How to Tell If a Person Has a Concussion

Co-authored by Scott Anderson, MA, ATC, SFMA, DNSP and Sophia Latorre

Last Updated: August 10, 2021 Approved

A concussion is a traumatic brain injury that most often occurs when someone is hit in the head. Concussions can also occur due to falling, physical abuse, vehicle, bicycle, or pedestrian collisions, and injuries from contact sports such as rugby and football. Though the effects of a concussion are usually temporary, a person with a suspected concussion should be evaluated by a healthcare professional. Repeated concussions can cause serious damage to the brain, including chronic traumatic encephalopathy (CTE).^{[1]
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Research source} Though it may seem like a scary situation, most people with concussions fully recover within a few days.^{[2]
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Part 1

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Checking for Immediate Signs

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Not everyone who gets a concussion will lose consciousness, but some people do. This is the most obvious sign that someone has a concussion. If the person has blacked out after a blow to the head, seek emergency medical treatment.^{[3]
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Ask the person some basic questions such as, “What is your name?” and “Do you know where you are?” If their answers are delayed, slurred, don’t make sense, or are hard to understand, they may have a concussion.

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If the person has a blank stare, seems confused, or doesn’t know where they are, it could be a sign of a brain injury. If they seem dazed, don’t remember what happened, or appear to have memory loss, they likely have a concussion.^{[4]
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If someone vomits, especially repeatedly, after being hit in the head or involved in another type of accident, this usually indicates a concussion. If they haven’t vomited, ask them if they feel nauseated or have an upset stomach, which may also be a sign of a concussion.^{[5]
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People with concussions often have problems with their motor skills, such as being unable to walk in a straight line or catch a ball. If the person is having trouble with these things or has a delayed reaction time, they likely have a concussion.
A headache that lasts more than a few minutes is a common sign of a concussion.^{[6]
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Scott Anderson, MA, ATC, SFMA, DNSP
Sports Medicine & Injury Prevention Specialist

Expert Interview. 24 March 2020.} Blurred vision, “seeing stars,” and/or feelings of dizziness or fogginess may also indicate a concussion.^{[7]
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If you suspect a concussion, the person should be carefully monitored for the next several hours. Symptoms of a concussion often change over a period of time.^{[8]
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Scott Anderson, MA, ATC, SFMA, DNSP
Sports Medicine & Injury Prevention Specialist

Expert Interview. 24 March 2020.} It’s not a good idea to leave them alone, in case they end up needing emergency medical treatment. If possible, arrange for someone to stay with the person for at least a few hours after the incident and monitor their behavior.

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Monitoring Them for Additional Symptoms

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1
Look for symptoms over the next several days or weeks. While some concussion symptoms show up immediately, some don’t appear until days or weeks afterwards. Even if the person seemed fine after the incident, they may begin to show signs of a concussion later on.^{[9]
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- The victim may exhibit signs such as slurred speech, confusion, nausea or vomiting, impaired balance or coordination, dizziness, blurred vision, or headache.
- These symptoms could indicate medical issues other than a concussion, so it’s important to have the person examined by a healthcare provider.
Sudden changes in behavior or mood often indicate a concussion. If the person seems grouchy, irritable, angry, sad, or otherwise emotional, seemingly without a reason, they may have a concussion. If the person becomes violent, acts out, or loses interest in their favorite things or activities, this can also indicate a concussion.^{[10]
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People that are suffering from concussions are often more sensitive to bright lights and loud noises. If these things make the person cringe or complain of pain, or if they have ringing in their ears, they may have a concussion.^{[11]
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Look for behavior that contradicts their usual patterns or habits. If the person has lost their appetite or is eating much more than normal, it could be a sign of a concussion. Similarly, if the person has trouble sleeping or is sleeping excessively, they may have a concussion.^{[12]
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Even if the person seems clear-headed after the incident, they may develop issues later on. If they seem unfocused, unable to concentrate, or have trouble remembering things that happened either before or after the incident, they likely have a concussion.^{[13]
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If the person that you suspect may have a concussion is a child, determine if they seem to be crying more than usual. Though most of the concussion symptoms are the same in children and adults, children may cry excessively because they are in pain, feeling off, or don’t know how to express what is wrong.^{[14]
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Seeking Medical Treatment

