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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  • zariyah

    today i was in dance and i fell on my head on the hard dance floor really hard because my partner dropped me. its been about 5 hours since its happend. i been having this really bad headache and i told me mom. i put ice on my head hoping it would help but not as much. i have a big bump in the back of my head. should i see a doctor? should i go to school tomarrow? do i have a concussion?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      I can only give the general information in the post. You and your mom will have to decide the specifics. Maybe, show her the post? It’s good that you told your mom so she can keep an eye on you. If you don’t see a doctor, perhaps you could have the school nurse check you. Here’s another post on head injuries http://www.thesurvivaldoctor.com/2013/08/21/head-trauma-symptoms/

  • Tabs

    Just recently I had a episode where I passed out, due to smoking weed for the first time, I passed out, and woke up but I wet myself and knew everything that happened leading up to it and after. I have no problems with focusing or etc. No headaches, no anything. I do feel almost light in the head but it always goes away. I have a small bump on my head, but it’s just sore. Most the trauma hit my face and I received a broken nose. Do I have a concussion. (I also had the same occurrence when I had a edible. I passed out. I had the same symptoms leading up to it except I was in bed and threw up afterwards. )

    • Tabs

      Mind u the wetting part was due to the fact I got up to use the restroom….I had to go pretty bad. :/ and when I passed out I let it all out. :(

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        A concussion is from a head injury. Sounds like you passed out for another reason. You should be checked out by a doctor and absolutely no more weed.

        • Tabs

          Thank you! And I did just get checked out. It was from the weed. My body rejected it. Also my body’s heartbeat slowed down. So deff no more weed.

  • Emily

    Last Night I Had A Few Friends OvEr And We Were All Just HangoinIng Out. I WeNt To Do A Somersault And Ended Up Hitting My Head AgainT The Ground (Grass And Dirt)… I Was Only A Couple Inches Off The Groumd But Hit It Hard Enough To Make ALogjt Thump noise. I Was Fine Last Night, Running Aroumd Amd Stuff, But All Day Today I Have Had Bad Headache. I Remember Everything That Happened Before And After Last Night Amd A Headache Is The Only “Symptom” I have.. Do I Have A Concussion Or Is It Just A Headache FRom Hitting The Ground?

    I Know The SpellIng And Caps Is Weird…. Thats Not From Me Thoigh My Keyboard Is Broken..

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Emily, I can’t diagnose individuals without an exam. All I can do is give you the general symptoms in the post. If you have concerns, have someone check you out. Here’s another post you might be interested in. http://www.thesurvivaldoctor.com/2013/08/21/head-trauma-symptoms/

  • Zachary Doe

    So I fell Monday night, got bump, and since then have had a headache, confusion, trouble sleeping, and slowed thinking. Been resting as much possible though did work tonight as server I’m working tomorrow. Been taking teyanol each day, and citing.my bruise. Isn’t getting worse, but isn’t.going.away. can’t really see doctor till Monday. How Worried should I be?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Zachary, I can’t diagnose or treat you individually without an exam but, in general, with a concussion (and it sounds like you have one), please read the post section “Aha. You Have a Concussion. What to Do,” and the section about when it becomes an emergency. Until you see a doctor, you should rest mentally and physically and that would mean not working.

  • Kate

    I fell directly on my back after doing a lay out on a spring floor today.I tried to tuck my head in and land on my back but my head flew back and hit the floor. I have a very minor headache but I’m not sure if it’s bad enough to see a doctor.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Kate, have someone–parent, coach–check you out.

  • bobby

    I got hit in the head by a pitch when i was up to bat, i have had a headache for about 3-4 days now and cant focus on anything. I also get dizzy and nauseated when i run. do i have a concussion?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      sounds like it. You should tell your parents, teachers, and coaches.

  • jon

    So, I ramed my head into the door and punched my nose hard ( it bleed a lot). Aside from the obvious mental unstable ness going on, my neak hurts so bad as does my nose and the temples on my head. I am unable to sleep I’m too uncomfortable I can’t seem to find that spot. I feel like a complete moron because this was self inflicted and I’m quite embarrassed. No one will understand why I did it but as of now I’m in a lot of pain this happened 2 hours ago and well i am scared I actually did something extremely serious to myself I’m horrified at the fact that it could be quite dangerously serious. Am I over reacting?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      You should see a doctor this morning to check out your neck.

  • Chloe

    Hey so I was running really fast to pick up a ball for dodgeball in gym class and while I was running I hit my left temple really hard on a concrete wall and afterwards I had a really bad headache nausea dizziness and I kept crying and felt sad so I looked it up and it seemed like I might have a concussion so I told my mom and she let me rest the rest of the day and then I slept all of the next day I feel better but I still have a headache but not as bad as the day it happened should I go to a doctor or do you think I will probably be fine if I just rest a bit more or?…

    Thankyou

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Chloe, you should check back with your mother and have her look you over and, yes, rest mentally and physically, as long as you have a headache (see post).

  • alyssa

    I played soccer and in the game I never got hit by the ball but I had blurred vision and I felt like I couldnt see some parts of the field. After that my vision cleared but I felt like I was going to throw up and had a mager headacke like an hour after the game. I am alittle sensitive to lit but headackes come on amd off and they hurt. Something as simple as a laugh can make me have a headacke.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Alyssa, tell your parents and have them check you out. Sounds like you might need to see a doctor if this is continuing.

  • Chris

    I got hit in the eye yesterday. I have a black eye but when I got hit, the fist hit more of my eye ball. I’m still waiting for the swelling to go down and more color to show up. I have symptoms of a concussion. When I move my eye around it hurts, I’m naseous, and I just feel out of it. I have a slight headache as well. Please get back to me soon!

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Chris, you should get checked out.