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7 Concussion Symptoms You Should Never Ignore

Anyone with a head injury and possible concussion should be checked by a health care professional. If you’re the one with the injury, don’t rely solely on your own assessment for signs you’re getting worse and need reevaluation.

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What is a concussion?

Any time you hit your head—or have your head jerked abruptly (like whiplash during a car accident)—you can experience a type of brain injury known as a concussion. In general, your brain is protected by your skull, a cushion of cerebrospinal fluid, and a tough set of membranes known as meninges. But during a head injury, the brain moves back and forth, hitting the inside of the skull. The blows can damage blood vessels and nerves, and cause traumatic injury.

The resulting symptoms can include temporary unconsciousness (although this doesn’t always happen), nausea and vomiting, double or blurry vision, confusion, ringing in the ears, and a headache. Symptoms often happen right away but they can also develop later, and last for days, weeks, or even months. (Make sure you don’t fall for these common concussion myths that you assume are true.)

People with a concussion can have a sensitivity to light or noise, experience irritability, have trouble remembering what happened before or after the injury, or have mood, behavior, or personality changes, according to the Centers for Disease Control and Prevention. Repeated concussions are now known to be particularly dangerous. (Read a story about this NFL player’s experience with concussions and chronic traumatic encephalopathy, a degenerative brain condition caused by repeated blows to the head.)

Here are more details about concussion symptoms and some additional symptoms that could indicate a more serious injury.

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Loss of consciousness

While a loss of consciousness doesn’t happen in every case of concussion, if someone does lose consciousness they should regain consciousness fairly quickly. An episode that lasts more than a couple of minutes is especially worrisome. Seek medical attention right away if the individual does not wake up.

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Trouble staying alert

If the person with a head injury is not attentive and fully oriented within at least 30 minutes after the trauma, that’s a concern. Monitor the person for signs of confusion, amnesia around the traumatic event, and delayed responses to questions.

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Bleeding from the ear

If you’re not sure if there’s been a direct injury to the ear, get evaluated: Blood dripping from an ear could signal a skull fracture that has damaged a blood vessel or even the lining around the brain.

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Diffuse (all-over) headache

Does the pain extend beyond the area of the injury?  Severe pain that is deep and spreads throughout the head, that does not get better with time, could be a sign of damage. Until the person has been thoroughly checked by an expert, he or she should avoid certain medications.  Aspirin, for example, can increase the risk of internal bleeding. A nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen also might slightly increase the risk. If the person takes a narcotic-based pain killer, you won’t know if it’s the medicine or the trauma causing a change in his or her mental status and pupils. Wait for the doctor to tell you these drugs are safe to take. (Don’t miss these signs your headache is something more serious).

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Unusual fluid

Fluid flowing from the nostrils or ears, especially if it’s clear, could be from a tear in the lining around the brain that holds in the cerebrospinal fluid. Note that the fluid usually tastes salty, too.

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Seizure

A seizure after head trauma can be a sign that there’s been a serious brain injury, but it may not occur immediately after the trauma. (Look out for these other signs you need to go to the ER after a head injury.)

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Irregular pupil dilation

If your pupils are normal, it doesn’t mean you don’t have a serious head injury. But if they’re clearly unequal or don’t constrict equally to light, that could be a sign of expanding pressure on the brain, and this condition requires immediate attention. Just try to make sure the pupil wasn’t already like that before the injury—perhaps because of a prior problem or even because one of the eyes is artificial. Yes, I’ve seen it happen.

How to survive any crisis:

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Sources
Medically reviewed by Renata Chalfin, MD, on March 30, 2020