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You’ve Got a Concussion ... What’s Next?

Capt. Brian Daniels was playing a pick-up game of basketball on base when he tripped, fell and hit his head on the metal net-post. Though feeling a bit dazed, he finished the game anyway. Still feeling dizzy after the game, he passed if off as exercising on an empty stomach. So, he ate a protein bar and went to his duty station. His headache and dizziness worsened and following his duty shift, he went to the clinic on base. The doctor diagnosed him with a concussion.

Daniels made several wrong decisions after that jolt to his head. But, he made a correct one also. Can you identify what Daniels did wrong and what he did right? Do you know what steps to take to give yourself the best chance of recovery after a head injury … or how to protect yourself from another concussion?

Here’s what Daniels did right: he got checked out by a provider. However, he waited too long. Daniels kept playing a contact sport after his run-in with the post. Then, after ignoring important warning signs, he went to work.

What critical steps should we take after a blow or jolt to the head? The most important step is to see a medical provider immediately. Undiagnosed and untreated concussion puts you at risk for sustaining another concussion during the healing period. If you have a concussion, your provider will instruct you on what is OK and what to avoid while you recover. You’ll also learn when, and under what circumstances, you can return to regular activities.

Here’s what you should know now:

The First 24 Hours

Just like with a muscle tear or bruise, a concussion requires plenty of rest — both for the body and the brain. Resting your body means no physical work, heavy lifting or exercise until your provider says it’s OK. Resting your brain means limiting activities that require intense concentration, such as working on the computer, playing video games and watching television. Rest allows the brain to physically and mentally recover while removing the risk of sustaining a second concussion while the brain is healing from the first.

Rest applies to the first 24 hours and beyond. Other actions you should begin right away include:

  • Get plenty of sleep (six to eight hours)
  • Avoid activities that could lead to a second concussion (contact sports, combatives, driving)
  • Let others know you have a concussion in case you need help
  • Stay well hydrated by drinking plenty of water
  • Avoid alcohol and drugs
  • Avoid caffeine and energy drinks
  • Don’t take sedatives or other drugs unless instructed by your doctor

Red Flags

Recovery is different for each person, but chances are your symptoms will improve within hours and resolve completely within days to weeks. However, monitoring is needed as some individuals may experience persistent or worsening symptoms. These symptoms may be “red flags,” indicating that you might need to seek immediate medical attention again. See your medical provider immediately if you experience any of the following:

  • Severe headaches
  • Unsteady on feet
  • Blurred or double vision
  • Decreasing level of alertness
  • Increased confusion
  • Repeated vomiting
  • Slurred speech or unusual behavior
  • Seizures
  • Weakness or numbness in arms and legs

Recovery

When you’re ready to return to regular activities, your provider will guide you, if necessary, through a gradual approach with examples of safe activities. Research has shown that a gradual return to pre-injury activity may help many patients avoid long-term symptoms and post-concussion syndrome. The Defense and Veterans Brain Injury Center (DVBIC) recently released “Progressive Return to Activity Following Acute Concussion/Mild Traumatic Brain Injury” guidelines for your primary care and rehabilitation providers.

While every injury and recovery is different, always seek medical attention for a head injury. Don’t go to work or school, or resume sporting activities until you have fully recovered. And, rest.

Find more information and tips on the first 24 hours following a concussion in the DVBIC “Acute Concussion Educational Brochure.”

Dr. Therese West is a subject matter expert with Defense and Veterans Brain Injury Center clinical practice/clinical recommendations division. West develops health care guidance including clinical recommendations and clinical support tools for military providers. She is nationally certified as a family nurse practitioner and a certified pediatric nurse, as well as authored several articles on traumatic brain injury.



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