Concussion
Concussion
What is a concussion?
A concussion, or mild traumatic brain injury (mTBI), is a brain injury that occurs when force is transmitted to the brain causing it to move quickly within the skull. This sudden movement causes a disruption in how parts of the brain communicate and results in a variety of symptoms. Concussions usually occur from a direct blow to the head, but can also occur when a hit or blow to the body transmits a force to the head causing the brain to violently move back and forth inside the skull. Although a concussion by itself is not life threatening, it is a serious injury that should be treated by experts in concussion care.
Appointment Information
To request an appointment or to get more information, please call 734-615-7246 and a team member will get back to you within two business days.
NeuroSport Concussion Care
The U-M NeuroSport Concussion Care is one of the few comprehensive programs in the country dedicated to the neurological concerns of athletes.
What are the symptoms of a concussion?
- Headache
- Nausea
- Vomiting
- Balance problems
- Dizziness
- Visual problems
- Fatigue
- Sensitivity to light
- Sensitivity to noise
- Numbness/tingling
- Feeling mentally foggy
- Feeling slowed down
- Difficulty concentrating
- Difficulty remembering
- Irritability or moodiness
- Sadness
- Decreased interest in hobbies
- Nervousness
- Drowsiness
- Sleeping less than usual
- Sleeping more than usual
- Trouble falling asleep
Red Flag Symptoms: When to go to the ER
Seek immediate medical attention or call 911 if you experience any of the following symptoms:
- Loss of consciousness for more than one minute
- Increasing confusion or inability to stay awake
- Repetitive vomiting
- Seizure or convulsion
- Severe or increasing headache
- Severe neck pain
- Weakness, tingling, or burning in arms or legs
- Persistent double vision or loss of vision
- Increasingly restless, agitated, or combative
Family members should monitor the patient closely for any of these “red flag” signs or symptoms. Bring the patient back to the ER immediately if you see any of the above symptoms.
How is concussion diagnosed?
A physical exam and careful history are the best ways to diagnose a concussion. Your doctor may or may not need to perform imaging to rule out more serious injuries, such as bleeding in the brain or skull fractures. Concussions cannot be seen or diagnosed on imaging (X-rays, CT or CAT scans, MRIs), or diagnosed by a blood test.
How is concussion treated?
Recovery from concussion is a complex and dynamic process. During recovery it is critical to identify the factors responsible for symptoms and to develop a treatment plan targeting them. If recovery is not properly managed it can lead to unnecessarily prolonged recovery. Management of recovery should be individualized and directed by a healthcare provider with expertise in concussion care who has ready accesses to treatment resources.
Concussion care at Michigan Medicine
Michigan Medicine generally offers two care pathways:
- NeuroSport: For people who regularly exercise or participate in sports. To schedule an appointment, call 734-615-7246.
- Physical Medicine and Rehabilitation (PM&R) Concussion Clinic: For people who do not regularly exercise or participate in sports. To schedule an appointment, call 734-936-7175.
Your healthcare professional can help determine which clinic is appropriate for you.
Activity and exercise
Follow your healthcare professional’s instructions throughout your recovery.
During the first 1–2 days
- Get relative rest.
- Avoid activities that could lead to another hit to the head.
- Limit activities that significantly worsen your symptoms.
Relative rest does not usually mean staying in bed or sitting in a dark room all day. Light activities that do not significantly worsen symptoms may be appropriate.
As your symptoms improve
Gradually return to light activity, such as:
- Everyday household and personal activities
- Walking
- Riding a stationary bicycle
A small and brief increase in symptoms may occur. Slow down or stop if an activity causes a significant increase—generally more than 2 points on a 10-point symptom scale—or if symptoms do not settle after you rest.
Balance activity with rest, increase activity gradually, and follow your concussion specialist’s advice.
Symptoms may worsen with:
- Mental or physical exertion
- Bright lights
- Loud noises
- Busy or crowded places
Support your recovery
- Aim for 8–10 hours of sleep each night.
