Top stories
- Concussion — a mild traumatic brain injury: the function of nerve cells is disrupted, but there is usually no visible tissue damage.
- Loss of consciousness, repeated vomiting, severe drowsiness — call an ambulance immediately, without waiting for the condition to improve.
- The examination is started by a neurologist: asking about the circumstances of the blow, checking memory, vision, coordination and reflexes.
- A CT scan of the head is ordered if a bone fracture or haemorrhage is suspected, in order to rule out complications.
- Recovery requires rest: return to work and sport gradually, otherwise the headache and fatigue will come back.
What is a concussion
A concussion is a mild head injury in which brain function is temporarily disrupted. Below is an explanation of what exactly happens with this kind of injury, what circumstances cause it, and who is affected by it most often.
What happens in the body
A concussion occurs at the moment of a sharp blow or jolt, when the brain briefly shifts inside the skull. The brain is soft and mobile, it floats in fluid and is not rigidly attached to the walls of the skull. During a blow, the head sharply changes position, and the brain shifts by inertia, striking the inner surface of the bones. Because of this, the coordinated work of nerve cells is briefly disrupted, although there is usually no visible damage to the tissues. The person feels unwell for several days, but the condition gradually improves on its own. The disruption can be noticed by how the person responds to questions, maintains balance, and tolerates light and noise. If after a blow to the head the person's well-being does not return to normal, this is a reason to see a doctor rather than wait for it to pass on its own.
What causes it to develop
- A fall: a blow to the head when falling from one's own height or higher is the most common everyday cause, especially on slippery floors and stairs.
- A fight: a direct blow with a fist or an object to the head sharply shifts the brain inside the skull and triggers a disruption of its function.
- A road traffic accident: in a collision or sudden braking, the head jerks forward and back, even if there was no direct blow.
- A sports injury: contact sports involve collisions and falls in which the head receives a blow or a sharp jolt.
- Sudden acceleration or deceleration: the head changes speed without a direct blow, while the brain continues to move inside the skull by inertia.
- A practical takeaway: knowing these circumstances makes it easier to notice the moment after which the person's well-being changed, and to tell the doctor about it in time.
Who experiences this more often
A concussion most often happens to people whose lives involve the risk of falls, blows, and sudden collisions. Children and adolescents fall into this group because of active games, running, and falls on playgrounds and in yards. People who engage in contact sports receive blows to the head regularly during training and competitions. Older people encounter this with falls, because balance becomes less stable with age. Drivers and passengers find themselves in such situations during road accidents, where the head sharply jerks forward and back. Construction and manufacturing workers are at risk because of heights, machinery, and falling objects nearby. If a person has already had such an injury, they should be more careful in situations with the risk of a repeated blow to the head.
What symptoms can occur?
The symptoms of concussion appear immediately after a blow or a fall, but sometimes they become noticeable a little later. They vary in severity and combination, so it is important to know what to look out for in the first hours.
How it is noticed at the very beginning
In the first hours, concussion most often manifests as a headache and dizziness, which a person puts down to tiredness after a fall. These sensations are often accompanied by unsteadiness when walking, when you are pulled slightly to one side and it is hard to keep your balance. Nausea or vomiting also belong to the early signs and are noticeable even to those around. Sluggishness and difficulty concentrating show themselves in that a person answers questions slowly and loses the thread of the conversation. Increased sensitivity to light and sound makes you squint and ask for the brightness or volume to be turned down. Drowsiness or, conversely, difficulty sleeping also indicate that the condition requires attention. If at least one such sign appears after a blow, do not wait for everything to pass on its own — see a doctor.
Signs that occur most often
- Headache: pressing or throbbing, it intensifies with movement and bending over, so it interferes with everyday tasks.
- Dizziness and unsteadiness: the gait becomes unsteady, the person is pulled to one side, and this is noticeable to others.
- Nausea or vomiting: they appear soon after the blow and are a reason to see a doctor without delay.
- Sluggishness, difficulty concentrating: the person answers slowly, loses the thread of the conversation and tires quickly from simple tasks.
- Increased sensitivity to light and sound: bright lighting and loud sounds cause irritation and increase discomfort.
- Drowsiness or difficulty sleeping: you feel sleepy during the day, but cannot fall asleep at night, and this disturbance lasts for more than an hour.
When to seek help urgently
Examinations and tests
Tests for concussion help rule out fractures and haemorrhages. The doctor selects them based on the patient's condition, not on a template.
How the examination begins
The examination begins with a neurologist asking about the circumstances of the injury and checking neurological functions. The doctor clarifies exactly how the person was hit, whether they lost consciousness and whether they remember the moment of the impact itself. The specialist then assesses memory, vision and coordination to understand the general state of the nervous system. Reflexes are checked separately: changes in them help to notice hidden disturbances in brain function. If alarming signs are detected during the examination, the doctor may refer the patient for additional tests. This sequence is needed so that the condition is first assessed using simple methods, and only then resorting to instrumental diagnostics. Write down in advance how the injury occurred and what you felt after it — these details noticeably help the doctor.
What is prescribed and what it shows
What is worth preparing for the appointment
- Circumstances of the injury: describe how and where you were hit, whether you lost consciousness — this sets the direction for the whole examination.
- Discharge summaries and reports: bring previous medical documents, if you have them, so that the doctor can see the overall picture.
- List of complaints: write down what is bothering you now: headache, nausea, dizziness — so that nothing is forgotten.
- Results of previous examinations: bring scans and reports, if they were done earlier, for comparison with the current condition.
- A companion: ask a loved one to travel with you if it is difficult to concentrate or find your way after the injury.
