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Neurological Institute

A concussion is a mild brain injury. Concussions are caused by a bump, blow or jolt to the head or body. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can lead to a concussion and should be considered serious. 

You can’t see a concussion. Signs and symptoms of concussion can appear immediately after the injury or may evolve over the next day. Concussions Signs and Symptoms Information

 Signs You Will See
  • Looks very fatigued
  • Frequent yawning
  • Stiff neck
  • One pupil (middle of eye) larger than the other
  • Squinting
  • Slow to respond
  • More irritable
  • Moves slower/seems off-balance
  • Poor memory
  • Things seem too loud (typically for children)
  • Sleeps a lot more/less
Symptoms Reported
  • Headache
  • Not feeling right
  • Sore neck
  • Feeling irritable
  • Double/blurry vision
  • Lights too bright
  • Dizzy or off-balance
  • Nausea
  • Change in sleep pattern
  • More/less/falling asleep

If any of the above symptoms are severe or worsening, you should contact your doctor or visit an emergency room for an immediate evaluation.

Our concussion specialists are prepared to work with you to assess your condition and recommend an individualized plan of treatment. We are equipped with innovative technology and testing procedures to diagnose and treat concussions.

Diagnosing a concussion 
Your  signs and symptoms will be evaluated and a neurological examination will be conducted. Your doctor may recommend a brain imaging to determine the severity of your injury. A computed tomography (CT) scan is sometimes performed after an injury. This is a series of X-rays that provides cross-sectional brain and skull images. Also, magnetic resonance imaging (MRI) can help diagnose potential complications, such as bleeding or swelling in your brain or skull. 
Post-Concussion Home Instructions

Returning to activities or school after a concussion
It is important not to return to activities before full recovery from a concussion. This is especially important for younger athletes in order to avoid the chance of suffering from a second concussion before the first has completely healed. Once the patient is symptom-free, we recommend a gradual, incremental approach prior to return to any activity, which is a clinical protocol that ensures a full and safe recovery. Following a concussion, there is a period of change in brain function that may last anywhere from 24 hours to 10 days and in some cases longer. During this time, the brain may be vulnerable to more severe or permanent injury. The first step in recovering from a concussion is rest. Rest is essential to help the brain heal.

  • Students with a concussion need rest from physical and mental activities that require concentration and attention as these activities may worsen symptoms and delay recovery. Exposure to loud noises, bright lights, computers, video games, television and phones (including texting) all may worsen the symptoms of concussion. As the symptoms lessen, increased use of computers, phone, video games, etc., may be allowed.

  • Most athletes who experience an initial concussion can recover completely as long as they do not return to contact sports too soon. Athletes must show no signs of post-concussion symptoms for 1-3 consecutive days without medication before return to play protocol begins. The athlete will progress only one stage each day (24 hours). If the athlete sustains a second concussion during this time period, the risk of permanent brain injury increases.

Using the Return to Play form,  it is important to do a symptom check with the athlete after they have completed each stage.

  • Stage 1 - Light aerobic exercise with no resistance training (50-60% of MHR) 10-15 minutes (e.g., walking, stationary bike, hand bike on low intensity)
  • Stage 2 - Moderate aerobic activity with resistance training (60-70% of MHR) 20-25 minutes (e.g., running, light weights – no squat, dead lift or bench press)
  • Stage 3 - Sport specific activity and non-contact training drills. Heavy exertion (70-80% of MHR) 25-30 minutes (e.g., non-contact training or non-contact practice)
  • Stage 4 - Full practice including light contact activities (e.g., head balls in soccer, sleds in football)
  • Stage 5 - Full Practice - full contact
  • Stage 6 - Return to full participation (pending physician clearance)
  • MHR (Maximum Heart Rate) = 220 – athlete’s age

    *If concussive symptoms occur during or after activity, the athlete should stop all activity until symptom free for 24 hours. Athlete may resume with phase in which they were previously symptom free.

    Please note if a physician note is received that requires the athlete to be in a stage longer than one day that must be followed.

Outreach program (p
reventing a concussion)
Educating the Houston community about proper assessment and care of the sports-related head injury is a top priority for the center. Our allied health care professionals visit schools in Greater Houston, providing a committed relationship between the community and Houston Methodist. Education about concussions is a significant part of our efforts to ensure that athletes know how to prepare for play in order to prevent injuries, and when an injury does happen, they know how to respond immediately. As a medical center that is backed by experts in all fields, we are able to work across departments to ensure that our patients receive an accurate diagnosis and the appropriate care, taking full advantage of the extensive research and the latest technologies.
Prevent concussion and neck injuries brochure

Concussion recovery infographic


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