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

Healing or recovering from a concussion takes time. It may take days to weeks, or even months. You may be irritable, have trouble concentrating, be unable to remember things, have headaches, dizziness, and blurry vision. These problems will probably 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 similar drugs unless your doctor told you to.

Eat a light diet. Light activity around the home is okay. You do not need to stay in bed. However, avoid exercise, lifting weights, or other heavy activity.

Have an adult stay with you for the first 12 - 24 hours after you are home from an emergency room.

• Going to sleep is okay. 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 doctor how long you need to do this.

Do not drink alcohol until you have recovered all the way. Alcohol may slow down how quickly you recover, increase your risk for another injury, and make it harder than it already is to make decisions.

As long as symptoms are present, avoid sports activities, operating machines, being overly active, and hard labor. Ask your doctor when you can return to your activities.

Make sure friends, people you work with, and family members are aware of your recent injury.

Talk to your employer about the timing of important projects. Consider having others check your work. You should not perform work activities that may place others in danger until all symptoms are gone.

Family, workmates, and friends should understand that you may be more tired, withdrawn, easily upset or confused, may have a hard time with tasks that require remembering or concentrating, and may have mild headaches and less tolerance for noise.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
• Allowing rest times during the day
• Having extra time to complete projects

A doctor 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 a lot after 2 or 3 weeks, talk to your doctor.

Call the doctor 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

Biros MH, Heegaard WG. Head injury. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 38.

Hunt T, Asplund C. Concussion assessment and management. Clin Sports Med. 2009;5-17.