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Concussion Symptoms and Diagnosis

The signs and symptoms of a concussion aren't always obvious.

There are instant signs that a concussion has occurred and common symptoms that may start right away or develop slowly over time.

A concussion can occur with both a direct knock to the head or an indirect blow to the body that impacts the head.

It's vital to know the signs and symptoms of concussion and seek proper diagnosis and treatment from a trained concussion expert.

Contact the UPMC Sports Medicine Concussion Program

To learn more about concussion treatment or make an appointment with a UPMC Sports Medicine Concussion Program expert:

What are the Immediate Signs of a Concussion?

  • Disorientation or confusion. Any change in mental status means an injury has occurred. Coaches should remove an athlete from play right away.
  • Vomiting. Throwing up right after an injury or blow to the head is a red flag that a concussion has occurred.
  • Amnesia. Some people have memory loss of the moments leading up to the injury or the moments right after. In some cases, memory loss may extend to include hours and even days prior to or after the injury.
  • Loss of consciousness. You don't have to lose consciousness to sustain a concussion. Less than 10% of people who suffer a concussion lose consciousness. But it's vital to take any loss of consciousness — even for a few seconds — very seriously.

What are the Common Symptoms of a Concussion?

  • Headache/feeling of pressure in the head. Headache is the most common symptom. When a concussion occurs, the brain moves inside the skull in an unnatural way. Think of how an egg yolk moves within its shell. This causes a series of metabolic events that may lead to pain or pressure in the head.
  • Migraine. In some cases, migraine headaches happen as well. Migraine symptoms include headache with nausea or sensitivity to light or noise.
  • Cognitive problems. Concussions can impact one's ability to think, concentrate, or process thoughts and directions. This may lead to problems learning new things.
  • Dizziness/motion sensitivity. When concussion affects the vestibular system, it can cause problems adjusting to space and motion, including a feeling of being carsick. It may also cause issues with balance and coordination.
  • Fogginess. This feeling is perhaps the hardest symptom to define. It often leads one to feel one step behind themselves or detached. Fogginess may increase when in busy settings, such as grocery stores or school cafeterias.
  • Nausea or vomiting. Many people feel sick or throw up in the days, or even weeks, after a concussion. Sometimes this is due to vestibular dysfunction, but it can also be from a migraine.
  • Fatigue or feeling sluggish. Many people feel fatigued, often toward the end of a long day, when recovering from concussion. Taking naps may seem like a good idea. But the best way to fight fatigue is to keep a regular sleep schedule and get a good night's sleep.
  • Changes in mood. Feelings of depression, anxiety, and irritability are common. Although most people start to feel more like themselves as they heal, some may need specific treatments. Psychotherapy, or sometimes a prescription, can help manage mood swings.

The experts at the UPMC Sports Medicine Concussion Program have found at least six different clinical paths a concussion may take. That's how we know each person will have different combinations of symptoms at different degrees.

Though clinical assessments can help pinpoint the degree of injury, it's vital to listen to your body and track your symptoms. This can help us provide you with the best course of treatment for your specific injury.

How Do You Diagnose a Concussion?

First, you should find a doctor trained in diagnosing and managing concussions.

To help tell the type and severity of your concussion, our program's experts:

We may also refer you to:

  • Neuroimaging for brain scans.
  • Vestibular ocular motor screening.
  • Physical and exertion training and rehab.
  • Primary care sports medicine doctors for medication management.
  • Behavioral vision therapy.

What to Expect at Your Concussion Exam

During the exam, your doctor will check your:

  • Vision
  • Hearing
  • Strength and sensation
  • Balance
  • Coordination
  • Reflexes

Cognitive tests

Tests such as ImPACT® (Immediate Postconcussion Assessment and Cognitive Testing), are key tools we use to diagnose a concussion.

ImPACT can test many factors, including your:

  • Memory
  • Concentration
  • Ability to recall information

Imaging tests

Your doctor may also order MRI or CT scans to make sure there's no bruising or bleeding in your brain. 

Learn More About Concussions

Concussion Basics

What is Neurocognitive Assessment?

Vestibular Assessment of Concussion Patient