Signs and symptoms of a concussion can vary extremely between people. It is not always obvious that someone has a concussion, so if the mechanism of injury for a concussion was present, a concussion should always be suspected and thoroughly investigated.
You do not need to lose consciousness to suffer a concussion, and in most cases there is no loss of consciousness. If you do lose consciousness, however, you have most certainly sustained a concussion. Any loss of consciousness should be taken seriously, and any bouts lasting more than approximately a minute are considered severe.
Signs and symptoms of a concussion can vary extremely between individuals and can last days, weeks, months, or even longer in some cases. Fortunately, however, in the majority of cases symptoms usually resolve within 7-10 days.
One of the most common symptoms of a concussion is a headache. Confusion is another common sign. This sign can easily be overlooked by the examiner unless the patient is moderately to severely confused, so ruling out a concussion should not be based on the fact that the patient ‘did not appear confused.’
Other signs and symptoms of a concussion that may be present on their own or in combination are concentration difficulties, decreased attention, difficulty with mental tasks, memory problems, difficulties with judgment, a decrease in balance and coordination, a feeling of disorientation, a feeling of being ‘dazed,’ fatigue, blurred vision, light and/or sound sensitivity, difficulty sleeping or sleeping more than usual, being overly emotional, being irritable or sad, neck pain, a feeling of ‘not being right’, and ringing in the ears. Amnesia may be another symptom. Two types of amnesia can occur: Retrograde amnesia which is forgetting events that happened before or during the concussion event, or anterograde amnesia, which is when you do not form new memories about events that occurred after the concussion. In severe concussions, a change in personality may even occur. If a patient shows even one sign or symptom listed above this should be indicative of a concussion occurring and a full concussion evaluation should proceed.
Signs and symptoms that are even more severe after an injury to the head, such as recurrent vomiting, a change in pupil size, blood or fluid coming from the ears or nose, seizures, or obvious physical coordination or mental difficulties indicate a severe brain injury and require immediate emergency attention.
In most cases signs and symptoms appear immediately after the concussion has occurred, however in some cases the signs and symptoms can be delayed by a few hours or possibly even days. For this reason if the mechanism of injury suggests a concussion despite a lack of obvious symptoms being immediately present, the patient needs to be thoroughly examined for latent development of concussion signs or symptoms over a reasonable time frame, and a concussion must be thoroughly ruled out before returning to activity.