Brain & Neurosurgery
Concussions
Mild traumatic brain injury — modern evaluation and return-to-play.
A concussion is a mild traumatic brain injury caused by a blow or jolt to the head. Most resolve fully with proper management within 1–4 weeks. The keys to good outcomes are: (1) accurate diagnosis, (2) appropriate cognitive and physical rest in the first 24–48 hours, and (3) graduated return to activity guided by symptoms — not just calendar time. Our team manages concussions with current evidence-based protocols.
Understanding the Condition
What is Concussions?
A concussion is a temporary disruption of brain function caused by traumatic force — direct or indirect. The mechanism is functional, not structural; standard CT and MRI are usually normal. The clinical diagnosis is made on history (mechanism + symptoms) and exam.
Management has evolved significantly. The old approach of 'cocoon therapy' (extended dark-room rest) has been replaced by brief initial rest (24–48 hours) followed by graduated return to activity. Sub-symptom-threshold aerobic exercise actually accelerates recovery.
Common Causes
- Sports impacts (football, hockey, soccer, lacrosse — head-to-head, head-to-ground)
- Motor vehicle accidents
- Falls (especially in children and older adults)
- Whiplash without direct head impact (yes, can cause concussion)
- Assault or workplace injury
Common Symptoms
- Headache (most common)
- Confusion or 'feeling dazed'
- Memory problems (especially around the injury)
- Dizziness or balance problems
- Nausea or vomiting
- Sensitivity to light or noise
- Sleep changes
- Mood changes (irritability, depression, anxiety)
- Slowed thinking or 'brain fog'
When to Seek Care
When Should You See a Specialist?
Any suspected concussion warrants evaluation. Red flags requiring ER: loss of consciousness over 1 minute, repeated vomiting, worsening headache, unequal pupils, increased confusion, seizures, or any focal weakness. For routine concussions, a sports medicine or neurology evaluation in the first few days establishes baseline and management plan.
Treatment Options
How We Treat Concussions
We always begin with the least invasive treatment that's likely to work for you. Surgery is reserved for cases where conservative care has been given a fair trial — or when the situation truly requires it.
Conservative (Non-Surgical) Care
- Initial 24–48 hour rest (cognitive and physical)
- Graduated return-to-activity protocol
- Sub-symptom-threshold aerobic exercise (now known to accelerate recovery)
- Headache management
- Vestibular therapy when balance/dizziness persists
- Vision therapy when needed
- Cognitive rehabilitation for prolonged recovery
- Return-to-school accommodations as needed
Surgical Options
- Concussions themselves are not surgically treated
- Surgery is occasionally needed for complications (e.g., subdural hematoma found on imaging)
Recovery & Outlook
What to Expect After Treatment
About 80–90% of concussions resolve fully within 1–4 weeks. The remaining 10–20% develop post-concussion syndrome with symptoms lasting weeks to months — these patients benefit from multidisciplinary care (sports medicine, vestibular PT, vision therapy, sometimes neurology). Multiple concussions or prolonged symptoms warrant subspecialty referral.
Meet Your Team
Specialists Who Treat Concussions
Related Treatments
Services That Address Concussions
Concussions — Frequently Asked Questions
Related Conditions
You May Also Want to Read About
Sports Injuries
A wide range of athletic injuries from sprains and strains to fractures and dislocations.
Traumatic Brain Injury
Comprehensive neurosurgical care for moderate and severe TBI, including post-injury rehabilitation coordination.
Headache & Migraine
Cervicogenic headaches, chronic migraines, and surgical migraine treatment for medication-resistant cases.
Get Expert Help for Concussions
Our specialists can diagnose your condition and design a personalized treatment plan that gets you back to the life you love.