A concussion is a mild traumatic brain injury (mTBI) resulting from a blow or jolt to the head or body, causing the brain to move rapidly within the skull. This movement temporarily disrupts normal brain function, leading to various short-term symptoms. These effects may include issues with concentration, memory, balance, and mood. Nausea and vomiting are common physical symptoms, and their timing and nature can indicate the injury’s severity.
Immediate Vomiting: Common Concussion Symptom or Red Flag?
Nausea and a single instance of vomiting are common symptoms that can occur shortly after a concussion. This response often results from the brain’s reaction to trauma, which can cause chemical imbalances and activate the central nervous system’s vomiting center. The injury can also disrupt the inner ear’s vestibular system, which controls balance, leading to unsteadiness and motion sickness that trigger nausea.
The nature of the vomiting is a key factor in determining the need for urgent care. Persistent, repeated episodes of vomiting, or vomiting that is forceful or projectile, should be treated as a medical emergency. This pattern is a red flag that may indicate rising intracranial pressure (ICP) inside the skull. Increased pressure can be caused by dangerous conditions like brain swelling or a hemorrhage (bleeding inside the skull).
If the vomiting is accompanied by other severe symptoms, or if the individual is unable to keep fluids down, seek immediate medical attention. While a single episode of vomiting is often part of the concussion process, any progression to repeated or severe vomiting suggests a life-threatening complication. Prompt medical evaluation is necessary to rule out internal bleeding or significant brain trauma.
Other Emergency Symptoms
Several symptoms beyond repeated vomiting signal a severe injury requiring emergency medical attention. These “red flag” signs indicate the brain may be under significant pressure or experiencing structural damage. A severe headache that worsens over time, rather than improving, is a concerning symptom. This escalating pain suggests increasing pressure within the cranial cavity from swelling or bleeding.
Changes in consciousness are emergency indicators, including an inability to wake up or a loss of consciousness lasting longer than 30 seconds. Any new seizures or convulsions following the injury warrant immediate emergency care. Serious neurological signs include changes in pupil size, such as one pupil being larger than the other, or new vision problems like double vision.
Physical changes like slurred speech, weakness, or numbness in the arms or legs point to compromised brain function. Unusual behavior, increasing confusion, or significant agitation should also prompt an emergency visit.
Navigating Recovery and Follow-Up Care
Once a medical professional has cleared the individual of life-threatening complications, the focus shifts to managing acute symptoms and promoting recovery. The initial 24 to 48 hours should involve “relative rest,” meaning the person reduces physical and cognitive strain. This involves avoiding activities that worsen symptoms, such as high-concentration tasks, extensive screen time, or strenuous physical activity.
Light activities of daily living, such as short walks or preparing a meal, are permitted as tolerated. Adequate sleep is a powerful factor in recovery, and the individual should be allowed to sleep without being woken up frequently, which is a common misconception in older concussion care.
Schedule a follow-up appointment with a primary care physician or a concussion specialist within a few days of the injury. This visit establishes a formal diagnosis and a personalized management plan for the gradual return to school, work, and sports. Most people show significant improvement within one to four weeks, but consistent medical supervision ensures symptoms are tracked and recovery progresses safely.