Q: Do I need to see a concussion specialist?
A: Yes — in the days following a concussion you should see a concussion expert. That expert could be a physician specializing in brain disorders (a neurosurgeon or neurologist) or a neuropsychologist specializing in assessing brain disorders through tests of mental functions such as attention, concentration, and memory. Given that the neurologic examination is almost always normal, a physician specializing in concussion usually works with a neuropsychologist as part of a team approach, ensuring a comprehensive evaluation and diagnosis. See Evaluation and Assessment.
Q: Should I go to the emergency room for a head injury?
A: Not necessarily—not every head injury requires a trip to the ER. But if you sustain a head injury with any of the following symptoms you should be seen in an emergency room:
- Loss of consciousness at the time of the injury
- Confusion or disorientation after the injury
- A headache along with nausea and/or vomiting
- Evidence of deteriorating mental status
Also, if you experience any of these symptoms within 24 hours of a head injury, you need to go to the emergency room, even if you felt okay at the time of injury. (See How Soon To Be Treated.)
Any individual who suffers a head injury followed by any of these serious symptoms should be evaluated in an emergency room:
- Unusual behavior or confusion
- Progressive or worsening symptoms
- Weakness, numbness, slurred speech
- Difficulty with eye movements
- Worsening or severe headache
- Vomiting multiple times
- Difficulty waking up or arousing
- Discharge of clear fluid or blood from the nose or ears
Q: Does a helmet protect me against a concussion?
No. A helmet provides protection against skull fracture, so it’s a good idea to wear one when engaging in activities and sports where there is a high risk of head injury. But although a helmet can cushion your skull, it can’t prevent your brain from moving within the skull and sustaining a concussion or other traumatic brain injury. Find out more About Concussions.
Q: What treatments are available for concussion?
A: Concussions usually resolve on their own within one to six weeks without medical treatment. They do require a patient’s cooperation, though: The brain needs rest — both physical and cognitive — in order to recover. A trained clinical neuropsychologist can assess the patient and make a recommendation on how much time will be needed to allow for a full recovery. The neuropsychologist can also identify post-concussion difficulties that do require intervention. See Brain Injury Treatments.
If intervention is needed, treatments may be provided by one or more specialists with expertise in the post-concussion symptoms the individual is experiencing:
Neurologist for headache, sleep difficulty
Neuropsychologist for cognitive or emotional difficulty
Neuro-ophthalmologist for visual disturbances
Physiatry for problems with balance or vertigo
Q: My concussion was weeks ago! Why don’t I feel better yet?
A: Concussions usually resolve without medical treatment within one to six weeks. Some people continue to feel the effects of the injury for longer than that, a condition known as post-concussion syndrome. Neuropsychologists can identify post-concussion difficulties that require intervention, along with the appropriate treatments. See Cognitive Remediation for Post-Concussion Syndrome.
Q: Am I now at greater risk for another concussion?
A: Yes, there is an increased risk of a second concussion from a head injury sustained soon after a first concussion. This may be due to slower reaction times, dizziness, headache, and other concussion symptoms related to incomplete healing and recovery of the first concussion. That makes it especially important to follow expert recommendations about returning to work, school, and sports after a concussion. Complete healing helps reduce the risk that a minor head bump can cause a second concussion. See Second Impact Syndrome.