any signs or symptoms that suggest a more serious injury to your brain. The most widely used test for suspected brain injury is a computerised tomography (CT) scan . 

However, if it is thought you may have damaged the bones in your neck, an  X-ray  may be used to assess the damage quickly. CT scans are avoided on children under 10 where possible, but may be necessary in some cases.

A CT scan takes a series of X-rays of the inside of your skull and puts them together using a computer. The image that is created forms a cross-section of the inside of your skull and brain.

A CT scan is usually recommended in adults who:

  • have persistent problems in speaking, carrying out instructions or opening their eyes
  • have signs and symptoms that suggest the base of the skull is fractured, such as clear fluid running from the nose or ears, or very dark blotches above and below the eyes (“panda eyes”)
  • have a seizure or fit after the injury
  • have vomited more than once since the injury
  • are unable to remember events more than 30 minutes before the injury
  • have any signs of neurological problems, such as loss of feeling in certain parts of the body, problems with balance and walking, and persistent changes in eyesight

A CT scan is also recommended for adults who have experienced some loss of consciousness or memory since the injury and who:

  • are aged 65 or over
  • have a problem that makes them prone to uncontrollable bleeding, such as a blood clotting disorder (for example, haemophilia) or are taking the anticoagulant medication  warfarin
  • were injured in a particularly serious accident, such as a road accident or falling from a height of more than one metre

A CT scan may be recommended in children who:

  • lost consciousness for more than five minutes
  • are unable to remember what happened before or after the injury and this has lasted more than five minutes
  • are unusually drowsy
  • have been sick three times or more since the injury
  • had a seizure or fit after the injury
  • have signs and symptoms that suggest the base of the skull is fractured, such as “panda eyes”
  • have memory loss
  • have a large bruise or wound to the face or head

A CT scan is also usually recommended for babies less than a year old who have a bruise, swelling or cut on the head bigger than 5cm (2 inches).

There are some self care techniques you can use to relieve mild concussion symptoms. If more serious symptoms start to develop, you should seek immediate medical treatment.

Some self care techniques for mild symptoms of concussion are:

  • if concussion has resulted from playing sport, you should stop playing immediately
  • apply a cold compress to the injury to reduce swelling – a bag of frozen vegetables wrapped in a towel could be used, but never place ice directly on the skin as it’s too cold; apply the compress every 2 to 4 hours and leave it in place for 20 to 30 minutes
  • take  paracetamol  to control pain – do not use  non-steroidal anti-inflammatory drug (NSAID)  painkillers like  ibuprofen  or  aspirin  as these can sometimes cause bleeding at the site of the injury
  • get plenty of rest and avoid stressful situations where possible
  • avoid drinking any alcohol or taking recreational drugs
  • undertake a step by step return to work, college, school and sport – you can read more about this in the return to sports section
  • only drive a car or ride a bike when you feel you have completely recovered
  • do not play any contact sports for at least 3 weeks – this includes sports like football and rugby
  • make sure you have someone to stay with you for the first 24 hours after the injury in case you experience more serious follow-up symptoms

When to seek follow-up advice

Sometimes the symptoms of a more serious brain injury do not occur for several hours, or possibly days, after the initial injury has taken place. This means it’s important that you remain alert for signs and symptoms that could suggest a more serious injury has occurred.

Go to your nearest A&E if you or someone in your care experiences symptoms like:

  • unconsciousness or lack of consciousness, like problems keeping their eyes open
  • mental confusion, like forgetting who or where they are
  • any drowsiness that goes on for longer than one hour when they would normally be wide awake
  • any problems understanding or speaking
  • any loss of balance or problems walking
  • any weakness in one or both arms or legs
  • any problems with eyesight
  • a very painful headache that will not go away
  • any vomiting
  • any fits or seizures
  • clear fluid coming out of the ear or nose
  • bleeding from one or both ears

Contact your GP if:

  • your concussion symptoms last longer than 28 days

Returning to sports

You should rest for at least 24 to 48 hours after a concussion.

Following this, you can gradually return to normal life and then sport using a step by step approach. In the first 24 to 48 hours you can continue to do things like reading and walking.

You should carefully and slowly return to normal life to lower the risk of:

  • making your symptoms worse or
  • causing new symptoms.

