Treating a concussion

It is often recommended to stay in hospital for observation for 24 hours after a concussion. That is mainly a preventive measure: If a rare complication like hemorrhage does develop, it can be treated quickly.

It is usually possible to go home if no complications develop during those 24 hours. It is recommended not to be at home alone in the first few days.

If the symptoms do not get better within a few days of the injury, or even get worse, it is important to go to hospital and find the root cause.

There are usually two phases to recovery:

• Rest (up to three days after injury): You should rest and get plenty of sleep in the first days after injury. Complete bed rest isn’t necessary, but it is important to avoid physical and mental strain. That also includes not using mobile phones and computers, and not watching TV.
• Gradual return to normal activities (up to three months after injury): It is a good idea to gradually return to activities after the short rest phase. Whether school, work, housework, or exercise – you can increase physical and mental exercises step by step. It is important to listen to your body: Take breaks if you develop symptoms or they get worse. Light exercise like walking or slow cycling are suitable forms of sports activities at first. Exercises where the head is only moved a little are then possible afterwards. Experts recommend waiting for the symptoms to disappear completely before returning to contact sports like soccer and martial arts.

Medication can be taken in the short term to relieve acute symptoms like headache and nausea. Painkillers like paracetamol are available over the counter. Doctors can prescribe antiemetics to help prevent nausea and vomiting.

Some people still have symptoms for several weeks after concussion. They can include headache, nausea, fatigue, insomnia, listlessness, anxiety, irritability, and problems with concentration and memory. Persistent symptoms can restrict daily activities and also affect family and close friends.

Many people find ways to cope better with the symptoms, such as:

• Rest: Regular breaks can help with fatigue and concentration problems.
• Avoiding triggers: It can help to avoid or reduce certain activities, like not sitting at the computer for too long or listening to loud music.
• Relaxation techniques: Some people try relaxation techniques like meditation to cope better with stress.
• Structured daily life: Some people find it helps to clearly plan and structure their day. Daily or weekly plans might be suitable.

More persistent symptoms sometimes can’t be relieved with those kinds of changes. Various therapies like rehabilitation, physical therapy and psychological therapy might then be an option. It is best to talk to a doctor to find the best treatment for you. They can then refer you to a specialist practice for neurology, neuro-surgery, rehabilitation medicine, or psychiatry, or to a specialist hospital.

Studies have found pointers that the following treatments might help:

• Physical therapy methods: These methods are used to treat persistent symptoms such as dizziness, headaches and neck pain. These can include light endurance training, and mobility and balance exercises.
• Psychotherapy methods: Treatments such as cognitive behavioral therapy are an option for treating problems like anxiety, irritability or listlessness.
• Interdisciplinary approaches: Rehabilitation and psychological methods are often combined to relieve more persistent symptoms following a concussion.