Most concussions don’t involve passing out. That’s the first thing every parent, athlete, and adult should know — because the old belief that “I didn’t lose consciousness, so I’m fine” causes thousands of missed concussions every year. The truth: a concussion is a brain injury, even when it’s mild. Untreated, it can leave you foggy, dizzy, and exhausted for weeks. And on the more serious end of the spectrum, a head injury with internal bleeding can become fatal within hours if not caught early.
This guide from ER of Mesquite walks you through what concussions actually are, how to recognize them across age groups, when to head to the ER, and what to expect for recovery. Our 24/7 freestanding emergency room in Mesquite, TX has on-site CT scanning, board-certified emergency physicians, and a dedicated pediatric care team — meaning kids, athletes, and adults can get answers and concussion treatment within minutes of walking in.
1. Understanding Concussions & Head Injuries
What Is a Concussion?
A concussion is a mild traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head — or even a hit to the body that whips the head and brain back and forth. The sudden movement causes the brain to bounce or twist inside the skull, stretching brain cells and disrupting normal chemistry. The damage is microscopic, so it doesn’t usually show up on imaging, but the symptoms are very real.
Concussion vs. Traumatic Brain Injury — Mild, Moderate, Severe
All concussions are TBIs, but not all TBIs are concussions. Doctors categorize traumatic brain injuries by severity:
| Severity | Loss of Consciousness | Memory Loss | Typical Recovery |
| Mild (Concussion) | None or under 30 min | Under 24 hours | 7–14 days for most |
| Moderate | 30 minutes – 24 hours | 1–7 days | Weeks to months |
| Severe | More than 24 hours | More than 7 days | Months to lifelong |
Common Misconceptions
Several myths cause people to dismiss real concussions:
- “You have to lose consciousness to have a concussion.” False — most concussions don’t involve any loss of consciousness.
- “If the CT scan is normal, there’s no concussion.” False — concussion damage is too microscopic to see on imaging. CT rules out bleeding and skull fracture; it doesn’t rule out concussion.
- “You can shake it off and keep playing.” False — returning to play with an active concussion risks second-impact syndrome, which can be fatal.
- “You shouldn’t let someone with a head injury sleep.” Mostly false in mild cases — but they should be checked periodically and seen by a doctor first.
2. Common Causes of Head Injuries
Falls — #1 Cause Across All Ages
Falls are the leading cause of head injury, especially in young children (under 4) and adults over 65. Bathroom falls, falls from playground equipment, slipping on ice, and falls from height all carry significant head injury risk.
Sports & Recreational Injuries
Football, soccer, hockey, lacrosse, cheerleading, bicycling, skateboarding, gymnastics, and boxing all produce regular concussions. Even “non-contact” sports like volleyball and basketball cause head injuries through falls, collisions, and elbow strikes.
Motor Vehicle Accidents
Car crashes cause some of the most severe head injuries — even with seatbelts and airbags, the rapid back-and-forth motion of a collision causes the brain to slam against the skull. Whiplash injuries are particularly likely to produce concussions even without direct head impact.
Workplace & Construction Injuries
Falls from height, falling objects, machinery accidents, and slip-and-fall incidents at construction sites, warehouses, and manufacturing facilities account for thousands of head injuries each year.
Assault & Violence-Related Injuries
Physical assaults, domestic violence, and violent crime are significant — and frequently underreported — causes of head injuries. These often involve repeated impacts, increasing severity.
3. Recognizing Concussion Symptoms
Concussion symptoms can be subtle, easy to miss, and often appear gradually. They fall into four categories — and any combination of symptoms below should prompt medical evaluation, especially after a known head injury.
Physical Symptoms
- Headache or pressure inside the head
- Nausea or vomiting
- Dizziness or balance problems
- Blurred or double vision
- Sensitivity to light or sound
- Fatigue or feeling “slowed down”
- Ringing in the ears
Cognitive Symptoms
- Confusion or feeling “in a fog”
- Difficulty concentrating or remembering
- Slowed thinking or response time
- Forgetting the moments before or after the injury
- Trouble following conversations
Emotional Symptoms
- Irritability or mood swings
- Sadness or feeling down
- Anxiety or nervousness
- Feeling more emotional than usual
Sleep Symptoms
- Sleeping more than usual
- Trouble falling asleep
- Trouble staying asleep
- Drowsiness during the day
Delayed Symptoms — Why They Can Appear Hours or Days Later
One of the most dangerous aspects of head injuries is that symptoms don’t always appear immediately. Headache, confusion, or balance problems can develop hours or even days after the impact. This delayed presentation is one reason why everyone with a significant head injury — even those who feel fine afterward — should be observed closely for at least 24–48 hours.
