Do You Have a Concussion?

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This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim cannot get expert medical help. Please see the disclaimer.

How to Know If You Really Have a Concussion

by James Hubbard, MD, MPH

Almost everyone has hit their head and seen stars. Sometimes it kind of dazes us. We usually rub it and go on with what we’re doing. But sometimes, people get symptoms, and they linger. Then the question becomes, do you have a concussion? And why does it matter to know?

I hope you know you should see a doctor if you ever get knocked out. But what if you just have bad headache? And what should you do if you can’t get to a doctor?

We’re learning more and more how seemingly minor concussions can damage our thinking for as much as a lifetime. No matter the reason for the head trauma, whether it’s sports or a fall or a tree limb, you should know what to watch for and what you should do.

Any sport has its share of concussions—any—from soccer to football to basketball to cheerleading. Concussion can happen at all ages, but a mild concussion in a young person’s still-developing brain has the potential to be more serious than in an adult’s.

Still, that doesn’t mean we older folks shouldn’t worry. For instance, the military has gone into overdrive trying to learn how to prevent concussions and what the best treatment is to diminish long-term effects. And if you follow pro football, you know concussions have become the sport’s most talked-about injury. Many former players are just now reaping the damage from the times they “got their bell rung” and just shook it off. Multiple concussions take their toll.

But, even after one concussion—even what we’d call a mild one—the effects can linger for weeks to months to years, especially if the injury isn’t treated correctly.

Do You Have a Concussion?

Check the Neck

Never forget, if there is a head injury, there could be a serious neck injury. Check the neck thoroughly. Neck injuries cannot ever be ruled out unless the person is alert enough to follow commands and tell you what hurts, what’s numb, etc. See my post and video for stabilizing a neck.

In order to know if you have a concussion, technically termed a “mild traumatic brain injury,” you have to know the signs and symptoms to look for. Most of the following information comes from the CDC’s website section on concussions. The “Heads Up” videos are especially good.

Get to a Doctor

Of course, a thorough, expert medical exam and X-rays—if indicated—are essential after any head or neck trauma, but it becomes a must even if it’s hard to get to a doctor if there is:

  • Any loss of consciousness greater than 30 seconds
  • Weakness or numbness of an arm or leg, hand or foot, fingers or toes
  • Neck tenderness
  • Loss of range of motion in the neck

Signs and symptoms of a concussion come in four general categories. These problems can occur immediately or start hours after the injury.

1. Physical

  • Headache
  • Increased sensitivity to light or sounds
  • Dizziness
  • Trouble with balance
  • Nausea or vomiting
  • Double or blurry vision

Quick exams to check for these signs and symptoms:

    1. Have the person stand, feet together and eyes closed. Be ready to catch if they start falling because of balance problems. If they pass this …
    2. Have them open their eyes and stand on one foot.
    3. Have them walk a straight line.
    4. Have them stretch out a hand, then touch their nose with their index finger. Alternate hands and repeat a few times.

If the person has problems with any of these, think concussion.

2. Thinking

  • Confusion
  • Amnesia (can be trouble remembering things that happen either before or after the injury)
  • Loss of consciousness
  • Feeling foggy
  • Disorientation—trouble knowing what happened, where they are, who they are, or what day it is.
  • Books adTrouble focusing
  • Slurred speech
  • Slowed verbal or physical responses
  • Excessive drowsiness

Quick exams:

    1. Ask them their name, your name, what day it is, and where they are. If they can’t answer all the questions, or if they answer very slowly, they’ve likely had a concussion.
    2. Place your pointer finger about a foot from their face. Have them follow your finger as you move it from side to side, up and down, and diagonally. They should be able to follow it without much lag time.

3. Mood

  • Mood swings
  • Increased irritablility
  • Excessive fatigue that lingers
  • Nervousness/anxiety
  • Depression/sadness

4. Sleep

  • Trouble getting to sleep
  • Sleeping more than usual
  • Sleeping less than usual

See what people are saying about The Survival Doctor e-books.

When a Concussion Becomes an Emergency

Downloadable Chart

The CDC has a chart you can download to follow the status of someone post-concussion. Click here to download the PDF.

Any person with a concussion should be observed for 24–48 hours for any new problems and for initial problems getting worse. If things do get worse, it becomes essential that the person get expert medical help right away since they are going to need further evaluation, along with treatment that just can’t be done in the field.

