The question of what to do after a head injury can be bewildering. Too often, people don’t get properly evaluated for concussion because they don’t know the signs or don’t think their injury is severe enough. For others, heading straight for the emergency room seems like the most appropriate course of action. This is understandable, but for most concussions, it isn’t necessary. Going to urgent care for a concussion can be more accessible and equally effective in most cases, yet it remains widely overlooked.
Deciding whether you should be going to urgent care for a concussion or the ER begins with being able to recognize concussion symptoms. Arming yourself with that knowledge ahead of time can help ensure that you get the right care if and when you need it.
A concussion is a form of mild traumatic brain injury (mTBI) that occurs when a blow, bump or whipping action jolts the brain in motion inside the skull. It can disrupt the brain’s chemistry, stressing neural connections and sometimes injuring brain cells in the process. While most people picture this as a direct hit to the head, that’s not always how it happens. Whiplash-type forces, like the violent snapping motion of a car accident, can produce the same internal brain movement without any contact to the skull at all.
The clinical term “mild” refers to the fact that concussions are rarely life-threatening. But the effect of a concussion can be quite serious. Mood changes, cognitive difficulties and sleep disruption can all follow a poorly managed concussion, and some symptoms may persist for months.
The scale of the problem is larger than most people appreciate. The CDC puts the annual U.S. count at 1.4 to 3.8 million concussions, but recent surveillance data reported by the Concussion Alliance suggests the true burden is substantially higher — with 2 to 12% of adults reporting a concussion or TBI within the past year alone. The Brain Injury Alliance estimates that for every 300,000 sports-related concussions diagnosed annually, as many as seven times more may never be caught.
Despite football’s outsized presence in the conversation about concussion, falls are the single leading cause. They’re responsible for nearly half of all traumatic brain injuries in the U.S., and motor vehicle crashes rank second. Concussion is common injury that can happen to anyone.
According to the CDC and Mayo Clinic, concussion symptoms typically fall into four areas:
Symptoms can surface hours or even days after the injury. Paying attention to how you or your child feels in the first 24 to 72 hours is just as important as the initial check.
Assuming that any injury involving your head requires ER care can mean spending unnecessary time in a stressful waiting room when more appropriate care is available nearby. Urgent care centers are well-equipped to evaluate and manage most concussions, and for most patients, it’s the right first call.
A concussion diagnosis is made based on your history, your reported symptoms and a hands-on physical and neurological examination. According to the AANS, standard imaging — CT scans and MRIs — does not detect a typical concussion, because the injury is a disruption of brain chemistry and function rather than a visible structural change. Imaging becomes relevant only when there’s specific clinical concern about bleeding, swelling or a fracture. For most concussions, it isn’t needed at all.
At Coastal, our providers will evaluate how the injury occurred, your complete symptom profile and timeline, your cognitive performance, balance and coordination, and your neurological reflexes including eye tracking. From that assessment, they can confirm a diagnosis, identify whether you need a higher level of care and give you a clear plan. If imaging or a specialist referral is warranted, we’ll get you there.
If you’re awake, oriented and able to describe what happened, urgent care services can likely provide the right level of concussion treatment. Symptoms typically well-suited for urgent care include: a headache that’s present but stable rather than escalating; mild dizziness or coordination difficulty; nausea without recurrent vomiting; light or sound sensitivity; and mild fogginess or memory gaps around the time of the injury.
Multiple locations, the ability to book online or walk-in without an appointment and extended hours make urgent care a practical choice for your convenience and your recovery.
A significant share of concussions go unrecognized or are mismanaged because of widely held beliefs that simply don’t hold up to scrutiny. Here’s what the evidence shows.
According to Banner Health sports medicine physician Dr. Steven Erickson, only about 5% of concussions involve a loss of consciousness. Research from the University of Pittsburgh Medical Center finds that losing consciousness doesn’t predict severity or recovery time. Feeling shaky, foggy or “off” is reason enough to be evaluated.
Delayed symptom onset is one of the defining characteristics of concussion. UT Southwestern Medical Center’s neuropsychologists are explicit: feeling fine immediately after impact does not rule out a concussion. Symptoms can take hours or more to emerge, which is why returning to activity before being evaluated is one of the most common and consequential mistakes after a head injury.
As Michigan Medicine sports neurologist Dr. Matthew Lorincz notes, “Doctors can’t detect concussion with a test or a scan.” Concussion changes happen at the cellular and neurochemical level, below the resolution of standard imaging. Scans detect structural damage like bleeding or fractures, not concussion.
The image of a concussion patient confined to a dark, quiet room in total rest is deeply ingrained and largely outdated. Research reviewed in a PMC-published study found that patients who were completely shut down from activity did not recover faster (and some recovered more slowly) than those who kept up light movement. Current evidence supports relative rest for the first day or two, then a gradual return to activity. Sleep is beneficial; the old concern about sleeping after a concussion has been disproven.
