Concussion Symptoms + How to Manage Them - Dr. Axe

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10 Life-Threatening Concussion Symptoms


Concussion Symptoms - Dr. Axe

In the not-too-distant past, coaches often told athletes to “walk it off” after a collision or a fall left an athlete groggy or woozy. Concussion symptoms were often brushed off or ignored. Smelling salts were common on the sidelines. It is frightening to think of the number of athletes who were sent back in with a brain injury.

Today, we acknowledge those symptoms can be the first sign of a concussion. Concussions are much more widespread than many of us realize and can be serious if not properly evaluated by medical professionals.

According to researchers from the University of California Brain Injury Research Center, somewhere between 1.6 million and 3.8 million sports-related concussions happen in the United States each year. Athletes in their teens seem to statistically have the greatest number diagnosed. (1)

Contact sports like rugby, football, ice hockey and wrestling are those most commonly associated with concussions for male athletes, while soccer, basketball, cheerleading and ice hockey are associated with brain injuries in female athletes. A recently released survey of 13,000 junior high and high school brought light to the troubling scope of young athletes experiencing concussions.

This report shows that 14 percent of the surveyed group have been diagnosed with a concussion and, even more concerning, nearly 6 percent have been diagnosed with more than one concussion. (2) For the thousands of young athletes today, a concussion on a young developing brain can have significant long-term consequences — especially for those who experience more than one. In fact, another recent 2017 study found that adolescents who experience multiple concussions have an increased risk of developing multiple sclerosis, or MS. (3)


New research is also bringing light to proper treatment protocols for female athletes. Researchers have found that females recover from a concussion much more slowly than their male counterparts. In fact, evidence points to the median recovery time for females as 28 days in a dramatic contrast to the 11 days for males. Authors of the study published in The Journal of the American Osteopathic Association also urge further investigation to determine why. (4)

Researchers are at odds as to why females require longer recovery and in an article published in Scientific American, several concussion specialists chime in with reasons ranging from when the injury occurs during the menstrual cycle to smaller neck sizes and more visual stability issues following an injury. (5)

As the rates for concussions in young athletes continues to increase, it is fortunate that all 50 states and the District of Columbia have finally passed “return-to-play” laws legislating education and training for concussion symptoms and response in school athletic programs. However, not all states require coaches to receive such training; parents must ask about concussion protocols prior to allowing any participation. Knowing the early signs and symptoms of a brain injury is imperative, whether you are an athlete, a coach or a parent. (6)

On the field or on the court, a head-to-head collision, a whiplash type motion, or the head hitting the ground can all cause a brain injury, and concussions are technically considered a mild TBI or traumatic brain injury. After a hit or collision, if there is a loss of consciousness, confusion, headache, dizziness or a temporary loss of memory, emergency medical attention is needed. You may be able to “walk off” a sore muscle but not a brain injury.

What Is a Concussion?

A concussion is a type of a traumatic brain injury, or TBI, that affects brain function and health. While some people lose consciousness even briefly after a blow to the head, you can have a concussion even if you’ve not lost consciousness. (7)

The first 24 hours after even a mild TBI is important. While the vast majority of people who experience a concussion will recover within a few days or weeks, there are serious — and potentially life-threatening — complications that patients must be monitored for. These include subdural hematomas, epidural hematomas, edema and ontusion. (8)

To understand the absolute need for medical evaluation, it is important to realize what actually happens in the brain during the trauma. Blunt force trauma events cause the brain to physically strike the inside of the skull at the point of impact, and then rebound, hitting the opposite side. This can cause bruising on the brain, a contusion and bleeding. (9)

According to the Centers for Disease Control (CDC), traumatic brain injury is the leading cause of disability and death in children and adolescents; two age groups are at the greatest risk — 15 to 19 and 0 to 4. (10) As mentioned, for the older group competitive sports is the culprit, but for infants and toddlers brain injuries are often the result of falls, vehicle accidents or physical abuse.

For the rest of the population, 50 percent of concussions are a result of car accidents, with falls, sports and assault making up the remainder. The use and or abuse of alcohol and drugs is considered a major contributing factor, according to Harvard Medical School. (11)

Wearing appropriate safety equipment, including seat belts while in a vehicle and helmets when participating in sports, can help to prevent brain injuries; however, there is no helmet on the market that is perfect. If there were, concussions wouldn’t be of such concern to the NFL and NHL where the equipment used is state-of-the-art, and player lawsuits due to brain injuries are increasing. (12)

What is a concussion?: concussion symptoms - Dr. Axe

Signs & Symptoms of a Concussion

After a blow to the head, whiplash-like event, car accident, assault or a fall, it is important to realize that concussion symptoms may not appear for hours or even days after the event.

