Concussion in adults - discharge

Getting better from a concussion takes days to weeks, months or sometimes even longer depending on the severity of the concussion. 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.

You may use acetaminophen (Tylenol) for a headache. Do not use aspirin, ibuprofen (Motrin or Advil), naproxen, or other non-steroidal anti-inflammatory drugs. Consult your provider before taking blood thinners (for example, if you have a history of heart problems such as abnormal heart rhythm).

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 OK. Ask your provider 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 provider how long you need to do this.

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

As long as you have symptoms, avoid activities that increase your risk for a serious head injury, such as:

• Sports
• Operating machines
• Being overly active
• Doing physical labor

Ask your provider when you can return to your activities.

If you do sports, your provider 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Let your family, co-workers, and friends know that you may be more tired, withdrawn, easily upset, or confused.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

Your provider 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

If symptoms do not go away or are not improving after 2 or 3 weeks, talk to your provider.

Contact your provider sooner 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

Brain injury - concussion - discharge; Traumatic brain injury - concussion - discharge; Closed head injury - concussion - discharge

American Academy of Neurology website. AAN position: Sports Concussion. www.aan.com/advocacy/sports-concussion-position-statement. Updated April 29, 2020. Accessed July 6, 2024.

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(24):2250-2257. PMID: 23508730 pubmed.ncbi.nlm.nih.gov/23508730/.

Harmon KG, Clugston JR, Dec K, et al. American Medical Society for Sports Medicine Position Statement on Concussion in Sport Clin J Sport Med. 2019;29(3):256. PMID: 30730386 pubmed.ncbi.nlm.nih.gov/30730386/.

Papa L, Goldberg SA. Head trauma. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 33.

Trofa DP, Caldwell JME, Li XJ. Concussion and brain injury. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 126.

Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.