The Children’s Hospital of Philadelphia points the other way: younger patients, especially adolescents, often need a longer recovery time and more careful monitoring than adults. The developing brain is not more resilient to concussion; it may be more vulnerable. Returning to contact sports before full recovery is not a risk worth taking.
Falls account for roughly half of all concussive brain injuries in the U.S. Workplace accidents, vehicle collisions and everyday incidents make up much of the remainder. Concussion is a general injury that doesn’t require a sports uniform.
For a smaller but critical subset of head injuries, the ER is the only appropriate destination. Certain symptoms point toward serious complications such as brain bleeding, significant swelling or structural fractures that require advanced imaging, possible surgery and close monitoring.
Head to the ER or call 911 right away if any of the following are present: loss of consciousness; a headache that worsens continuously rather than holding steady; vomiting that recurs; seizures of any kind; a visible difference in pupil size; slurred or confused speech; weakness, numbness or tingling in the limbs; disorientation severe enough that the person doesn’t recognize familiar people or surroundings; inability to stay awake; or blood or clear fluid from the nose or ears.
These warning signs can develop immediately or hours after the initial injury. Don’t wait to see whether they resolve on their own.
If age or medication is a factor: Anyone 65 or older, or taking blood thinners such as warfarin, Eliquis, Xarelto or Plavix, should have a lower threshold for the ER. The CDC reports adults 75 and older account for roughly a third of TBI-related hospitalizations and more than a quarter of TBI-related deaths. Anticoagulants significantly raise the risk of serious brain bleeding after even a minor impact. When in doubt, choose the ER.
The numbers behind concussion reinforce why recognizing the injury, and getting to the right setting for brain injury care promptly, genuinely matters.
The CDC reports more than 214,000 TBI-related hospitalizations in 2020 and nearly 69,000 deaths in 2023, not counting the far larger number treated in urgent care or primary care settings, or those that went unaddressed. Older adults carry a disproportionate share of serious outcomes, while young athletes represent a high-volume group. An estimated 1.6 to 3.8 million sports-related concussions occur annually, and research suggests up to 43% go unreported and untreated.
Research in the NIH’s National Library of Medicine finds that 80 to 90% of concussion patients recover fully within two weeks when the injury is properly identified and managed early. About 15% develop post-concussion syndrome, in which symptoms last three months or longer, a risk that early, accurate care helps reduce.
Knowing what to do before an injury happens makes it easier to act decisively when you find yourself in need of immediate care for concussion. A little preparation now can make a real difference in your outcome.
If the injured person is conscious, responsive and showing mild to moderate symptoms without any red-flag signs, urgent care is where you should go. Don’t wait for symptoms to worsen, and don’t talk yourself out of it because the person “seems okay;” with concussion, seeming okay and being okay are not the same thing. For families with young athletes, finding your nearest Coastal Urgent Care location before the season starts means one less decision to make in a stressful moment.
A little preparation helps your provider make the most accurate assessment.
Bring or know:
Be ready to describe:
Bring a witness if possible: Memory gaps around the time of impact are common, and a firsthand account from someone who saw the injury is genuinely useful to your provider. It’s also a good idea to have a companion with you to take notes, as your own memory may be compromised after a concussion.
Most concussions don’t need an emergency room, but they do need prompt evaluation, an accurate diagnosis and a clear plan. Going to urgent care for a concussion means faster access and the same quality of clinical assessment, without the stress of an unnecessary ER visit. When serious warning signs are present, the ER is non-negotiable. For everything else, we’re here — no appointment needed. Find your nearest location at CoastalUC.com/find-a-clinic.
Absolutely. For mild to moderate concussions — most cases — urgent care is typically the most appropriate first stop. Our providers can perform a full clinical evaluation and neurological assessment, confirm a diagnosis, rule out more serious injuries and send you home with a clear recovery plan, all without the stress of the ER.
Quite a bit! Our providers will review your health and injury history, conduct a neurological exam (including balance, coordination and eye movement tests), assess your cognitive function and evaluate your symptoms. Based on that comprehensive picture, we can diagnose your concussion, determine whether further evaluation is needed and build a personalized recovery plan. If imaging or specialist care is required, we’ll refer you to the right place.
The 4-hour rule refers to the practice of closely monitoring someone after a head injury during the first several hours, when symptoms of a more serious underlying injury (such as intracranial bleeding) may not yet be apparent. If symptoms are worsening rather than stabilizing during that window, particularly a rapidly escalating headache or increasing confusion, don’t wait. Seek emergency care right away.
The three most reported concussion symptoms are headache, dizziness and confusion or difficulty with memory and concentration. Nausea and sensitivity to light or sound are also very common. Any of these following a blow to the head or a jarring impact to the body is reason enough to be evaluated by a medical provider.