4. Concussion Symptoms by Age
Concussion in Infants & Toddlers — Hard to Spot
Young children can’t describe symptoms, so concussion in infants and toddlers shows up as behavioral changes:
- Persistent crying that won’t be soothed
- Refusing to eat or nurse
- Loss of interest in favorite toys or activities
- Unusual irritability or sleepiness
- Changes in balance or unsteadiness when walking
- Vomiting or unusual fussiness
Any infant under 1 year with a head injury — especially from a fall over 3 feet — should be evaluated promptly. Their thin skulls and developing brains are uniquely vulnerable.
Concussion in Children & Teens
School-age children and teens may show classic concussion symptoms but also exhibit:
- Difficulty in school or with homework
- Personality changes noticed by parents or teachers
- Withdrawal from social activities
- Trouble with usually easy tasks
Children take longer to recover than adults — typically 2–4 weeks vs. 7–14 days. Pushing them back to school or sports too soon dramatically worsens outcomes.
Concussion in Adults & Athletes
Adults often minimize symptoms — pushing through headaches, dismissing dizziness, returning to work too quickly. Athletes are especially likely to underreport symptoms to stay in the game. Trust the symptoms; mental toughness isn’t a substitute for recovery.
Concussion in Seniors — Higher Risk of Complications
Adults over 65 are at dramatically higher risk for complications after a head injury — particularly subdural hematoma (bleeding under the skull lining), which can develop slowly over days or weeks. Seniors on blood thinners, anti-platelet medications, or anti-coagulants need CT evaluation after even minor head injuries. Symptoms may include subtle confusion, mood changes, or one-sided weakness rather than classic concussion signs.
| ⚠️ Head injury within the last 24 hours? Even mild head injuries deserve professional evaluation — especially in children, seniors, or anyone on blood thinners. Walk in 24/7 to ER of Mesquite at 1745 N Belt Line Rd, Mesquite, TX or call (214) 377-8495. On-site CT scan, board-certified physicians, no appointment needed. |
5. When a Head Injury Becomes a Medical Emergency
Red-Flag Symptoms That Mean “Go to the ER Now”
- Loss of consciousness for any length of time
- Persistent or worsening headache
- Repeated vomiting (more than once)
- Confusion, slurred speech, or strange behavior
- Vision changes, including blurred or double vision
- Trouble walking, severe balance issues, or coordination problems
- Weakness or numbness on one side of the body
- Severe or worsening dizziness
- Anyone on blood thinners with a head injury
- Children under 2, seniors over 65, or pregnant women
Symptoms That Mean “Call 911 Immediately”
- Loss of consciousness lasting more than a few seconds
- Seizures or convulsions
- Clear fluid or blood draining from the nose or ears
- Unequal pupil size or sudden vision loss
- Severe progressive weakness or paralysis
- Severe head wound with visible skull or heavy bleeding
- Inability to wake the person, or extreme drowsiness
Signs of Skull Fracture or Brain Bleed
Skull fractures and brain bleeds (subdural hematoma, epidural hematoma, subarachnoid hemorrhage) are surgical emergencies. Warning signs include:
- Bruising behind the ears (Battle’s sign) or around the eyes (raccoon eyes)
- Clear cerebrospinal fluid draining from nose or ear
- Visible deformity of the skull
- Severe headache that worsens over hours
- Confusion that progresses rather than improving
- A “lucid interval” — feeling fine, then suddenly deteriorating hours later
Second-Impact Syndrome — Why Athletes Must Wait to Return
Second-impact syndrome is a rare but catastrophic condition that occurs when an athlete sustains a second head injury before fully recovering from the first. The brain loses its ability to regulate blood flow, swelling rapidly and often fatally. Most cases occur in athletes under 20. The lesson:
Never let an athlete with concussion symptoms return to play until cleared by a physician. “When in doubt, sit them out” is the universal sports medicine rule.
Decision Matrix — 911, ER, or Home Observation?
| Call 911 Immediately | Go to ER Now | Home Observation OK |
| Loss of consciousness for more than a few seconds | Brief LOC or memory gap from the event | Mild bump, no LOC, no symptoms |
| Seizures or convulsions | Persistent headache, nausea, or vomiting | Mild headache that responds to OTC meds |
| Clear fluid or blood from nose or ears | Confusion, slurred speech, or vision changes | Normal alertness, no balance issues |
| Unequal pupil size or sudden vision loss | Worsening symptoms 1–6 hours after injury | No nausea, no vomiting, no confusion |
| Weakness or numbness on one side | Children, seniors, or anyone on blood thinners | No risk factors and able to be observed |
6. What to Do Immediately After a Head Injury
Step-by-Step Response in the First 30 Minutes
- Stop the activity immediately. No “shaking it off” — even mild concussions worsen with continued activity.
- Check for serious injury — is the person conscious, breathing, and responsive? If not, call 911 immediately.
- Apply ice (wrapped in cloth) to swelling for 15–20 minutes.