Concussion Symptoms in Healthy Adults:

The most common signs of a concussion in healthy adults include: (13)

  1. Temporary loss of consciousness
  2. Headache
  3. Feeling of pressure in the head
  4. Ringing in the ears
  5. Confusion or brain fog
  6. Memory loss surrounding the event
  7. Nausea or vomiting
  8. Slurred speech
  9. Fatigue
  10. Delayed response to stimuli
  11. Appearing dazed
  12. Mood and personality changes including irritability and depression
  13. Sensitivity to noise and direct light

Concussion Symptoms in Adolescent and Teen Athletes

As everyone’s brain is different, and the type and severity of the trauma is different, it is important to understand and be able to recognize concussion symptoms across different age groups. For adolescent and teen athletes, the most commonly recognized symptoms include: (14)


  1. Brief loss of consciousness
  2. Poor recall of events prior to or after the hit or fall
  3. Appearing dazed and stunned
  4. Confusion
  5. Uncharacteristic signs of clumsiness
  6. Personality changes including extreme irritability, anxiety, aggression and anger
  7. Headache
  8. Neck pain
  9. Nausea or vomiting
  10. Vertigo or dizziness
  11. Changes in senses including hearing, vision, smell and taste
  12. Fatigue
  13. Inability to retain new information
  14. Slow reaction time to orders or stimuli

Second-impact syndrome is the result of a second brain injury before a previous brain injury has healed. This may lead to cerebral vascular congestion, cerebral swelling and may result in death. Pediatric and adolescent athletes are at the highest risk for this serious concussion complication, and this is a major contributing factor to the development of legislation in all 50 states about concussion education for schools and athletic departments. (15)

As a parent, it is imperative that you keep a close eye on your child if they sustain a hit to the head and are diagnosed with a concussion; sometimes young athletes may fib and say they aren’t experiencing symptoms so they can get back to their teams. It is essential that personality changes, including anger and depression, are noted as well as any signs of poor memory or recall. These can be signs that the brain has yet to heal completely.

Concussion Symptoms in Seniors

For the seniors among us, brain injuries are a significant concern as research shows that the elderly are at a heightened risk of serious, potentially life-threatening complications, including intracranial hemorrhage following even a mild concussion. Long-term cognitive, psychosocial and physical dysfunction is possible and recent research shows that TBIs may trigger the premature onset of Alzheimer’s disease and Parkinson’s disease. (16)

Depression is common and has been identified with poorer recovery, particularly in the elder community. So many of the common symptoms of a concussion in healthy adults and teens are seen in seniors as signs of natural aging or dementia. This makes it more difficult for a brain injury to be diagnosed properly. If a senior has recently fallen and any of the signs are noted, a medical examination is warranted.

  1. Unexplainable bruises
  2. Unconsciousness
  3. Confusion and disorientation
  4. Uncharacteristic emotional changes including depression, anxiety or even giddiness
  5. Dizziness and clumsiness
  6. Headache
  7. Changes in vision
  8. Difficulty remembering new information
Common concussion symptoms - Dr. Axe

Concussion Symptoms in Infants and Toddlers

The CDC, as mentioned above, identifies TBIs as the leading cause of disability and death in teens and those 0 to 4 years of age. The primary causes of concussions in infants and toddlers are falls, car accidents and physical abuse. As it is impossible for them to verbally communicate the pain and symptoms they are experiencing, watching for the following signs may help you identify a concussion or more serious brain injury due to shaken baby syndrome: (17)

  1. Crying when head moves
  2. Excessive crying for no apparent reason
  3. Behavioral changes including extreme irritability
  4. Loss of interest in toys and activities
  5. Changes in sleep habits
  6. Vomiting or nausea
  7. Bumps or bruises on head
  8. Clumsiness or stumbling for walkers
  9. Labored breathing, difficulty catching a breath
  10. Poor appetite
  11. Tremors
  12. Seizures

A special note about shaken baby syndrome:

