For a suspected concussion, your first stop should be an urgent care clinic, your primary care doctor, or a sports medicine physician, ideally within 24 to 48 hours of the injury. If you or your child shows danger signs like seizures, repeated vomiting, worsening headache, or loss of consciousness, skip the clinic and go straight to the emergency department. The right setting depends on the severity of symptoms and how long they’ve been present.
When to Go to the Emergency Room
Most concussions don’t require an ER visit, but certain symptoms signal a potentially serious brain injury that needs immediate attention. Call 911 or go to the nearest emergency department if you notice any of the following after a blow to the head:
- Seizures or convulsions
- Repeated vomiting
- One pupil visibly larger than the other
- Slurred speech, weakness, numbness, or loss of coordination
- Increasing confusion, restlessness, or agitation
- Loss of consciousness or inability to stay awake
- A headache that keeps getting worse
For infants and toddlers, inconsolable crying and refusal to eat or nurse are additional warning signs that warrant emergency care. These danger signs can indicate bleeding or swelling in the brain, which requires rapid evaluation and possibly imaging. In the ER, doctors use a set of clinical criteria to decide whether a CT scan is needed. Factors like vomiting more than twice, signs of a skull fracture, amnesia lasting longer than 30 minutes before the injury, and age over 65 all raise the threshold for ordering a scan. Routine imaging isn’t recommended for a straightforward concussion because most concussions don’t produce visible changes on CT or MRI.
Primary Care and Urgent Care
If there are no danger signs, a primary care physician or urgent care clinic is the appropriate first step. These providers can perform a focused neurological exam, assess your symptoms using standardized tools, and determine whether you need rest, monitoring, or a referral to a specialist. The CDC recommends that children with a possible concussion be seen by a healthcare provider within the first 24 to 48 hours.
During an initial evaluation, the provider will typically check your balance, memory, concentration, and eye movements. Many clinics use structured assessment forms designed specifically for concussion, which help score your symptoms on a standardized scale. This visit establishes a baseline so your recovery can be tracked over follow-up appointments. The provider will also give you specific guidance on returning to daily activities, which current guidelines say should happen gradually after no more than one to two days of initial rest.
Sports Medicine Clinics
If the concussion happened during sports, a sports medicine physician is often the best first-line evaluator. These doctors have specific training in recognizing concussions, managing return-to-play timelines, and distinguishing concussion symptoms from neck injuries or other conditions that can mimic them. Many sports medicine practices use the SCAT6, a standardized evaluation tool developed specifically for sport-related concussions, with a separate child version for ages 8 to 12.
Some athletes receive a quick sideline assessment at the time of injury. These brief screenings, which take about five to six minutes, test mental status and basic neurological function to determine whether the athlete should be removed from play. A sideline screen is not a diagnosis. It’s a triage step. Any athlete pulled from a game still needs a full clinical evaluation before being cleared to return.
What Happens During a Clinical Evaluation
A thorough concussion evaluation goes beyond checking whether you “feel okay.” Clinicians assess multiple functional areas to build a complete picture of how the injury is affecting your brain. One common tool is the Vestibular/Ocular Motor Screening, or VOMS, which tests how well your eyes and balance system are working together. The provider will ask you to follow a finger with your eyes, move your head side to side while focusing on a target, and slowly bring a small object toward your nose until your vision doubles. After each task, you rate your headache, dizziness, nausea, and mental fogginess on a 0 to 10 scale.
These tests pick up problems that a standard physical exam might miss. For instance, if your eyes can’t converge on a near point closer than 5 centimeters from your nose, that’s considered abnormal and suggests the concussion is affecting your visual processing. The results help guide treatment. Someone with primarily visual symptoms may need different rehabilitation than someone whose main issue is headaches or balance problems.
Dedicated Concussion Clinics
For symptoms that persist beyond two to three weeks, or for injuries that feel complex from the start, a dedicated concussion clinic offers the most comprehensive evaluation. These programs bring together specialists from multiple fields under one roof, which means fewer appointments and a more coordinated treatment plan.
A typical interdisciplinary concussion program includes sports medicine physicians, neurologists, neuropsychologists, physical therapists, and sometimes psychiatrists or speech therapists. The neurologist focuses on persistent symptoms like headaches. The neuropsychologist evaluates memory, attention, and processing speed through formal testing. Physical therapists trained in concussion rehabilitation work on balance, gait, and graded exercise programs to help you safely return to physical activity. Occupational therapists can help with return-to-work readiness, addressing specific demands of your job.
Some programs also include cervical therapy, a specialized form of physical therapy targeting the upper neck. Head injuries often involve neck strain, and neck problems can produce symptoms that overlap with concussion, including headaches, dizziness, and difficulty concentrating. Treating both issues simultaneously leads to faster recovery.
Specialist Referrals for Lingering Symptoms
Most concussions resolve within a few weeks, but roughly 15 to 30 percent of people experience symptoms that last longer. If yours haven’t improved, your primary care provider will likely refer you to one or more specialists depending on which symptoms are dominant.
Persistent or worsening headaches often warrant a referral to a neurologist experienced in post-concussion headache management. Cognitive problems like brain fog, difficulty concentrating, or declining performance at school or work are best evaluated by a neuropsychologist, who can run detailed tests of memory, attention, and executive function. If you’re experiencing anxiety, depression, or personality changes after the injury, a psychiatrist or psychologist with concussion experience can determine whether those symptoms are directly related to the brain injury or a reaction to the disruption it’s causing in your life.
Vision problems that don’t resolve, such as blurred or double vision, light sensitivity, or difficulty reading, may require a neuro-ophthalmologist. These specialists evaluate how the brain processes visual information, which is different from a standard eye exam checking whether you need glasses.
Evaluations for Children
Children and adolescents need evaluation from providers experienced in pediatric concussion. Their brains are still developing, and symptoms can look different than in adults. Young children may not be able to describe what they’re feeling, so providers rely more on behavioral observations, parent reports, and age-appropriate symptom scales. The CDC’s clinical guidelines for pediatric mild traumatic brain injury emphasize using validated, age-appropriate tools rather than defaulting to imaging.
Pediatric concussion programs are available at many children’s hospitals and typically include pediatricians, pediatric neurologists, and neuropsychologists who understand how concussion affects learning and school performance. These teams can coordinate accommodations like reduced homework loads, extra test time, or modified screen use while your child recovers. Return-to-activity plans for children follow a stepwise approach, starting with light cognitive activity and progressing gradually based on symptom tolerance.