You feel "off."
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Maybe things seem cloudy or you're just out of it. "I call this the Sudafed feeling," says Pieroth. While it probably hurt when you hit your head (most blows do, after all), that's not enough to diagnose a concussion. You must also experience changes in your mental status, per the definition from the CDC.
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Other people notice something isn't right.
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Remember, the hallmark of a concussion is neurological symptoms. And that might show up in the way you move or interact with someone. You might get up from a chair and veer off balance, for instance. Or slur your speech as you start talking. Or your coordination could be totally messed up. It's those things—which family and friends can plainly point out—that indicate you need to get checked out, stat.
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You're there, but no one's home.
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It might seem like you're really out of it, says Pieroth. "I tell my patients to watch out for 'concussion face,'" she says. Here's what it looks like: You're giving a blank stare and you look dazed and confused.
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Your personality is different.
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Let's say you normally carry on long conversations with your spouse, get into (friendly!) debates, and talk about the news. Now it appears that your brain is moving at half speed. It takes longer to process info, there's a delay when you try to answer questions, you have trouble recognizing people, and you're not as sharp. Maybe you're even acting abnormally silly or agitated. "These symptoms show up because people with concussions are slow to think. That's a hallmark sign," says Pieroth.
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You're vomiting—a lot.
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This goes way beyond nausea. In fact, it's normal to feel nauseated after you get hit on the head because a blow can jostle your inner ear and shift your sense of balance. Or maybe the injury made you emotional and you get an upset stomach, which in turn makes you feel pukey. The nausea isn't enough to diagnose a concussion, but your doc will want to evaluate you for one if you're repeatedly vomiting.
You got knocked out.
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Any time you get hit on the head and lose consciousness, you need to go to the hospital, say Pieroth. But make sure you ask someone around you what happened. "Many times the person themselves won't know if they got knocked out or not," she says. It's also possible to think you were unconscious when you were actually awake and responsive (talking and moving around) the whole time, which is a type of amnesia. However, if you were alone when you were injured, it can be hard to know definitively, so it's best to see a doctor to be safe.
MORE: How To Protect Yourself From Head Injuries
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Your symptoms happen right away.
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There's a myth that you can develop a concussion days or weeks after the incident, but Pieroth says this isn't true. If symptoms are delayed, there may be something else going on, she says. (Though it can be easy to miss some of the signs and not pick up on a concussion until later, especially if you "look" fine, points out the CDC.) Bottom line: You don't want to be inappropriately treated for a concussion. Work with your doctor to see what else could be going on. It could be another serious injury-related condition like a neck injury or a blood clot in or around the brain called a hematoma. Get the help you need and you'll soon be on the path to being well again.
And they're getting worse.
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While a headache, mild confusion, or irritability might not signal a concussion, you should pay attention if those symptoms are getting more severe. "Usually with rest, symptoms will either stay the same or start to get a bit better," says Pieroth. "But if you're getting more fatigued, harder to arouse, or your headache has become severe, go to the ER," she says. It might be a concussion, or it might be a more serious neck injury. Either way, doctors will want to see you stat.
Jessica Migala is a health writer specializing in general wellness, fitness, nutrition, and skincare, with work published in Women’s Health, Glamour, Health, Men’s Health, and more. She is based in the Chicago suburbs and is a mom to two little boys and rambunctious rescue pup.
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