Dr. Neil J. Patel, MDSports Neurology & Brain Health

A concussion is a mild traumatic brain injury caused by a bump, blow, or jolt to the head or body that causes the brain to move rapidly inside the skull, disrupting normal brain function.

Seek emergency care immediately for any of these red-flag symptoms: loss of consciousness, repeated vomiting, worsening headache, seizure, unequal pupils, slurred speech, weakness or numbness, confusion that worsens, or neck pain. When in doubt, get evaluated.

No. Current consensus guidelines (Amsterdam 2022) state that any athlete with suspected concussion must be removed from play immediately and not return the same day. Return-to-play requires stepwise progression supervised by a qualified clinician.

A concussion is the acute injury. Persisting symptoms after concussion (formerly post-concussion syndrome, PCS) refers to symptoms (headache, dizziness, cognitive issues, mood changes) that persist beyond the typical 10-14 day recovery window, often requiring multidisciplinary care.

Chronic Traumatic Encephalopathy (CTE) is a progressive neurodegenerative disease associated with repetitive head impacts. It can only be diagnosed definitively after death. Risk factors include cumulative exposure to subconcussive and concussive impacts over many years.

Yes. Modern evidence supports that it is safe to sleep after a concussion, provided the person has been evaluated and does not have red-flag symptoms. Rest is a key component of early recovery.

Most concussions do not require imaging. CT scans are used acutely to rule out bleeding when red-flag symptoms are present. MRI may be ordered for prolonged or atypical symptoms.

The Sport Concussion Assessment Tool, 6th edition, is the current standardized sideline and clinical assessment tool used by sports medicine professionals to evaluate suspected concussion in athletes aged 13 and older.

Most concussions resolve fully. However, repeated concussions and poorly managed recovery can contribute to prolonged symptoms, mood disorders, cognitive difficulties, and increased risk of neurodegenerative disease later in life.

Return-to-Play (RTP) is a medically supervised stepwise protocol that gradually reintroduces physical activity after concussion, ensuring each stage is tolerated without symptom recurrence before progressing.

Yes. Developing brains are more susceptible to injury and take longer to recover. Youth athletes also have higher rates of second-impact syndrome, making conservative management essential.

Subconcussive impacts are head hits that do not cause concussion symptoms but may contribute to cumulative brain injury over time, particularly in sports with repetitive head contact like football, soccer heading, and combat sports.

You cannot prevent all concussions, but you can reduce risk through proper technique, rule enforcement, fit-tested equipment, neck strengthening, and culture changes that encourage reporting symptoms.

Most concussions can be managed by primary care. A sports neurologist or brain injury medicine specialist is recommended for prolonged symptoms, complex cases, multiple concussions, or when return-to-play decisions are high-stakes.

Baseline concussion testing is a pre-season assessment of an athlete’s normal, healthy brain function, typically measuring reaction time, processing speed, memory, attention, balance, and eye movement performance. The value is comparative: if a concussion occurs during the season, the athlete is re-tested and the results are compared against their own pre-injury data rather than against population averages. This individual comparison matters because a “normal” post-injury score can still represent a real decline for an athlete who started above average, and because athletes, especially adolescents, often under-report symptoms when motivated to return to play. Objective testing catches deficits that symptom reporting alone would miss. The most widely used computerized tool is ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing), an FDA-cleared, roughly 25-minute battery measuring verbal and visual memory, visual motor speed, and reaction time. CNS Vital Signs is another established computerized neurocognitive battery, producing standardized scores across domains including memory, psychomotor speed, cognitive flexibility, and executive function. Many programs add the King-Devick test, a rapid two-minute number-naming test of eye movement and attention, along with balance assessments such as the Balance Error Scoring System (BESS) and SCAT6 components, building a multidimensional baseline rather than relying on a single instrument. Two important caveats: no baseline test diagnoses a concussion, and no test score by itself clears an athlete to return. Concussion remains a clinical diagnosis and clearance remains a clinical decision. Baseline testing provides objective data inside that decision: one piece of converging evidence, interpreted alongside symptoms, examination findings, and performance through the graduated return-to-play protocol. Ideally, baselines are repeated each season, since normal development changes adolescent test performance year to year.

Not every concussion is preventable, but the risk of a second one can be meaningfully reduced. The single most important step is completing a full, medically supervised return-to-play protocol after the first concussion. The brain is most vulnerable during incomplete recovery, and returning too soon is the primary preventable cause of repeat injury and the rare but catastrophic second impact syndrome. Beyond protocol compliance, proven risk-reduction strategies include proper technique (tackling and heading mechanics that keep the head out of contact), well-fitted and properly maintained equipment, neck-strengthening programs that may reduce forces transmitted to the brain, limiting unnecessary head contact in practice, enforcing rules that penalize dangerous play, and building a team culture where reporting symptoms is expected rather than discouraged. No helmet prevents concussion (helmets prevent skull fractures and reduce some impact forces), so equipment is one layer of protection, never a license for riskier play.

Most adults recover within 10-14 days, and most children and adolescents within 2-4 weeks. Recovery typically follows a pattern: relative rest for the first 24-48 hours, gradual return to cognitive and light physical activity through the first week, and resolution of most symptoms by weeks two to three. Symptoms persisting beyond 4 weeks in adults or 2 weeks in children meet criteria for persistent post-concussive symptoms, which are treatable with multidisciplinary care. Factors that lengthen recovery include younger age, high initial symptom burden, prior concussions, and pre-existing migraine, anxiety, depression, or ADHD.

First, remove them from play immediately, with no return the same day, even if they say they feel fine. Check for emergency red flags: repeated vomiting, worsening headache, seizure, unequal pupils, slurred speech, weakness or numbness, increasing confusion or drowsiness, or neck pain. Any of these means the emergency department now. Without red flags, your child should be seen by a clinician within 24-72 hours to confirm the diagnosis and set up a recovery plan. At home: allow normal sleep (waking them hourly is no longer recommended), limit screens and schoolwork for the first 1-2 days, then begin a gradual return to light activity that stays below the symptom threshold. School comes before sport: a graduated return-to-learn with temporary accommodations (shorter days, breaks, postponed tests) should be completed before contact sport resumes. Expect recovery to take 2-4 weeks for most children; involve a concussion specialist if symptoms persist beyond two weeks, worsen, or if your child has a history of prior concussions.