Neurology and Neurosurgery

A bump on the head or a concussion? How to tell the difference.

Nuvance Health neurologist discusses concussion symptoms and treatment

By Dr. Paul Wright, Senior Vice President and System Chair of the Nuvance Health Neuroscience Institute


Paul Wright

Learn how to spot the signs of a concussion and what to do if you think you may have one

Head injuries in adults can occur in a variety of ways, including while working on home improvement projects and during car accidents, falls or participation in recreational sports. Sometimes, a blow to the head or a jolt to the body can cause a concussion, a type of traumatic brain injury (TBI) that occurs when the brain bounces around or twists inside the skull.


Although there are a few things you can do to reduce your risk of getting a concussion, accidents may still happen. Here is what you need to know about concussions, including how to spot the signs and when to seek medical care.


Related story: Two-year-old narrowly survives emergency brain surgery during COVID-19 pandemic


What are the signs of a concussion?

Adults who have experienced a concussion may seem dazed, feel sluggish, forget where they are or what they are doing, appear clumsy or unbalanced in their movements or respond to questions slowly. They might also experience a headache, nausea, vomiting, vision changes, balance problems, difficulty concentrating or sensitivity to light or noise.


Get evaluated as soon as possible by a clinician who has experience treating concussions if you think you may have one.


Although concussion symptoms often show up right away, some concussion symptoms may not appear for hours or days after the injury occurred. Monitor your condition and alert your healthcare clinician about any new or changing symptoms.


What concussion symptoms require emergency care?

Some concussion symptoms could indicate a serious problem. Go to the emergency department or dial 911 if you sustained a bump, blow or jolt to the head or body and experience “red-flag” symptoms, including:

  • One pupil is larger than the other
  • Drowsiness or an inability to wake up
  • Headache that gets worse, is severe or does not go away
  • Slurred speech
  • Weakness, numbness or decreased coordination
  • Repeated vomiting or prolonged nausea
  • Convulsions or seizures
  • Unusual behavior or mood/personality changes, such as confusion, restlessness or agitation
  • Loss of consciousness — even briefly


Where should I go for concussion care?

Dial 911 or go to the emergency department if you have any of the “red-flag” symptoms outlined above.


Nuvance Health emergency departments have neurologists and neurosurgeons available 24/7 who are equipped to provide emergency concussion and TBI care.


For less-severe symptoms, see a primary care or urgent care clinician as soon as possible.


Related story: Man survives traumatic brain injury after falling from a ladder


How is a concussion diagnosed?

Your healthcare clinician will ask about symptoms, how the injury occurred and if you have had concussions in the past. They will also conduct a complete neurological exam.


Imaging tests — such as a CT or MRI — are not usually necessary to diagnose a concussion. Your healthcare clinician will only order these tests if they recommend further evaluation for you.


Depending on whom you see for an initial evaluation, they may refer you to a neurologist for follow up care. Nuvance Health neurologists are experienced in treating concussions and can recommend an appropriate treatment plan for you.


How is a concussion treated?

Rest is a crucial component of concussion recovery. You might need to limit physical activity and activities that require thinking and remembering. Your healthcare clinician will tailor additional treatments if necessary to your specific needs that may include medication, physical therapy, adjusting work routines or neuropsychiatric care.


When can I resume normal activities after a concussion?

Your healthcare clinician will provide more information about when you can safely return to exercise, work and other routine activities. They will base recommendations on several factors including your overall health, concussion history, the severity of the injury and the rate of recovery.


Recovery may be slower in adults over the age of 40, so it is important to remember to take it easy and let your healthcare clinician know if your symptoms worsen or do not improve over time.


Related article: Kids and concussions: Know the signs and when to seek treatment


The bottom line: If you think you may have a concussion, it is important to see a primary care, neurologist or urgent care clinician as soon as possible. If you experience “red-flag” concussion symptoms, visit the emergency department or dial 911 immediately.


Learn more about Nuvance Health neurology and neurosurgery care.