Symptoms of Concussion

At the time of the injury, signs of a concussion may include brief loss of consciousness or confusion and disorientation. In the period after a concussion, signs and symptoms can include:

• Grogginess, confusion, feeling “in a fog”
• Sensitivity to light and noise
• Nausea or vomiting
• Headache
• Problems with balance, vision, or coordination
• Fatigue, drowsiness, or changes in sleep patterns (insomnia, or sleeping more or less than usual)
• Poor concentration, memory lapses, or slow response times
• Irritability, anxiety, or sadness

Post-concussion headache is very common, but experts advise against taking over-the-counter pain relievers for a while after the injury. This is because persistent or worsening headaches may indicate the need for more intensive work-ups, including MRI or CT scans. Masking those headaches with pain medication could cause a delay in further testing. Headache that persists should be reported back to the patient’s primary physician or neurologist.

Most of the symptoms of concussion resolve on their own within two weeks without medical treatment. Patients are advised to rest and to avoid strenuous physical or mental activities that can aggravate symptoms. (See Diagnosing and Treating Concussion.)

An assessment of a patient’s post-concussion symptoms can be complicated, especially in athletes (youngsters as well as professionals). Some may enjoy the attention or staying out of school and may even exaggerate their symptoms.  However, it's more common for dedicated athletes to deny or downplay their symptoms in the eagerness to return to their sport. Careful evaluation by a concussion expert, with sound return-to-play guidelines, can help a patient avoid the far greater danger of repeated concussion.  

(Concussion and post-concussion syndrome are not neurosurgical conditions; you may be referred to a neurosurgeon if your brain injury is more severe than concussion.)