Not every concussion requires a trip to the emergency room, but everyone who suffers a concussion should be seen by a concussion specialist as soon as possible after the injury. (See How Soon to Treat a Concussion)
Phase 1 (immediately after the injury) is acute care, meaning a visit to the emergency room to rule out any brain bleed or other serious brain injuries. For concussions that don’t require emergency room visits, or as follow-up to an evaluation in the emergency room, an individual should go through three additional phases of assessment and treatment:
Phase 2 (within a day or two of the injury, whether or not the patient has not gone to the ER) consists of a neurological and neuropsychological examination that can be conducted as an outpatient.
- A neurological exam assesses any physical symptoms that are the result of brain injury and includes evaluation by a neurologist (who may order imaging studies).
- Neuropsychological testing helps to identify any cognitive problems such as issues with memory, attention, or reasoning that might be due to the concussion.
- These neurological and neuropsychological evaluations contribute to the Roadmap to Recovery, including a recommendation of when to return to school, work, and/or athletics.
Phase 3 (based on the results of the assessment) may simply consist of monitoring to ensure full recovery; if continuing symptoms warrant it, this phase may include treatment for a variety of post-concussion issues, including:
- Neurological problems such as headache, sleep, and dizziness, which are addressed by a neurologist who may prescribe medication or monitor recovery
- Cognitive and emotional problems, which are are addressed with neuropsychological treatment
- Visual or balance problems, which are addressed by an ophthalmologist or physiatrist as needed
Phase 4 (if needed) is follow-up as required with a neurologist or neuropsychologist for recurring problems, continuing until a full recovery is reached.