Surrounded by a bony shield, protective membranes and cushioning fluid, our brains are the most protected organ in our bodies. Despite all this armor, a hard fall, car accident or collision on the sports field can cause potentially serious brain injuries called concussions.
There are many misconceptions about concussions. Athletes are what pop into most peoples’ minds when they think of concussion but older adults actually have the highest rates of brain injury-related hospitalizations and deaths. Falls, not football, account for the highest percentage of concussions. And CDC data suggests that most concussions may go unrecognized and untreated.
That’s because many people don’t recognize or brush off signs that they should be examined by a medical provider. With a little guidance, recognizing concussion symptoms and choosing the right place to get help doesn’t have to feel overwhelming.
While 70 percent of people say they are familiar with concussions, more than 80 percent can’t identify the most common signs and symptoms. Learning the basics can ensure you get timely care if you ever need it.
A concussion is a type of traumatic brain injury (TBI). It happens when your brain bounces or twists in your skull, triggering chemical changes and sometimes stretching and damaging brain cells. Typically, such injuries are caused by a blow to the head or a hit to the body that causes the head to violently snap in one direction and then the other (as in whiplash).
Clinically, concussions are considered “mild traumatic brain injuries” because they are not typically life-threatening. But “mild” is misleading; they can have serious health consequences and should always be evaluated by a medical professional. The historical concussion severity grading scale (1 to 3) has been shown to be unreliable at predicting recovery and is no longer standard. Today, concussions are evaluated individually using multiple factors and assessments.
The CDC estimates that between 1.4 and 3.8 million concussions occur in the U.S. every year. Falls are the leading cause of concussions and since older adults and very young children have a higher risk of falling, they also have a higher concussion risk. If you’re caring for a parent, grandparent or young toddler, a fall that seems minor may warrant medical attention sooner rather than later.
Athletes are another high-risk group. More than 300,000 sports-related concussions occur annually in the U.S., the majority in contact sports. If your child plays sports, it’s important to know the signs of concussion.
Other groups with increased concussion risk include teens and adolescents, people in higher-risk occupations such as construction and landscaping, people in the military and people with a history of prior concussions.
According to Mayo Clinic and the CDC, common symptoms of a concussion fall into four main categories:
Physical:
Cognitive:
Emotional/Behavioral:
Sleep:
Symptoms don’t always appear immediately; they can take hours, or even days, to develop, so monitor yourself or your child even if you feel fine right after an injury. Many people are also surprised to learn that you don’t have to black out to have a concussion. The American Association of Neurological Surgeons (AANS) notes that many people with concussions never lose consciousness and may not have any visible signs of injury.
Should you go to urgent care for a concussion? For most people urgent care is the practical and appropriate place to get first-line help. If you or a family member has taken a blow to the head and are experiencing mild symptoms but remain conscious and coherent, urgent care can likely provide the care you need. Our providers are experienced in assessing these injuries and will guide you toward the next level of care if needed.
Symptoms appropriate for urgent care include:
Urgent care centers offer quick access to experienced medical providers, walk-in availability, extended hours and multiple convenient locations. This makes it a great choice when your symptoms aren’t severe enough for the emergency department, but you can’t get in to your primary care provider quickly.
Our urgent care providers will assess the following to confirm a concussion diagnosis, rule out more serious injuries and build a recovery plan tailored to you:
One important note: According to the AANS, brain imaging such as CT scans and MRIs is typically not helpful and should be reserved for situations where there’s concern about bleeding, swelling or a fracture. If it’s needed, your provider may refer you to an emergency department or specialist. This isn’t cause for alarm, it’s simply the right next step in your care.
Some severe concussion symptoms are red flags for a more serious brain injury, such as bleeding in or around the brain, significant swelling or a skull fracture. These may require more advanced testing, surgical evaluation or around-the-clock monitoring that is only available at the emergency room.
Call 911 or go directly to the ER if you experience any of the following:
Seek ER care even if these symptoms appear hours or days after the initial injury.
