Key takeaways
- A concussion is a brain injury caused by a blow to the head or a hit to the body that snaps the head back and forth. No blackout is required.
- Headache that will not clear, fog, trouble concentrating, light sensitivity, a short fuse, and bad sleep after a wreck are reasons to say so on the phone.
- A worsening headache, repeated vomiting, one pupil larger than the other, slurred speech, or growing confusion is an emergency room trip now.
- Missouri Injury Clinic publishes a concussion rehab lane. Mention the head when you call for the back.
The back is what got you to this bulletin. But a lot of the people who write to the desk describe a second thing, usually in passing. A headache that started that night and has not really left. Trouble following the foreman through a simple instruction. A fuse that is shorter than it was. Bright light in the break room that hurts. They did not black out, so they did not think of it as a head injury. This page is about why it might be one.
What a concussion is
The CDC describes a concussion as a type of traumatic brain injury caused by a bump, blow, or jolt to the head, or by a hit to the body that causes the head and brain to move rapidly back and forth. That second clause is the one that matters in a car wreck. Your head does not have to hit anything. The same whip that strains the neck in a rear-end hit moves the brain inside the skull, and that motion can injure it. (CDC, HEADS UP: what is a concussion.)
Loss of consciousness is not required. Most concussions do not involve a blackout. People use "I never lost consciousness" as proof they are fine, and it is not proof of anything. What counts is what happened in the hours and days after.
What it looks like on a shift
Headache that is worse than a normal one and does not clear. Feeling slowed down or foggy. Trouble concentrating on a task you normally do without thinking. Forgetting what you walked over to get. Being bothered by light or by the noise of the floor. Dizziness, balance that feels off, nausea. Sleeping more than usual or not being able to sleep. Irritability, a short fuse, feeling more emotional than the situation calls for. The CDC lists these across four groups: thinking, physical, emotional, and sleep. (CDC, concussion signs and symptoms.)
None of those are a diagnosis. They are reasons to tell the clinician about the head when you call about the back, so the exam includes it.
The danger signs
Some things are not a clinic call. The CDC lists danger signs after a head injury that mean an emergency room right now: a headache that gets worse and does not go away, weakness, numbness, or decreased coordination, repeated vomiting, slurred speech, one pupil larger than the other, drowsiness or inability to wake up, convulsions or seizures, increasing confusion, restlessness, or agitation, or losing consciousness. If any of those are happening, stop reading and go.
Working with a concussion
A physical job with a concussion is a real problem, and not only because it hurts. Operating a forklift, driving a route, or working at height with slowed reaction time and a foggy head is a safety issue for you and the people around you. Tell the clinician what you do and be honest about the fog. Tell your supervisor too. This is not the injury to tough out on the line.
The general shape of concussion recovery, per the CDC, is rest for the first day or two, then a gradual return to normal activity as symptoms allow, stepping back if they flare. Screens, bright light, loud floors, and anything that takes hard concentration tend to push symptoms. The specifics come from the person who examines you. (CDC, concussion recovery.)
The concussion rehab lane
Missouri Injury Clinic publishes TBI and concussion rehabilitative therapy after acute injury as one of its three lanes. On its TBI rehab page the clinic names the tools it uses: vagus nerve stimulation, neurofeedback, Alpha Stim, sensory motor integration, exercise with oxygen, oculomotor rehabilitation, and cognitive rehabilitation. This bulletin does not evaluate those tools and will not tell you which of them you need. It notes that the lane exists, so that when you call about the back you know to mention the head, and the exam can look at both.
Punch in
Say the head when you call about the back.
One phone call covers both. Tell the South County room it was a car crash, when, and that you have had a headache or fog since. They will know what to examine.
Say it was a car crash and when. Ask for the earliest slot that fits your shift.
The quiet version
A lot of concussions after a wreck go unmentioned because the back is louder. The headache gets blamed on the neck, which is sometimes right. The fog gets blamed on bad sleep, which is sometimes right. The short fuse gets blamed on the crash being stressful, which it was. Say all of it anyway. The clinician can sort out what is neck and what is head. You cannot, and neither can this bulletin.
Everything on this page is educational and general. It is not medical advice and it is not a diagnosis. If the head took a hit, get it examined by somebody who can.