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If the victim doesn’t respond or wake up after losing consciousness, experiences worsening headaches, vomits repeatedly, has blood or fluid leaking from the ears and nose, has a seizure, difficulty breathing, or slurred speech, take them to the emergency room immediately. These symptoms could indicate a very serious brain injury.^{[15]
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Even if emergency medical treatment isn’t required, all head injuries should be evaluated by a licensed healthcare professional. If you suspect someone has a concussion, take them to the doctor within 2 days of the incident.^{[16]
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In general, the symptoms of a concussion decrease over time. If the opposite is happening and the person experiences worsening pain, such as headache, and/or increased fatigue, seek immediate medical attention. These signs could indicate a more serious injury.
Usually, bed rest is prescribed for people with concussions. This includes both physical and mental rest, meaning the person should avoid physical activity (like exercise) as well as strenuous mental activity (such as playing video games or doing crossword puzzles). Be sure to rest for as long as the doctor recommends, and always follow any other treatment plan as prescribed by your healthcare provider.^{[17]
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National Health Service (UK)
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If the victim got a concussion while playing a sport, exercising, or doing another physical activity, remove the person from the game or activity. They should not resume the activity until evaluated by a doctor, especially if it is a contact sport in which they may get hit again.

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Question

How can I tell if a head injury is mild or severe?

Scott Anderson, MA, ATC, SFMA, DNSP
Sports Medicine & Injury Prevention Specialist
Scott Anderson is the Chief Clinical Officer at SyncThink, an award winning startup founded out of Stanford University. Scott previously served as the Director of Sports Medicine/Athletic Training for Stanford University for over ten years from 2007 to 2017. Scott has over 18 years of clinical and management experience, and is a recognized international speaker on topics of clinical specialization, which include developmental kinesiology, neuroscience/concussion, and movement dysfunction. He is a certified Dynamic Neuromuscular Stabilization Practitioner (DNSP), Sports Safety Specialist and is certified to conduct Selective Functional Movement Assessments (SFMA), and Functional Movement Screenings (FMS). He earned a BS in Athletic Training from Washington State University in 2000 and an MA in Athletic Administration from Saint Mary's College in 2002.

Scott Anderson, MA, ATC, SFMA, DNSP

Sports Medicine & Injury Prevention Specialist

Expert Answer

A neurological specialist will be able to rule out other problems, like cervical injury, that can have similar symptoms to a head injury.

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Is it ok to take Ibuprofen if there's a possible concussion?

Jonas DeMuro, MD
Board Certified Critical Care Surgeon
Dr. DeMuro is a board certified Pediatric Critical Care Surgeon in New York. He received his MD from Stony Brook University School of Medicine in 1996. He completed his fellowship in Surgical Critical Care at North Shore-Long Island Jewish Health System and was a previous American College of Surgeons (ACS) Fellow.

Jonas DeMuro, MD

Board Certified Critical Care Surgeon

Expert Answer

Ibuprofen, sold under the brand name Motrin, is an NSAID drug. As such, it effects platelet function, and can be associated with bleeding. As a concussion may have a small amount of cerebral hemorrhage, you should not take Ibuprofen (Motrin), as it potentiates the bleeding. Discuss this with your physician so he can give specific advice your your situation if analgesic medications are needed.

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Are intermittent headaches a symptom of a concussion?

Sarah Gehrke, RN, MS
Registered Nurse
Sarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous (IV) therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.

Sarah Gehrke, RN, MS

Registered Nurse

Expert Answer

Yes, it is possible. Post-concussion headaches can vary and may also feel like a tension headache or even a migraine. Sometimes the tension-type headache can be caused from a neck injury that happened at the same time of the head injury. If you have a concern, you should talk to a doctor -- especially if memory loss or confusion is also present.

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Tips

Minor bumps may not be a concussion and the injured person may respond adequately and have no complaints. It is still a good measure to keep a close watch for emergency signs, especially vomiting, sluggish speech, or disorientation.

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Always monitor the victim for a long period after the injury to be sure they do not worsen. Allow them to rest, but awaken them every so often and ask them questions.

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The recovery time from a concussion may last anywhere from a few hours to several weeks. This differs for each person and individual injury.

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Warnings

A serious head injury can result in a coma if the victim is not treated immediately.

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Repeated injury to the brain can lead to brain swelling, long-term disabilities, or death. You are more likely to suffer repeated concussions if you do not allow the brain to heal after an initial concussion.

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Severity of a head injury may be difficult to assess but if someone is knocked unconscious call emergency services. Brain hemorrhage should be ruled out and may not exhibit symptoms right away. A slow bleed could affect the person days after injury.

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