If you or a loved one is 65 or older, or takes blood-thinning medications like warfarin, Xarelto, Eliquis, or Plavix, the threshold for going to the ER should be lower. TBIs can be missed or misdiagnosed in older adults because symptoms can overlap with other conditions, and blood thinners significantly increase the risk of serious bleeding in the brain. Err on the side of caution.
Whether you’ve been evaluated at urgent care or the ER, what you do at home in the days following a concussion matters enormously.
When it comes to concussion aftercare, current evidence-based guidelines recommend home monitoring and “relative rest” for the first 24 to 48 hours. The goal is to limit activities that require heavy mental or physical exertion while still gently going about your daily routine:
Return to activity gradually, starting with light physical activity, then more demanding exercise and finally full return to work, school or sports. The CDC recommends asking your provider for written guidelines on timing. Returning too soon can worsen symptoms, extend your recovery and increase your risk of complications.
After going home, have a responsible adult check on you regularly for the first 24 hours. Return to care or call 911 if your headache worsens, confusion increases, you can’t recognize familiar people or places, you have a seizure or can’t stay awake. Keeping a symptom diary can be helpful at your follow-up visit.
All concussion patients should schedule a follow-up with their primary care provider or a concussion specialist. Most concussions resolve within a few weeks, but some people develop post-concussion syndrome, with symptoms lasting weeks or months. If you’re not improving within 2 to 4 weeks or develop new symptoms, seek additional care.
In the future, should you go to urgent care for a concussion? The following real-life stories* illustrate the difference between symptoms that are appropriate for urgent care and those that require emergency room help.
Jordan, aged 14, comes off the field holding her head after a fall. She feels foggy and has a headache, but knows who she is, where she is and what day it is. She hasn’t vomited, didn’t lose consciousness and her pupils are equal and normal. Her parents bring her to urgent care, where the provider performs a neurological screening, reviews her symptoms and confirms a concussion with no red-flag signs. Jordan goes home with instructions to rest, limit screens and get cleared before returning to sports. Her symptoms resolve in 10 days. The right call: urgent care.
Mark, aged 47, is rear-ended. His head snapped violently forward and back. His headache, initially mild, worsens over two hours. His wife notices he’s confused and keeps asking what happened, even after being told. These are red flags, so she calls 911. In the ER, imaging reveals a small bleed requiring monitoring and neurosurgical consultation. Mark’s outcome is good because they didn’t wait. The right call: the emergency room.
*These scenarios are meant to illustrate general principles only and are not a substitute for professional medical evaluation. If you’re uncertain about the severity of a head injury, seek care immediately.
A concussion is a brain injury that requires medical attention. The key is to match the level of care to your symptoms. For most concussions, urgent care is an accessible, effective and cost-efficient option. For any red-flag symptoms, the emergency room is the right call.
Don’t try to “walk it off” or wait and see. Getting evaluated promptly, following your provider’s aftercare instructions and giving your brain the time it needs to heal are the most important things you can do after a head injury.
If you’ve taken a bump to the head and aren’t sure what to do, the team at BestMed Urgent Care is here to help. Book online or walk in at any of our locations, no appointment needed.
You should be evaluated by a healthcare provider after any head injury that causes symptoms — even mild ones. Don’t wait to see if things improve on their own. All suspected concussions deserve medical assessment.
The guidance to monitor someone closely for the first several hours after a head injury comes from the importance of watching for red-flag symptoms that may signal a more serious brain injury. If symptoms are worsening rather than stabilizing or improving during that window, seek emergency care right away.
The three most common signs are headache, dizziness, and confusion or memory loss following a blow to the head. Nausea and sensitivity to light are also very common.
If your symptoms include any of the red-flag signs listed above — especially progressively worsening headache, repeated vomiting, seizure, loss of consciousness, or slurred speech — treat the situation as a potential emergency and get to an ER or call 911. When in doubt, it’s always safer to get evaluated.