- Keep them still and calm for 15–30 minutes.
- Watch for symptoms — headache, nausea, confusion, balance issues, sleepiness.
- Have someone monitor them for the next 24 hours.
- Go to the ER for any red-flag symptoms or if you’re unsure.
When to Apply Ice (and When Not To)
Ice helps with external swelling and bumps from a closed head injury. Don’t apply ice if there’s an open wound, suspected skull fracture, or significant bleeding — those need direct pressure and emergency care first.
Monitoring for Worsening Symptoms
For the first 24 hours after a head injury, watch closely for any worsening — increasing headache, confusion, repeated vomiting, drowsiness that’s hard to wake from, or any new neurological symptoms. Mild concussions usually improve gradually; symptoms that get worse over hours signal something more serious.
What NOT to Do
- Don’t sleep off a severe injury without medical evaluation first. Mild concussions can rest, but a serious head injury needs assessment before sleep.
- Don’t drive with active concussion symptoms — reaction time, vision, and judgment are impaired.
- Don’t return to play, work, or strenuous activity until cleared by a physician.
- Don’t take aspirin or ibuprofen if a brain bleed is possible — these can worsen bleeding. Acetaminophen is safer until evaluated.
- Don’t drink alcohol for at least a week after a concussion — it interferes with healing and masks worsening symptoms.
7. Concussion Treatment at ER of Mesquite
From the moment you walk in, ER of Mesquite treats head injuries with the urgency they deserve. You’ll be evaluated within minutes by a board-certified emergency physician — and we have the tools to rule out serious complications on-site.
Our 24/7 Head Injury Protocol
Our team begins with a focused history (mechanism of injury, loss of consciousness, symptoms timeline), thorough neurological exam, and assessment of cognitive function. Vital signs and screening labs are drawn while we determine whether CT imaging is needed.
Diagnostic Tools — Hospital-Grade, On-Site
- CT scan — the gold standard for ruling out brain bleed, skull fracture, and other emergencies. Most urgent care centers don’t have CT scanners — meaning they can’t safely evaluate head injuries. We perform CT scans on-site, with results read immediately by your physician. Read our complete CT scan guide or see our CT scan services.
- Digital X-ray — used for suspected skull or cervical spine fractures. Learn about our digital X-ray services.
- Neurological exam — pupillary response, balance, coordination, reflexes, cognitive screening.
- Vision testing — concussions frequently affect eye movement, focus, and visual processing.
Treatment Pathways
Treatment depends on what we find:
- Mild concussion (no bleeding) — observation, symptom management, detailed discharge instructions, return-to-activity guidance.
- Moderate to severe TBI — immediate stabilization, advanced imaging, neurosurgery referral when indicated.
- Brain bleed identified — urgent transfer to a hospital with neurosurgical capabilities.
- Skull fracture — evaluation for associated injuries, surgical consultation when needed.
- Lacerations or wounds — cleaning, suturing, and tetanus consideration.
Pediatric Concussion Care
Children’s brains heal differently — and need different evaluation. Our pediatric ER care team uses age-appropriate cognitive screening, pediatric-specific CT protocols (only when truly necessary), and gives parents clear written instructions for monitoring at home, return to school, and return to sports.
What to Expect From Walk-In to Discharge
As a freestanding emergency room, we deliver hospital-grade emergency care without the long hospital wait. Expect rapid evaluation, immediate imaging when indicated, clear communication of findings, and a detailed plan for recovery — including when to follow up and what symptoms should bring you back. Also relevant: head injuries often come with associated injuries like fractures or whiplash, which we can also evaluate and treat in the same visit.
8. Concussion Recovery — What to Expect
The Typical Recovery Timeline
Most adults recover from a mild concussion within 7–14 days. Children and teens often take 2–4 weeks. Some people — particularly those with prior concussions, certain medical conditions, or repeat injuries — may have symptoms lasting much longer. Recovery isn’t linear; some days are better than others. Patience is essential.
Rest, Light Activity, and the New “Active Recovery” Approach
The old advice was strict bed rest in a dark room for days. Current research shows that’s actually counterproductive. The new approach: brief initial rest (24–48 hours) followed by gradual, gentle activity — light walking, low-intensity stretching, screen time in moderation. Activities should be reintroduced at a level that doesn’t worsen symptoms. Pushing through symptoms slows recovery; staying entirely sedentary also slows it.
Return to Work, School, Sports — The Stepwise Protocol
Return-to-activity follows a graduated protocol, with each step taking at least 24 hours and only progressing if symptoms remain stable or improve:
- Step 1: Symptom-limited activity (light daily activities, limited screen time)
- Step 2: Light aerobic exercise (walking, stationary bike)
- Step 3: Sport-specific exercise (jogging, drills without contact)
- Step 4: Non-contact training (full practice without physical contact)
- Step 5: Full-contact practice (after medical clearance)
- Step 6: Return to competition or full activity
If any step triggers a return of symptoms, drop back to the previous step. Return to school typically follows a similar graduated approach.
