health

It is possible for a person to suffer a mild concussion
without knowing it, particularly if their
attention was focused on something else—such as getting out of a
damaged car, helping someone else to safety, or escaping from an
attacker. They may not seek medical help afterward. Most people, however,
will go to the doctor after a head injury if they have briefly lost consciousness,
are having prolonged vomiting spells, severe headaches, or such
vision problems as seeing double or seeing bright lights.
Because of the potential seriousness of a closed-head injury, the
doctor will take a careful history of the injury (its cause and other details
of the incident, as well as how long the patient was unconscious) as well
as a general medical history. The doctor will particularly need to know
whether the patient has had previous head injuries; is taking any bloodthinning
medications; or has a bleeding disorder.

The history is followed by several examinations and imaging studies:

• General physical examination. The doctor looks for injuries to the
  head and neck, including bleeding from the ears or nose, or other
  indications that the skull may have been fractured.
  
• Neurological examination. This part of the examination involves
  testing the patient’s reflexes, vision, hearing, balance, and
  coordination.
  
• A computed tomography (CT) scan. This type of imaging study is
  not always ordered if the concussion seems to have been mild. It is,
  however, usually performed if the patient is a child or elderly; is
  under the influence of alcohol or drugs; was injured in a motor
  vehicle accident; fell from a height of more than 3 feet (0.9 meters);
  cannot recall the accident or blow thirty minutes after it occurred;
  is having seizures; is vomiting; or is having trouble with short-term
  memory.
  
• Observation overnight in the hospital or at home for twenty-four
  to forty-eight hours. This is done to make sure that the patient
  does not have a more severe injury than was first thought. The
  doctor may ask a friend or relative of a patient sent home to wake
  them every few hours for the first thirty-six hours after the injury
  to make sure that they can return to full consciousness.
  
• Magnetic resonance imaging (MRI). This type of imaging study
  may be performed if the patient’s headaches and other symptoms
  are getting worse or have lasted a week or longer.