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Traumatic brain injury (TBI) treatment depends on the injury’s severity and the person’s symptoms. A concussion is a mild TBI, but it still needs assessment by a healthcare provider. Moderate or severe TBI may require emergency hospital care and rehabilitation. Call emergency services or go to an emergency department now for danger signs after a head injury, such as repeated vomiting, a seizure, worsening headache, confusion, weakness, or difficulty waking.
When is a head injury an emergency?
Do not wait to see whether these danger signs pass. Call emergency services or go to an emergency department if someone has any of the following after a head injury. The CDC also advises urgent care for these signs in children.
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- A headache that worsens or does not go away
- Repeated vomiting or nausea
- A seizure or convulsions
- Weakness, numbness, poor coordination, or trouble walking
- Slurred speech, unusual behavior, or increasing confusion, restlessness, or agitation
- One pupil larger than the other
- Loss of consciousness, unusual drowsiness, or inability to wake
- In a child, inconsolable crying or refusing to nurse or eat
Symptoms can begin immediately or appear hours or days later, and may change during recovery. They can affect physical comfort, thinking, mood, or sleep. Examples include headache, dizziness, balance or vision problems, fatigue, difficulty concentrating or remembering, anxiety or irritability, and sleeping more or less than usual. A new or worsening symptom should be discussed with a healthcare provider; emergency signs need emergency care.
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| Care pathway | Typical focus | What determines next steps |
|---|---|---|
| Mild TBI, including concussion | Provider assessment, symptom management, a brief period of relative rest, and a gradual return to ordinary activity | Symptoms, clinical findings, and whether symptoms improve or worsen |
| Moderate or severe TBI | Emergency hospital assessment and treatment; some patients need intensive care, procedures, or rehabilitation | Injury findings, medical stability, symptoms, and effects on daily function |
This is a general overview, not a way to diagnose an injury or choose a treatment plan. A healthcare team determines care based on the individual’s condition.
How is a concussion assessed, and does it need a CT scan?
A healthcare provider should assess a suspected mild TBI or concussion. Evaluation may include questions about symptoms and checks of learning, memory, concentration, and problem-solving. A normal result on a cognitive check does not rule out mild TBI.
A CT scan is not required for every concussion. A clinician may use one when the injury or the person’s condition raises concern about bleeding or another problem that needs to be identified. Whether imaging is appropriate depends on the clinical assessment; symptoms alone should not be used to decide that a scan is unnecessary.
What treatment and activity are typical for mild TBI?
CDC guidance recommends rest during the first few days, when symptoms are often most severe. A short break from work or school may help; the CDC says this is usually no more than one or two days. Prolonged strict rest is not the general approach in this guidance.
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After a day or two, ease back into regular activities and try light physical activity, such as a walk, as tolerated. If symptoms worsen, reduce activity and contact the clinician for advice. Ask for individualized instructions—ideally in writing—about returning to work or school, driving, exercise, and sports. Do not assume that being able to do one activity means it is safe to resume all of them.
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What happens in hospital for moderate or severe TBI?
Emergency and critical-care teams assess the injury and treat problems identified during evaluation. For severe TBI, care may include monitoring pressure inside the skull and medical or surgical treatment, depending on the findings and the person’s condition. Which interventions are appropriate is a clinical decision, not something a patient or caregiver should try to determine from a general guide.
The Brain Trauma Foundation’s Guidelines for the Management of Severe TBI, 4th Edition (2016) notes that evidence is not strong enough to support a specific recommendation for some treatment questions. For example, the guideline says evidence was insufficient to support a specific recommendation about hyperosmolar therapy’s effects on clinical outcomes or the use of a particular agent. The guideline is intended for clinical care, and its discussion does not provide a do-it-yourself treatment choice.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What can rehabilitation involve after moderate or severe TBI?
Some people need specialized medical care and rehabilitation after a moderate or severe injury. Rehabilitation is tailored to a person’s needs and may focus on relearning tasks, improving daily independence, reconnecting socially, participating in the community, or returning to work. The VA describes possible services including physical, occupational, speech-language, recreation, creative arts, kinesiotherapy, and vocational rehabilitation; support for cognitive or behavioral difficulties; mental health care; assistive devices; medicines or procedures; and, in some cases, emergency surgery. These are examples a care team may consider, not a standard package for everyone.
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How long does recovery take, and when should someone follow up?
The CDC says most people with mild TBI or concussion feel better within a couple of weeks. That is an expectation, not a guarantee: some people have symptoms for months or longer. Contact a healthcare provider if symptoms are not resolving within two to three weeks, or if they worsen after a return to usual activity. Use emergency care instead for the danger signs listed above.
Recovery after moderate or severe TBI varies from person to person. The VA says progress may be fastest during the first three months to a year, while slower gains can continue for years. This is not a promised schedule or individual prognosis; the treating team can discuss goals and follow-up based on the person’s recovery.
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