You should only move to the next step if the activity isn’t making symptoms worse or causing new symptoms. If the activity makes your symptoms worse, then you should rest and try again the next day if you feel ready.

After the initial rest period, doing some light physical activity can be good for your recovery. You should aim to return to normal daily activities like work and education, before you return to sport.

Current UK concussion guidelines for non-elite (Grassroots) sports recommend these steps:

  • Relative rest for 24 to 48 hours – minimise screen time and do some gentle exercise.
  • Gradually introduce daily activities like reading and some light physical activity like walking.
  • Increase study or work-related activities with rest periods, increase the intensity of exercise.
  • Part time return to study or work and sports training – you should not take part in any activities that risks impact to your head.
  • If you’re not experiencing symptoms after resting for 14 days, you can consider returning to full sports training.
  • After 21 days, you can consider competitive sports again, as long as you’re symptom free after 14 days of rest and during training in stage 5.

You should stop experiencing symptoms after about 2 to 4 weeks. Sometimes it can take longer. Everyone’s recovery is different. It’s important to gradually return to your normal activities to reduce the risk of a further brain injury or longer-term problems.

Children and teenagers might take longer to recover than adults.

If you’ve like to read more about the step by step return to sport, you can read the full guidance on the  Sport Scotland website . 

Post-concussion syndrome (PCS) is the term used to describe a collection of symptoms that can last for several weeks or months after the concussion.

The exact cause of PCS is not known. One theory is that PCS is the result of a chemical imbalance in the brain triggered by the initial injury that caused the concussion. Another theory suggests PCS may be caused by damage to nerve cells in the brain.

Symptoms of PCS

The symptoms of PCS fall into three main categories:

  • psychological
  • cognitive (affecting a person’s thinking ability)

Physical symptoms of PCS can include:

  • headaches  – often described as similar to migraines in that they cause a throbbing pain on one side or the front of the head
  • feeling sick (nausea)
  • sensitivity to bright lights
  • sensitivity to loud noises
  • ringing in the ears – the medical term for this is  tinnitus
  • double or blurred vision
  • lost, changed or reduced sense of smell and taste

Psychological symptoms of PCS can include:

  • anxiety 
  • irritability
  • lack of energy and interest in the world around you
  • having problems sleeping
  • changes in appetite
  • sudden and inappropriate outbursts of emotion, such as having fits of laughter or crying for no apparent reason

Cognitive symptoms of PCS include:

  • decreased concentration
  • forgetfulness
  • difficulty remembering things or learning new information
  • difficulties with reasoning (working out problems)

Treating PCS

There is no specific treatment for the symptoms of PCS, though many medications used to treat migraines have also proved effective in treating the headaches caused by PCS.

Antidepressants and talking treatments such as psychotherapy may help control the psychological symptoms, such as depression and anxiety.

Most cases of PCS will resolve within three to six months, and only 1 in 10 people will still have symptoms after a year.

There are a number of commonsense precautions you can take to reduce your risk of concussion.

These precautions include:

  • always wearing the recommended equipment when taking part in a contact sport such as rugby or boxing
  • making sure any contact sport you or your child are taking part in is supervised by a properly qualified and trained person
  • always wearing a seat belt when driving
  • wearing a motorcycle helmet – this is a legal requirement if you are riding a motorcycle in Scotland
  • wearing a cycle helmet – this is not a legal requirement, but cycle helmets have been recommended by several leading organisations, such as the Royal Society for the Prevention of Accidents

It is also easy to underestimate how many cases of concussion occur as the result of a  fall or slip at home or in the garden, especially in older people. Following some or all of the suggestions below will help keep your home and garden as safe as possible.

  • keep stairways clear so you do not trip over anything
  • use appropriate safety equipment if you’re doing any kind of DIY
  • use appropriate equipment to change a light bulb, such as a stepladder
  • clean up spillages to prevent someone slipping

For more information, visit the  Royal Society for the Prevention of Accidents  website.

Source: NHS 24 - Opens in new browser window

Last updated: 05 May 2023

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Also on NHS inform

  • Severe head injury

Other health sites

  • Brain and Spine Foundation
  • Headway: minor head injuries and concussion
  • RoSPA: accident prevention
  • Sportscotland: Scottish Sports Concussion Guidance

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