Concussion - adults - discharge

  • Description
    • A concussion may occur when the head hits an object, or a moving object strikes the head. A concussion is a minor or less severe type of brain injury, which may also be called a traumatic brain injury.

      A concussion can affect how the brain works for a while. It may lead to headaches, changes in alertness, or loss of consciousness.

  • Alternative Names
    • Brain injury - concussion - discharge; Traumatic brain injury - concussion - discharge; Closed head injury - concussion - discharge

  • What to Expect at Home
    • Getting better from a concussion takes days to weeks or even months. You may be irritable, have trouble concentrating, or be unable to remember things. You may also have headaches, dizziness, or blurry vision. These problems will likely recover slowly. You may want to get help from family or friends for making important decisions.

  • When you First go Home
    • You may use acetaminophen (Tylenol) for a headache. DO NOT use aspirin, ibuprofen (Motrin or Advil), naproxen, or other non-steroidal anti-inflammatory drugs.

      You DO NOT need to stay in bed. Light activity around the home is okay. But avoid exercise, lifting weights, or other heavy activity.

      You may want to keep your diet light if you have nausea and vomiting. Drink fluids to stay hydrated.

      Have an adult stay with you for the first 12 to 24 hours after you are home from the emergency room.

      • Going to sleep is okay. Ask your doctor whether, for at least the first 12 hours, someone should wake you up every 2 or 3 hours. They can ask a simple question, such as your name, and then look for any other changes in the way you look or act.
      • Ask your doctor how long you need to do this.

      DO NOT drink alcohol until you have fully recovered. Alcohol may slow down how quickly you recover and increase your chance of another injury. It can also make it harder to make decisions.

  • Activity
    • As long as you have symptoms, avoid sports activities, operating machines, being overly active, doing physical labor. Ask your doctor when you can return to your activities.

      If you do sports, a doctor will need to check you before you go back to playing.

      Make sure friends, co-workers, and family members know about your recent injury.

      Let your family, co-workers, and friends know that you may be more tired, withdrawn, easily upset, or confused. Also tell them that you, may have a hard time with tasks that require remembering or concentrating, and may have mild headaches and less tolerance for noise.

      Consider asking for more breaks when you return to work.

      Talk with your employer about:

      • Reducing your workload for a while
      • Not doing activities that may place others in danger
      • Timing of important projects
      • Allowing rest times during the day
      • Having extra time to complete projects
      • Having others check your work

      A doctor should tell you when you can:

      • Do heavy labor or operate machines
      • Play contact sports, such as football, hockey, and soccer
      • Ride a bicycle, motorcycle, or off-road vehicle
      • Drive a car
      • Ski, snowboard, skate, skateboard, or do gymnastics or martial arts
      • Participate in any activity where there is a risk of hitting your head or jolt to the head
  • When to Call the Doctor
    • If symptoms DO NOT go away or are not improving after 2 or 3 weeks, talk to your doctor.

      Call the doctor if you have:

      • A stiff neck
      • Fluid and blood leaking from your nose or ears
      • A hard time waking up or have become more sleepy
      • A headache that is getting worse, lasts a long time, or is not relieved by over-the-counter pain relievers
      • Fever
      • Vomiting more than 3 times
      • Problems walking or talking
      • Changes in speech (slurred, difficult to understand, does not make sense)
      • Problems thinking straight
      • Seizures (jerking your arms or legs without control)
      • Changes in behavior or unusual behavior
      • Double vision
  • References
    • Giza CC, Kutcher JS, Ashwal S, 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;80:2250-2257. PMID: 23508730

      Heegaard WG, Biros MH. Head Injury. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 41.

      Rossetti HC, Barth JT, Broshek DK, Freeman JR. Concussion and brain injury. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 125.