- Eat a balanced diet.
- Stay hydrated. For many people, this means drinking 60–80 ounces of non-caffeinated fluid daily.
- Avoid activities that could cause another concussion until a healthcare professional says they are safe.
Ask your healthcare professional how much fluid is appropriate for you, especially if you have been advised to limit fluids because of another medical condition.
Screen use
You may temporarily need to reduce time spent using:
- Phones
- Computers
- Tablets
- Televisions
- Video games
- Social media
Screen use is generally acceptable if it does not significantly worsen your symptoms.
If screens trigger symptoms:
- Use them for shorter periods.
- Stop before your symptoms become much worse.
- Take regular breaks.
- Gradually increase screen time as tolerated.
Returning to school or work
Temporary accommodations may help you return safely and successfully. Depending on your symptoms, you may need:
- Time away from school or work
- A gradual return
- Shorter school or workdays
- Additional time for assignments or tests
- Scheduled rest breaks
- Adjustments to lighting, noise, workload, or screen use
Your healthcare professional may provide a letter describing recommended accommodations.
Returning to exercise or sports
Do not return fully to sports or other activities with a risk of head injury until a qualified healthcare professional clears you.
Athletes should complete a step-by-step return-to-play program that gradually increases activity. This process helps your care team determine whether it is safe for you to advance.
Complete the program under the guidance of a healthcare professional with experience in concussion care. Do not move to the next step until your clinician says it is safe.
Recovery
Recovery is different for each person. With appropriate care, most people recover fully. Many children and adults recover within 30 days, although some people need more time.
Contact your healthcare professional if:
- Your symptoms are not improving.
- Your symptoms are getting worse.
- You have difficulty returning to school, work, or everyday activities.
- You have questions or concerns about your recovery.
For people who do not regularly exercise or participate in sports the PMR concussion clinic offers an evidence-based, time-limited comprehensive recovery program designed to get a patient’s recovery on track, or back on track, quickly. For those with recent experience of concussion, the PMR acute concussion provides a comprehensive educational session. This includes an explanation of the science behind concussion recovery, as well as dispels several common myths about concussion, and provides evidence-based recommendations about how to reengage in activities, and coping strategies for managing acute symptoms in a way that allows the patient to get back to everyday life.
For those whose injuries occurred more than six months ago, the PMR concussion program includes a six-week group intervention with more in-depth exploration of strategies to optimize functioning and improve mood. This includes consults with our physiatrists, and options for focused, time-limited therapies to optimize functional cognition and improve symptom management for pain, balance, and sensory issues. As with our inpatient program, the PMR concussion programs focus on evidence-based, patient-centered care with an emphasis on patient values, patient-specific goals, and optimizing functional outcomes.
Schedule an appointment
- NeuroSport: Call 734-615-7246.
- PM&R Concussion Clinic: Call 734-936-7175.
This information provides general guidance and is not a substitute for an evaluation or treatment plan from a qualified healthcare professional.
Locations
-
NeuroSport Clinic | Brighton Center for Specialty Care 7500 Challis Rd
Entrance 1 Level 1
Brighton, MI 48116-9416Get Directions -
NeuroSport Clinic | Burlington Office Center 325 E Eisenhower Pkwy Ste 100
Ann Arbor, MI 48108-3364Get Directions -
Neurosurgery Clinic | Taubman Center 1500 E Medical Center Dr
Floor 2 Reception G
Ann Arbor, MI 48109-5338Get Directions
Doctors
James Travis Eckner, MD
Professor
Physical Medicine & Rehabilitation, Electrodiagnostic Medicine
Ingrid Karen Ichesco, MD
Clinical Assistant Professor
Sports Medicine, Pediatrics
Matthew Thomas Lorincz, MD, PHD
Clinical Professor
Neurology
Michael James Popovich, MD
Clinical Associate Professor
Neurology
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