Danger signs and symptoms include:

  • Increasing headache
  • Slurred speech
  • Repeated vomiting
  • Increasing confusion
  • Seizures
  • Increasing irritability

Exam: Shine a light in one eye, then the other, to check the pupils. They should react and constrict equally. Note the initial exam, repeat every 30 minutes for a couple of hours, then every two hours for the next 24. Watch for changes. It’s much better to do this in a fairly dark place so the eyes will be dilated to start. Try it on a friend to get the hang of it, so you know what a normal exam looks like.

Aha! You Have a Concussion. What to Do.

Other than the above,

1. Rest. It is essential. Any person with a concussion needs to rest physically and mentally until the symptoms have been gone for 24 hours. That means no play and no school. And if you’re in a disaster, someone else needs to take charge if at all possible. It’s not only the danger of poor judgment that makes this important. It’s not even just the fact that getting a second concussion before the first heals is particularly dangerous. It’s that a concussion affects your whole brain. The metabolism changes, the synapses fire improperly. Physical activity can worsen this and also prolong recovery. So can mental activity. You have to rest your thinking. No texting or videogames, no television or reading, and delegate all decision making you can.

The symptoms can last from a few hours to many months. After they’ve gone away for 24 hours …

2. Gradually start back the mental and physical activities. If the headache or other symptoms return, you need to do less activity for 24 more hours.

I know this can be very, very inconvenient. But if you don’t do it right, symptoms will linger. In fact you may never get back to normal.

However, the good news is the vast majority of people with concussions do return to normal brain function, usually within 24–48 hours, especially if it’s their first concussion.

What about you? Have you known anyone who had a concussion? How did they do?

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  • Laureb

    me and my brother were having fun and he trough me on the couch and kept on slapping me and now i feel really really dizzy do I have a cincusion

    • James Hubbard, MD, MPH

      I can’t diagnose people without an exam. If you have concerns, you should have someone check up.

  • nicolas

    Is it possible to get a mild concussion and have none of the symptoms you described above?

    • James Hubbard, MD, MPH

      Maybe so, but you’d have symptoms of some sort. If there’s no brain dysfunction at all, I’m not sure why you’d think concussion since that’s pretty well the definition. Now, rarely, you could have something like some bleeding in the brain that might not initially cause much in symptoms but can become life-threatening. But, if that’s not a concussion. That’s another injury altogether.

      • nicolas

        The reason I was asking was last night I walked into a partially opened door (and hit the thin face that’s usually against the frame when the door is closed). I had heard about getting concussions from similar incidents before and found this site. The only pain I’ve had is pain on my face where it came in contact with the door (right above my eyebrow and on my nose). There are no cuts or bruises, though I expected a bruise. Someone watched me while I did the balance and motor tests you described in “Part 1″ of “Do you have a concussion?” To me, it sounds like I do not have a concussion, but I am not a doctor. What do you think? Also, I’m sorry if this sounds overly thorough. I have a very dear friend who has had problems with this and advised me to be very careful about what I “blow off.” Thank you.

        • James Hubbard, MD, MPH

          Nicholas, I can’t give you specific advice without an exam. However, again, a concussion depends on symptoms. Just because someone gets a lick on the head or a bruise doesn’t equal concussion, bruise or no bruise.

  • Bob

    I was riding a horse and it spooked and I fell off. I hit my head on the ground, nose first. It hurt for a few minutes. I rolled and got right back up, so I don’t think I lost consciousness at all. After getting right back up and walking after the horse, I felt a little dizzy for a second, like you sometimes do after falling and getting right back up. But I seemed fine, so I got back on and kept riding for about another half hour. Afterward, I tripped over something once, and had a bit of a headache, and was overall a bit shaken up. I was tired, but that is probably from lack of sleep. I felt a bit badly, but I don’t think my pupils are dilated. They are usually a bit bigger than other people’s but they look normal. Do I have a concussion, if even just a minor one? And if so, what should I do?

    • James Hubbard, MD, MPH

      Have someone check you out and see how they think you are. By the way, dilated pupils are not a sign of a concussion.

  • J

    I got hit in football on the side of my head… It hurt really bad for like admire after then went away for the rest of the game… However about 2 bourse after the game I started getting this pretty bad headache and felt a little out of it. Now it’s about a day and a half later and I still have a headache however earlier today I was able to play catch and surf. Do I have a concussion?

