Regardless of the injury severity, concussions can’t be seen on a CAT scan or MRI.



Patients often ask us why there has been such a big fuss about concussions recently. The reality is that, if left untreated, concussions can lead to a higher risk for a second concussion, which, if this occurs before the first concussion is resolved, can lead to permanent brain damage, swelling of the brain and possible death (Second Impact Syndrome – see sidebar). Other reasons you should care include:

  • More than four million concussions occur annually when there is a bruise to the soft tissue of the brain.
  • Regardless of the injury severity, concussions can’t be seen on a CAT scan or MRI.
  • Concussion rates are increasing, especially among middle school athletes.
  • Concussions aren’t always the result of an athletic injury; they can result from motor vehicle accidents, work injuries, falls or any daily mishap.
When Should You Seek Help for a Possible Concussion?

If symptoms such as headaches, dizziness, fatigue or fogginess last more than three to five days after an injury despite brain rest instructed by your primary care physician, or you return to school or work and the symptoms persist or worsen, you should seek additional medical help immediately.  Other symptoms not to ignore include the inability to tolerate car travel or crowds and an ongoing sensitivity to light and noise.

How is Today’s Concussion Treatment Different from Past Treatment?

The current approach to concussion is no longer passive. Although brain rest is still crucial, active physical and vestibular (dealing with balance) treatment should be initiated within a few days of the injury. Walking and small group socialization is encouraged even before returning to school or work.
Difficulty sleeping over the first week can be treated successfully with safely prescribed sleep aids that have been well-proven by research done at UPMC. Ongoing headaches, fogginess and light and sound sensitivity after one week can be successfully treated with non-addictive nerve modulators also well-proven by research done at UPMC.

Brain Rest Protocol

The MAC Alliance recommends that concussion patients refrain from any academics, homework or physical work until their brain is rested (no puzzles, reading, homework, email, internet, texting, gaming) and they are re-evaluated by a certified health provider.

Other brain rest tips:

  • Drink lots of fluids two-three times per day, especially sports drinks (Gatorade, PowerAde, Propel, coconut water, etc.)
  • Obtain seven to eight hours of sleep every night, with bedtime targeted before 11 pm.
  • Avoid texting and computer usage (no Facebook or other social media!).
  • View television in only 30-60 minute increments, at a maximum of three hours per day (or only one hour if back at school or work), on a large screen (not on a tablet, desktop or laptop) as long as symptoms do not worsen.
  • Limit phone calls to 15 minutes, with no more than four per day.
  • Listen to soft music if you like, but without ear buds or head phones.
  • Limit any daytime naps to less than 30 minutes.
  • Take daily walks. Wear sunglasses if you’re light sensitive.
  • Limit travel to one-half hour per day in any vehicle.

Allowable activities include listening to audiobooks, crafts, drawing, coloring, sewing, knitting, cooking and simple games such as Uno or Checkers. These activities should be kept to 30-minute intervals or less. A trip to an art or craft store like Michael’s or AC Moore can help prevent boredom. Don’t forget that in bad weather patients can walk indoors at local malls early in the morning before the crowds arrive.


More About Second Impact Syndrome

Eight cases of Second Impact Syndrome were reported in the U.S. in 2015.  Second Impact Syndrome occurs when a second concussion takes place before the previous concussion has healed. This repeated concussion results in sudden swelling of the brain, causing confusion, loss of motor control and sudden collapse. A second concussion can lead to permanent disability or even death.

For More Information

The U.S. Department of Health and Human Services Center for Disease Control and Prevention” provides a Fact Sheet for Parents regarding concussion in youth sports. For more CDC information, visit

Five Stage UPMC Concussion Program

Athletes benefit from a supervised Five Stage UPMC Concussion Program that was specifically designed to allow individuals to maintain strength and cardiovascular activity while making a concussion recovery. The recovery program is also used in all age groups for improved balance and to help clear up vestibular deficits while promoting physical activity.