Also known as abusive head trauma, it is a brain injury that occurs in a small child or infant due to excessive shaking. Be mindful of symptoms as they can mimic those of a minor concussion. In addition to the concussion symptoms noted above, bleeding in the eye as well as physical damage to the neck or ribs is common. If you suspect a young child has been shaken and is showing any of the signs, seek emergency medical attention immediately. (18)

Life-Threatening Concussion Symptoms

In rare cases, hematomas may form on the brain. Call 911 immediately if any of the following danger signs appear: (19)

  1. One pupil becomes larger than the other
  2. Patient cannot be awakened
  3. Excessive drowsiness
  4. Slurred speech
  5. Severe weakness in muscles
  6. Numbness anywhere on the body
  7. Decreased coordination
  8. Repeated vomiting
  9. Convulsions
  10. Seizures

Conventional Treatment

Any time there is a loss of consciousness, seek emergency medical attention immediately. Loss of consciousness may not occur after a physical trauma to the head, but the other concussion symptoms mentioned above do necessitate a thorough medical examination. For a diagnosis, the physician will ask about the details surrounding the injury, symptoms that were immediately experienced, and those encountered during the examination.

The medical team will also want to know if there have been any other head injuries in the past and any medications and herbal supplements the patient may be taking. Be prepared to have tests for reflexes, balance, memory and how the eyes respond to light. In some cases, a CT scan or an MRI scan may be ordered.

If the examination determines a concussion, otherwise healthy patients are typically sent home with very precise instructions. Be sure to follow the physician’s advice correctly. Standard directives include: (20)

  • Staying awake for 12–24 hours, or being awakened every 90 minutes to two hours.
  • Close monitoring of mental status.
  • Signs of extreme lethargy.
  • Physical and mental rest; this means refraining from reading, watching TV or using a digital device, as well as physical activities like moderate to strenuous exercise.
  • Avoid all activities that could cause further head injury.
  • Seek consultation with a concussion expert like a neurosurgeon or neurologist, particularly if this is not the first concussion sustained.

While symptoms of a mild concussion often dissipate in a few days or weeks, more severe concussions require longer to heal. As mentioned above, females tend to require 28 days for recovery, with males needing just 11 days to recover. It’s important to communicate any lingering symptoms to your overseeing physician and concussion specialist.

Athletes should obtain clearance from their medical team prior to engaging in contact sports or strenuous exercises. The same is true for individuals with occupations that require driving or operating heavy equipment, climbing ladders or scaffolding, or other activities that require optimal balance.

For seniors, particularly those who live alone, monitoring in the hospital or at a care facility may be warranted to ensure that life-threatening complications don’t arise.

Life-threatening concussion symptoms - Dr. Axe

6 Natural Ways to Boost Concussion Recovery

  1. Engage in light-to-moderate activity.
  2. Avoid technology.
  3. Diffuse lavender oil.
  4. Music therapy.
  5. Adequate sleep.
  6. Healthy diet and hydration.

Since concussion symptoms for the majority of people with a mild TBI will abate in the following days or weeks, treating symptoms with natural treatments can ease the discomfort.

1. Engage in light-to-moderate activity. In the first several days following the concussion, follow activity guidelines set by the physician. However, incorporating light-to-moderate exercise within seven days of injury may reduce the risk for developing persistent post-concussive symptoms, a recent study has found. Over 3,000 children and adolescents from 5 to 18 years of age were included in this study. While specific activities and duration were not identified, beginning with light activity and progressing to more moderate activity may be beneficial for long-term health — as long as no new symptoms arise (and old symptoms don’t worsen). (21)

Early during recovery, safe choices might include walking, yoga, pilates and light aerobic exercise leading to returning to non-contact training and more rigorous aerobic activities like high-intensity interval training as the brain and body continue to heal.