Which doctor should I see?
For concussion, care is provided by a neurologist, and under certain circumstances a neurosurgeon and an orthopaedic traumatologist are also involved. Let us look at who manages this condition, what happens at the first appointment and what treatment consists of.
Which specialist manages this condition
Concussion is managed by a neurologist, since it is they who assess the state of the nervous system and further observation. If there is no neurologist nearby, the initial examination may be carried out by an orthopaedic traumatologist, and if complications are suspected, a neurosurgeon is involved. At the first appointment, the doctor clarifies the circumstances of the injury, checks reflexes, coordination and memory in order to understand the overall picture. Separately, they find out how the person reacts to light, sound and movement, as this noticeably affects how they feel. In addition, the specialist asks about headache, nausea and episodes of loss of consciousness immediately after the blow. Such signs help distinguish an ordinary course from a condition that requires closer attention. If the symptoms do not go away for a long time, observation by a neurologist continues, and if complications are identified, for example intracranial haemorrhage, surgery may be needed. It is worth booking an appointment with the specialist who is available earlier, and then they will refer you to the right doctor themselves.
What treatment consists of
- Physical and mental rest: in the first days, the load on the body and head is limited so as not to provoke worsening of symptoms and to let the body recover.
- Gradual return to work and study: they return to the usual rhythm not immediately, but step by step, because a sudden start often brings back the previous complaints.
- Selection of therapy by the doctor: for headache and other symptoms, the specialist selects help individually, taking into account how the particular person feels and their characteristics.
- Observation by a neurologist: if the symptoms do not go away for a long time, the doctor continues to monitor the condition and, if necessary, changes the management approach.
- Surgery for complications: if consequences are identified, for example intracranial haemorrhage, surgical intervention becomes the only way to help.
What depends on the patient themselves
The regularity of observation by a neurologist and the accuracy of following their recommendations largely determine how recovery after concussion will go. If a person misses the scheduled visits or returns to exertion earlier than the due date, the symptoms often drag on and interfere with ordinary life. Many note that keeping rest in the first days noticeably eases the headache and removes the feeling of being worn out. It is worth writing down when and under what circumstances the complaints worsen, because such notes help the doctor assess the dynamics more accurately. Separately, it is important to honestly tell about your condition, even if it seems that everything has already passed and there is nothing to complain about. Relatives and close ones also influence the result: their calmness and readiness to help with household matters reduce unnecessary load. The practical conclusion is simple: do not rush things and come to the appointment with the neurologist at the appointed time, even if you feel well.
What helps prevent an exacerbation?
Preventing an exacerbation after a concussion is helped by a measured lifestyle without sudden exertion and repeated blows. Below is what exactly is changed in habits, which observations are kept under control and why regular visits to the doctor are needed.
What is changed in habits
Wearing a helmet when cycling, rollerblading and in contact sports reduces the risk of repeated head injury. It is worth fastening your seatbelt in a car always, even on short trips along a familiar route. At home, obstacles on the floor, wires and slippery rugs are removed so as not to trip in the dark. Strengthening the neck muscles and balance training make falls less likely in everyday life and on the street. Extreme sports require particular caution: there, speed and height leave little time for reaction. If the head has already hurt after a blow, it is better to return to previous exertion gradually, monitoring how you feel. Such a routine does not replace the treatment prescribed by a doctor, but noticeably reduces the chance of a new exacerbation.
What is worth keeping under control
- Headache: its character and frequency show how the brain is recovering after injury, and help the doctor adjust observation in time.
- Dizziness and balance: these sensations are noticeable when standing up abruptly or walking, so they are worth writing down so as not to miss a deterioration.
- Sleep and rest: lack of sleep increases fatigue and hinders recovery, so a stable routine with sufficient rest time is important.
- Physical exertion: its volume is increased gradually, because too rapid a return to sport often provokes the return of previous complaints.
- Repeated blows to the head: even a light collision in everyday life or at training requires attention, because each new injury aggravates the condition.
- A wellbeing diary: short notes about complaints and exertion give the doctor a clear picture and help build further observation.
How often to see the doctor
Regular check-ups with the doctor are needed even when you feel well, because some of the consequences of injury do not appear immediately. Scheduled visits allow delayed recovery to be noticed when the complaints still seem tolerable and do not interfere with ordinary affairs. At the appointment the doctor clarifies how exertion is tolerated, how sleep and attention change, and if necessary changes the recommendations. If new or worsened symptoms appear, the visit is not postponed, but agreed with the observing specialist. Between appointments it is useful to keep notes about how you feel, so that the conversation is based on facts and not on general impressions. Such control does not replace the prescribed treatment, but helps to adjust the lifestyle in time. Calm and consistent observation reduces the risk of exacerbation and makes recovery more predictable.
What is worth remembering
A concussion rarely passes without a trace if it is ignored, and so it is important to understand the logic of your actions. Below is what is worth keeping in mind when the first alarm has already subsided.
Key takeaways
A concussion is a condition in which well-being depends on how seriously it was taken in the first days. A person often feels better by the evening and therefore decides that there is no longer any reason for attention. Meanwhile, it is precisely at this moment that the most common mistake is made: returning to the usual workload before the body is ready for it. A concussion is insidious in that outward calm does not coincide with internal recovery. Headache, fatigue and difficulty concentrating may return after a sharp return to work or sport. If alarming signs appear after a blow, a visit to the doctor cannot be postponed — this is not a sign of weakness, but reasonable caution. A concussion does not require heroism, but it does require a pause and attention to your own condition. The basis for the decision is not how you feel in a particular minute, but a calm and consistent return to your usual rhythm.
