The signs and symptoms of a concussion can be subtle and may not be immediately apparent. Symptoms can last for days, weeks or even longer.
Common symptoms after a concussive traumatic brain injury are headache, loss of memory (amnesia) and confusion. The amnesia, which may or may not follow a loss of consciousness, usually involves the loss of memory of the event that caused the concussion.
Signs and symptoms of a concussion may include:
- Headache or a feeling of pressure in the head
- Temporary loss of consciousness
- Confusion or feeling as if in a fog
- Amnesia surrounding the traumatic event
- Dizziness or "seeing stars"
- Ringing in the ears
- Slurred speech
- Delayed response to questions
- Appearing dazed
Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury, such as:
- Concentration and memory complaints
- Irritability and other personality changes
- Sensitivity to light and noise
- Sleep disturbances
- Psychological adjustment problems and depression
- Disorders of taste and smell
Symptoms in children
Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they may not be able to describe how they feel. Nonverbal clues of a concussion may include:
- Appearing dazed
- Listlessness and tiring easily
- Irritability and crankiness
- Loss of balance and unsteady walking
- Crying excessively
- Change in eating or sleeping patterns
- Lack of interest in favorite toys
When to see a doctor
See a doctor within 1 to 2 days if:
- You or your child experiences a head injury, even if emergency care isn't required
The American Academy of Pediatrics recommends that you call your child's doctor for advice if your child receives anything more than a light bump on the head.
If your child doesn't have signs of a serious head injury, and if your child remains alert, moves normally and responds to you, the injury is probably mild and usually doesn't need further testing. In this case, if your child wants to nap, it's OK to let him or her sleep. If worrisome signs develop later, seek emergency care.
Seek emergency care for an adult or child who experiences a head injury and symptoms such as:
- Repeated vomiting
- A loss of consciousness lasting longer than 30 seconds
- A headache that gets worse over time
- Changes in his or her behavior, such as irritability
- Changes in physical coordination, such as stumbling or clumsiness
- Confusion or disorientation, such as difficulty recognizing people or places
- Slurred speech or other changes in speech
Other symptoms include:
- Vision or eye disturbances, such as pupils that are bigger than normal (dilated pupils) or pupils of unequal sizes
- Lasting or recurrent dizziness
- Obvious difficulty with mental function or physical coordination
- Symptoms that worsen over time
- Large head bumps or bruises on areas other than the forehead in children, especially in infants under 12 months of age
No one should return to play or vigorous activity while signs or symptoms of a concussion are present.
Experts recommend that an athlete with a suspected concussion not return to play until he or she has been medically evaluated by a health care professional trained in evaluating and managing concussions. Children and adolescents should be evaluated by a health care professional trained in evaluating and managing pediatric concussions.
Experts also recommend that adult, child and adolescent athletes with a concussion not return to play on the same day as the injury.
Apr. 02, 2014
- Evans RW. Concussion and mild traumatic brain injury. http://www.uptodate.com/home. Accessed Oct. 30, 2013.
- Halstead ME, et al. Sports-related concussion in children and adolescents. Pediatrics. 2010;126:597.
- Concussion: What can I do to feel better after a concussion? Centers for Disease Control and Prevention. http://www.cdc.gov/concussion/feel_better.html. Accessed Oct. 30, 2013.
- Heads up: Concussion in youth sports. A fact sheet for parents. Centers for Disease Control and Prevention. http://www.cdc.gov/concussion/HeadsUp/youth.html. Accessed Oct. 30, 2013.
- Heads up: Facts for physicians about mild traumatic brain injury (MTBI). Centers for Disease Control and Prevention. http://www.cdc.gov/concussion/HeadsUp/physicians_tool_kit.html. Accessed Oct. 30, 2013.
- Head injury. American Academy of Pediatrics. http://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/Head-Injury.aspx. Accessed Oct. 30, 2013.
- Schutzman S. Minor head trauma in infants and children. http://www.uptodate.com/home. Accessed Oct. 31, 2013.
- Giza CC, et al. Summary of evidence-based guideline update: Evaluation and management of concussion in sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;80:2250.
- McCrory P, et al. Consensus statement on concussion in sport: The 4th International Conference on Concussion in Sport held in Zurich, November 2012. Journal of Athletic Training. 2013;48:554.
- Wetjen NM, et al. Second impact syndrome: Concussion and second injury brain complications. Journal of the American College of Surgeons. 2010;211:553.
- Halstead ME, et al. Returning to learning following a concussion. Pediatrics. 2013;132:948.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Oct. 31, 2013.
- Brown AW (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 19, 2013.