Concussion

Also called Mild traumatic brain injury, Head injury

A brain injury, even when the scan is normal and nobody was knocked out. Most people recover in weeks; going back too fast is what makes it months.

What it is

A blow, jolt or shaking of the head that briefly disrupts how the brain works. Losing consciousness is not required and happens in a minority of cases.

A CT scan looks for bleeding, not for concussion. A normal scan does not mean nothing happened; it means nothing needs surgery. That distinction is behind a great deal of unnecessary distress and a great deal of premature return to work, school and sport.

Most people recover within two to four weeks. A minority have symptoms for months, and the strongest predictors of that are doing too much too soon, having had a previous concussion, and being told nothing was wrong.

A second concussion before the first has healed is genuinely dangerous, which is why sport has stand-down rules and why they are not negotiable.

Signs you might notice

Headache, feeling dazed or slowed down, dizziness, nausea, sensitivity to light and noise.

Difficulty concentrating, poor memory for the event, and feeling mentally foggy.

Irritability, tearfulness and low mood, which surprise people because they expect a head injury to be physical.

Sleeping more or less than usual.

Go to A and E or call 999 for: worsening headache, repeated vomiting, drowsiness or difficulty waking, confusion, seizure, weakness or numbness, slurred speech, clear fluid from the nose or ears, unequal pupils, or any head injury in somebody on blood-thinning medication.

How it can affect day-to-day life

The invisible part is the hard part. Someone looks completely well and cannot follow a conversation in a noisy room, read a screen for ten minutes, or hold their temper.

Employers, schools and families frequently expect recovery to be over once the scan comes back clear, and the person then pushes through, which reliably makes it last longer.

Older people fall, hit their heads and do not mention it. New confusion, headache or drowsiness in the days or weeks after a fall deserves the question asked directly. See falls and brain injury.

Supporting someone well

Rest for 24 to 48 hours, then start moving again gently. Complete dark-room rest beyond two days makes recovery slower, not faster; this advice changed and many people are still working from the old version.

Return in steps. Light activity, then more, dropping back a level whenever symptoms flare rather than pushing through.

Reduce screens at first, then reintroduce them in short blocks.

No alcohol, and no return to contact sport until cleared. In grassroots sport the rule is straightforward: if in doubt, sit them out, and no return on the same day.

For work or school, ask for phased return, quiet space, shorter tasks and no driving until symptoms have settled.

If symptoms are still there at four weeks, ask for referral rather than waiting it out.

Where to get help

A and E after any significant head injury, and always for the emergency signs above.

A GP if symptoms persist beyond two weeks, and ask about referral to a neuro-rehabilitation or concussion service.

Headway run a helpline on 0808 800 2244 and have the clearest guidance on returning to work.