2. Avoid technology. While the brain heals, mental rest is as important as physical rest. Avoid computers, video games, watching television and reading as the contrast in light and movement, as well as the required cognitive function, can cause symptoms to return or worsen, according to the Mayo Clinic and a wide range of other research. (22, 23)

Reintroduce technology slowly, and if any new symptoms arise or if old symptoms worsen, cease the activity immediately. It can be very difficult to keep children and teens away from their computers, tablets and phones, but it is essential for healing. In fact, studies show that resting the brain is associated with a full recovery and those who limit cognitive function can heal in half as much time. (24)

3. Diffuse lavender essential oil. Headaches are a common symptom that can linger for days or weeks. To safely treat a headache, diffuse a high-quality lavender essential oil and inhale deeply. A study published in the journal European Neurology found that inhaling lavender essential oil is safe and effective for headaches and migraines. Also, lavender is well-known to help induce relaxation while easing anxiety and depression. (25)

4. Try music therapy. To reduce stress, boredom, and to distract from unpleasant symptoms, music therapy can help, according to research from Wake Forest University School of Medicine. Researchers found that music is soothing for children and adults alike and actually improves the quality of life for patients by enhancing comfort and relaxation. Of course, music that soothes but doesn’t energize is preferred while healing. (26)

5. Get adequate sleep. In addition to the physical and cognitive rest, actual sleep is vital to allow the brain to heal properly. In a double-blind study published in the journal Pharmacology Biochemistry and Behavior, valerian root improves the quality of sleep. In fact, in this study 44 percent of participants reported “perfect sleep” while 89 percent reported “improved sleep.” (27)

Valerian root may cause side effects in some people, including headache and dizziness, so monitor carefully after the first dose. However, it is generally considered safe for adults. Consult with your doctor before giving it to children. To spur relaxation and sleep, sip a cup of tea before bed or take a tincture as recommended.

6. Eat a healthy diet and stay hydrated. While healing from a traumatic injury, it is imperative to stay hydrated and eat a well-balanced diet. Sipping on herbal teas throughout the day or even coconut water can improve hydration levels and keep the body functioning, even while at rest. Avoid processed foods and salty snacks because it is more difficult to process and release chemicals and sodium from the body during physical rest.

Focus instead on healthy snacks like my recipe for a probiotic-rich blueberry pudding, a protein-rich hummus or even spicy roasted chickpeas. For meals, be sure to include foods high in omega-3s that have been shown to help with depression while supporting healthy brain function.

Concussion Causes & Risk Factors

The physical trauma to the brain is a result of an impact, movement change or a sudden change in momentum that literally causes the brain to make contact with the skull and bounce back. Common traumas that can cause a concussion include: (28)

  • Direct blow to the head
  • Falling on a hard surface
  • Gunshot wounds
  • Violent shaking of the head
  • Whiplash

Recognized risk factors include:

  • Playing contact sports like hockey, football, rugby, soccer, basketball and cheerleading.
  • Competitive individual sports like cycling, wrestling, some martial arts disciplines and boxing.
  • Drug and alcohol use and abuse.
  • Improper use of safety equipment in sports.
  • Improper use of seat belts.
  • Being a victim of domestic abuse or elder abuse.


Repeated brain injuries are associated with chronic traumatic encephalopathy or CTE. Professional football and hockey players often have this progressive and degenerative disease. This chronic condition produces life-altering symptoms including anxiety, suicidal thoughts and actions, explosive anger and depression. (29)

In addition, research shows that mild TBIs and concussions are associated with an increased risk of prematurely developing Alzheimer’s disease and Parkinson’s disease. Protecting the brain from repeated injury by wearing appropriate protective gear, or even ceasing competitive sports, may be necessary to prevent long-term disabilities. (30)

Key Points

  • 20 percent of adolescents and teens report one or more concussion diagnoses.
  • Traumatic brain injuries are the leading cause of disability and death in children and teens.
  • Concussions occur when the brain hits the inside of the skull, and bounces back against the other side, resulting in bruising and tissue death.
  • Seniors are at the greatest risk for developing serious, and potentially life-threatening, complications.
  • Symptoms vary widely between individuals, the severity of the injury and the overall health before the injury. Common concussion symptoms include loss of consciousness, headache, vertigo and balance issues.
  • The brain must be given ample time to heal. Healing requires both physical and mental rest.

10 Life-Threatening Concussion Symptoms

Call 911 immediately.

  1. One pupil becomes larger than the other
  2. Patient cannot be awakened
  3. Excessive drowsiness
  4. Slurred speech
  5. Severe weakness in muscles
  6. Numbness anywhere on the body
  7. Decreased coordination
  8. Repeated vomiting
  9. Convulsions
  10. Seizures

6 Natural Ways to Boost Concussion Recovery

  1. Engage in light-to-moderate activity.
  2. Avoid technology.
  3. Diffuse lavender oil.
  4. Try music therapy.
  5. Get adequate sleep.
  6. Eat a healthy diet and stay hydrated.

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