    • J

      *a minute

      • James Hubbard, MD, MPH

        You should have someone check you out.

  • Alexandra

    I have had a concussion before. It was like 5 months ago. Everything was fine for a while and then school started again and i have been having trouble with tests, reading, etc. I don’t know if I should go back to the doctor. He cleared me and I have been taking it easy, but I’m still having heaving symptoms such as:
    -short term memory loss
    -long term memory loss
    -blurry vision
    -insomnia(which happened after incident)
    -pounding temples when concentrating
    -messed up speech. ex: “I’m going to go tqke a sleep” or “we have a sleeping bag that can keep you warm when it is -0.”
    -trouble concentrating.

    So, my question is should I go to the doctor, ER, or leave it. It is normal. Please reply or i’m going to ignore it. I have a soccer season.


    • James Hubbard, MD, MPH

      You should schedule and see a doctor asap.

      • Alexandra

        Ok. Thank you. So, no soccer?

        • James Hubbard, MD, MPH


          • Alexandra

            Great…but thank you so much. The good thing is that I will be safe.

  • caitlin

    I was in cheerleading today and my flyers calve muscle hit my head I can see talk move and do everything perfectly fine I just have a slight headache nothing major I realized my Headband I had on scratch my head a little not deep no stitches just a small scratch my mom cleaned it out, do I have a concussion?

    • James Hubbard, MD, MPH

      Have your mother check you out. But, to diagnose a concussion, you have to have trauma plus symptoms. A slight headache would depend on how slight and if over-the-counter medicines gets rid of it.

      • caitlin

        Ok thank you so much I really appreciate it

        • James Hubbard, MD, MPH

          You’re welcome

  • Alicia

    I was hit in the face by a soccer ball. I did not have any signs of trauma at the time. This happened July 27th. I started showing signs in mid August. I have been to the doctor due to arm injury. I tore my rotator cuff. I was going to physical therapy because they thought it was a pinched nerve. Well in Therapy I started to get dull headaches, dizziness and some vomiting. I forgot to mention being hit when I went to the doc due to arm issues. In September the signs started getting a little more intense. It is all on the side of my arm injury. I was hit on that side. Could it be symptoms of concussion or just the arm trauma?

  • Ben

    Hello. Yesterday I was on a high chair, and I fell off and hit my head on a sofa arm. Of course it hurt, but it didn’t knock me out or anything, and I’ve been able to function normally. I feel a bit drowsy, but it may be because I was up late last night, and am a bit tired. I felt fine a few hours ago once I woke up from a nap. I can balance, talk to people easily, and I’ve been walking around my campus with no problems. It hurts where I hit it when i touch it, and my head feels a bit heavy, but only now that I’ve started thinking about it. Am I overreacting? I’ve hit my head harder before this on the sidewalk on the child and I never had a concussion, so I feel like I’m just overreacting. Am I?

    • James Hubbard, MD, MPH

      Ben, you didn’t mention any symptoms other than tenderness around the bruised area. In general, a concussion needs two things. And injury and symptoms. Certainly there are other potential problems after an injury such as a bruised bone (most always) or a fracture, or bleeding inside. ( ) but for a concussion you’re going to have symptoms many of which I write in the post, at least feel funny or different. The bottom line though is, if you have concerned get the campus clinic to check you out.

  • drummajordyl

    While stunting on my cheer team, another girl and I hit heads pretty hard. Our athletic trainer had me take this test that each of us took at the beginning of the season. It showed that my reaction time and memory were way worse than before.I am really sensitive to light and sound. I’ve also had a bad headache for the last 48 hours. Thanks to cheer leading I have a concussion, keeping me away from both marching band and cheer.

    • James Hubbard, MD, MPH

      Hope you’re well so. Take care

  • Sam

    I play hockey I didn’t really get hit but I got clipped (tripped) and I didn’t hit my head but I spun around and I was like a ragdoll…the only thing is that I am not dizzy or throwing up and I can’t tell about the head ache…I had an head ache before I got tripped…but it got worse after the trip… Do I have a concussion?

    • James Hubbard, MD, MPH

      If you’re still having symptoms you should be checked out by a coach, trainer, etc.