Post-Concussion Syndrome — When Symptoms Last Months
Post-concussion syndrome (PCS) affects 10–20% of concussion patients, with symptoms — headache, dizziness, cognitive issues, mood changes — lasting more than 3 months. Risk factors include prior concussions, female gender, age (teens and seniors are higher risk), and prior history of migraines, depression, or anxiety. If symptoms persist beyond 4 weeks, a referral to a concussion specialist or sports medicine doctor is appropriate.
Long-Term Effects of Repeated Concussions (CTE)
Chronic traumatic encephalopathy (CTE) is a degenerative brain condition linked to repeated head impacts — primarily in contact-sport athletes (football, hockey, boxing, MMA) and military veterans. It can cause progressive memory loss, mood changes, impulsivity, and dementia, often appearing years after the last impact. CTE is one of the strongest arguments for taking every concussion seriously and never returning to play before fully healed.
9. Don’t Wait — Visit ER of Mesquite for Fast Concussion & Head Injury Care
Head injuries are one of the most under-diagnosed and over-toughed-out conditions in medicine. “I’m fine” is the wrong answer when your brain may be injured. At ER of Mesquite, board-certified emergency physicians are on duty 24 hours a day with on-site CT scanning to rule out brain bleed, neurological assessment expertise, and dedicated pediatric care for sports parents and school injuries. Whether you’re an athlete after a hard hit, a parent of a child who fell, or an adult after a car accident, you’ll get answers and concussion treatment within minutes of walking in.
| 📍 ER of Mesquite — 24/7 Emergency Care Address: 1745 N Belt Line Rd, Mesquite, TX 75149 Phone: (214) 377-8495 Hours: Open 24 hours a day, 7 days a week, 365 days a year Walk-Ins Welcome: No appointment needed On-Site Imaging: CT scan, digital X-ray, ultrasound, full lab Pediatric Care: Sports concussion and return-to-play guidance Insurance: All major commercial insurance accepted |
Frequently Asked Questions About Concussions
How do I know if I have a concussion?
If you experienced a hit to the head or body that jolted your brain — and you have any new symptoms like headache, dizziness, confusion, nausea, or balance problems — you likely have a concussion. You don’t need to lose consciousness to have one. When in doubt, get evaluated; missing a concussion is more dangerous than over-checking.
Should I sleep after a concussion?
For mild concussions, sleep is fine — and even helpful for recovery. The old advice about preventing sleep was based on the (rare) concern that someone might lapse into a coma from a brain bleed. The current approach: if you’ve been medically evaluated and a brain bleed has been ruled out (or there’s no reason to suspect one), sleep is part of healing. If you haven’t been evaluated and have serious red-flag symptoms, get checked first.
How long does a concussion take to heal?
Most adults recover within 7–14 days, children in 2–4 weeks. Some people take longer — particularly those with previous concussions, migraine history, or other risk factors. About 10–20% develop post-concussion syndrome with symptoms lasting months. Pushing through symptoms or returning to activity too soon extends recovery dramatically.
Can a concussion happen without hitting your head?
Yes. Concussions happen any time the brain is jolted hard enough to move inside the skull — including from whiplash injuries, hard falls onto the body, or impacts to the chest or back that whip the head forward. Direct head contact isn’t required.
When can my child return to sports after a concussion?
Only after they’re symptom-free at rest and through the full graduated return-to-play protocol (typically 1–2 weeks for adults, 2–4+ weeks for children), AND after medical clearance from a physician. Most schools and youth sports leagues now require written clearance. Returning before full recovery risks second-impact syndrome, which can be fatal in young athletes.
Do I need a CT scan for every head injury?
No. Many mild head injuries — especially in adults without red-flag symptoms — don’t need CT imaging. We use validated decision rules (Canadian CT Head Rule, New Orleans Criteria) to identify who genuinely needs imaging vs. who can be safely observed. CT scans are clearly indicated for loss of consciousness, repeated vomiting, severe headache, signs of skull fracture, anyone on blood thinners, children under 2, and seniors. Read our CT scan guide for more details.
Will my insurance cover an ER visit for a head injury?
Most commercial insurance plans cover emergency head injury evaluation, including CT scanning when indicated. ER of Mesquite accepts all major commercial insurance plans. Visit our insurance coverage page or learn about our no surprise billing policy for full details. We also offer flexible payment plans for uninsured patients.
How fast can I be seen at ER of Mesquite for a head injury?
Head injuries — especially with concerning symptoms — are evaluated within minutes of arrival. CT scans, when needed, are performed on-site with results read immediately by your emergency physician. No triage backups, no overcrowded waiting rooms.