Key takeaways
- Most concussions happen without a loss of consciousness. Not being knocked out is not an all-clear.
- Fog, a headache that will not settle, light or noise sensitivity, dizziness, nausea, and trouble concentrating after a crash are head symptoms, and they get their own headline.
- Worsening symptoms, repeated vomiting, confusion, or one-sided weakness are an emergency room trip right now.
- After acute care, Missouri Injury Clinic publishes a concussion rehab lane with specific tools. Rehab follows the ER; it does not replace it.
- Say the word head on the phone. Clinics can only examine what they know to ask about.
The neck gets the headlines after a crash because the neck complains loudly. The head is quieter, and the desk has learned to be suspicious of quiet. This piece is about the head injury nobody notices because nobody got knocked out.
What a concussion is
A concussion is a mild traumatic brain injury caused by a bump, blow, or jolt to the head, or by a hit to the body that makes the head and brain move quickly back and forth. That last clause matters for crash patients. The headrest stops the skull. The brain, floating inside it, keeps moving for a moment and then stops against bone. No part of that requires your head to touch anything.
The CDC's HEADS UP program, which exists to explain exactly this, is clear that most concussions occur without a loss of consciousness. (Source: CDC HEADS UP.) If you remember the whole crash, you can still have one.
What it looks like two days later
A headache that does not respond to the usual things. A fog that makes an ordinary shift hard. Trouble finding words or following a conversation. Light from the laptop feels aggressive; the restaurant is too loud. Dizziness standing up. Nausea with no obvious cause. Sleeping much more, or much less, than usual. Irritability that your household has noticed before you have.
Any of those after a crash is a head symptom, and it deserves to be treated as its own headline rather than a footnote to the neck. Write down when it started and whether it is settling or building. That second question is the one that decides where you go.
The bright line
Chest pain, a sudden severe headache, weakness or numbness on one side, trouble speaking, a loss of bowel or bladder control, or a head injury with vomiting or worsening confusion is an emergency room trip right now, not a call to a clinic. A headache that is getting worse rather than better, repeated vomiting, increasing confusion or drowsiness, a seizure, unequal pupils, or slurred speech belong on that list too. If the question is "should I go to the ER," the honest answer is usually yes, and the cost of being wrong in that direction is a long wait. The cost of being wrong in the other direction is not.
The National Institute of Neurological Disorders and Stroke publishes a plain overview of traumatic brain injury and its warning signs. (Source: NINDS, Traumatic Brain Injury.)
After the emergency phase
Once the ER has done its work and nothing dangerous is going on, the problem becomes the slow one: a brain that is not yet back to normal, and a life that did not pause. This is the rehab phase, and it is the one Missouri Injury Clinic publishes as a lane. The tools it lists on its TBI rehab page are vagus nerve stimulation (gentle microcurrent at the tragus), neurofeedback, Alpha Stim, sensory motor integration, exercise with oxygen, oculomotor rehabilitation, and cognitive rehabilitation using computerized brain-exercise software.
This desk does not evaluate those tools and is not qualified to. What we can say is the structural thing: rehab comes after acute care, never instead of it, and a rehab plan should look like any other plan, with findings written down, a goal, a timeline, and a straight answer about what would send you somewhere else. The skeptic's column has the four questions to ask.
When you call, say car crash, give the date, and then say: and I think I hit my head, or I have had a headache and fog since. That sentence changes what the exam includes. It costs nothing and it is the single most useful thing a concussion patient can do at the front desk.
The neck and the head together
They usually travel together after a crash. The same motion that strains the neck jolts the head, and a strained upper neck can produce headaches of its own that are easy to confuse with a concussion. Sorting that out is a clinical job, not a reader's job, and it is one more reason the desk keeps saying: get examined this week, say everything, keep the plan. This page is educational and is not medical advice.
Service desk
Head symptoms after a crash? Say so, and get examined this week.
After the emergency room, the rehab phase has a plan too. Call the nearest room and mention the head.