Stephen J. Schueler, M.D.

Overview Symptoms Evaluation Treatment questions for doctor specialist Home Care neuro checks return to sports warning signs Complications Underlying Cause Anatomy

Concussion Home Care

Home care for a concussion includes:

  • Avoid alcohol.
  • Avoid narcotic pain medications.
  • Avoid medications that make you sleepy.
  • Avoid driving until symptoms resolve.
  • Apply cold compresses to the scalp:
    • Wrap ice in a moist hand towel. Do not apply ice directly to the skin.
    • Apply for 20-30 minutes, every 1-2 hours, for the first few days.
  • Clean wounds thoroughly:
    • Use mild soap and water.
    • Gently dab the wound with hydrogen peroxide to remove clotted blood.
    • Do not scrub the wound.
    • Remove dirt or foreign material from the wound.
    • Dry the skin.
    • Apply an antibiotic ointment.
  • Eat a clear liquid diet for 24 hours.
  • Rest for 1-2 days. There is no need to try and keep the victim awake.
  • Perform neurological checks:
    • Every 1-2 hours for 24 hours
    • Make sure the person can be awakened
    • Make sure the person can walk
    • Make sure the person can speak normally
    • Make sure the person can move extremities normally
  • Acetaminophen for pain
  • Avoid aspirin.

Concussion Neuro Checks

Neuro checks should be performed once an hour, for the first 24 hours in someone with a concussion:

  • Make sure the person can be awakened
  • Make sure the person can walk
  • Make sure the person can speak normally
  • Make sure the person can move the arms and legs normally

Seek medical care immediately for:

Concussion Return to Sports

American Academy of Pediatrics Return to Sports Recommendations Following Head Injury

Grade 1 concussion:

  • Defined by:
  • Recommendations:
    • Return to sports activity same day only if all symptoms resolve within 15 minutes
    • If a second grade 1 concussion occurs, no sports activity for 1 week

Grade 2 concussion:

Grade 3 concussion:
  • Defined by:
  • Recommendations:
    • No sports activity for 1 week if loss of consciousness was only seconds
    • No sports activity for 2 weeks if loss of consciousness was minutes or longer
    • If a second grade 3 concussion, no sports activity until the person has no symptoms for 1 month
    • If abnormality is seen on CT scan of the brain or MRI scan or the brain, no sports activity for the rest of the season and the athlete should be discouraged from returning to contact sports.

Concussion Warning Signs

Notify your doctor if you have a concussion and any of the following:

Continue to Concussion Complications

Last Updated: Dec 8, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Concussion References
  1. Edwards P, Arango M, Balica L, et al. CRASH trial collaborators. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet. 2005 Jun 4-10;365(9475):1957-9. [15936423]
  2. Grappling with traumatic brain injury. Lancet. 2007 Dec 8;370(9603):1879. [18068492]
  3. Lee AC, Ou Y, Fong D. Depressed skull fractures: a pattern of abusive head injury in three older children. Child Abuse Negl. 2003 Nov;27(11):1323-9. [14637305]
  4. McKinley J. New challenges in assessing and managing concussion in sports. Am Fam Physician. 2007 Oct 1;76(7):948-9. [17956064]
  5. Ropper AH, Gorson KC. N Engl J Med. 2007 Jan 11;356(2):166-72. Review. No abstract available. Erratum in: N Engl J Med. 2007 Apr 26;356(17):1794. [17215534]
  6. Smits M, Dippel DW, de Haan GG, Dekker HM, Vos PE, Kool DR, Nederkoorn PJ, Hofman PA, Twijnstra A, Tanghe HL, Hunink MG. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA. 2005 Sep 28;294(12):1519-25. [16189365]
  7. Tender GC, Awasthi D. Risk stratification in mild head injury patients: the head injury predictive index. J La State Med Soc. 2003 Nov-Dec;155(6):338-42. [14750754]
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