Symptoms of a Concussion: The First 48 Hours

If you are searching "how long do concussion symptoms last", the honest answer for most adults is about a couple of weeks. The CDC reports that symptoms generally improve over time and that most people with a mild traumatic brain injury (TBI), the medical term for concussion, feel better within a couple of weeks. Recovery does vary, and MedlinePlus notes that it may take days to weeks, or even months.

I am Dr. Alireza Chizari, DC, DACNB, a Board-Certified Functional Neurologist, and I provide functional neurology care at California Brain & Spine Center in Calabasas. You are probably not looking for a textbook right now. You want to know whether the headache that still shows up at your desk, or the way store lights feel too bright, is part of the normal course or a sign to get checked. This guide answers that with what public-health sources report, and it explains what an evaluation for concussion treatment looks at when symptoms linger.

How Long Do Concussion Symptoms Last in Adults?

What the Usual Course Looks Like

The public-health sources line up closely here. The CDC describes symptoms that generally improve over time, with most people feeling better within a couple of weeks. The NHS gives a similar picture from the UK: you might have symptoms for up to two weeks after a head injury.

So if you are asking how long a concussion lasts, the usual answer is measured in days to a couple of weeks. The word usual matters. MedlinePlus is careful to say that healing from a brain injury takes time and may take days to weeks, or even months, and nothing in that range is a promise about any one person.

When Concussion Symptoms Last Longer

A smaller group follows a longer course. According to MedlinePlus, symptoms do not go away in a small number of people. If you are past the usual window, you are not outside what the medical literature describes, and it is worth having the symptoms looked at properly.

What Are the Symptoms of a Concussion?

The symptoms of a concussion fall into four groups in the CDC's description: physical, thinking and remembering, emotional, and sleep. You may notice a few of them or many, and the mix differs from one person to the next.

Physical Symptoms

The physical group includes headaches, dizziness or balance problems, being bothered by light or noise, feeling tired with no energy, vision problems, and nausea or vomiting early on. In an ordinary day that can look like a headache that builds by mid-afternoon, or overhead lights in a busy store that suddenly feel harsh.

Thinking and Memory

The CDC lists attention and concentration problems, feeling slowed down, and feeling foggy or groggy. For someone who runs a full calendar, this is often the hardest part to explain at work: the email that takes several reads, or the meeting where the thread slips away halfway through.

Emotional Changes

Anxiety or nervousness, irritability or being easily angered, and feeling sad are on the same CDC list. They are counted as concussion symptoms in their own right, so they belong in the conversation with whoever evaluates you, alongside the headache and the dizziness.

Sleep Changes

Sleep can shift in either direction after a concussion. The CDC includes sleeping less than usual, sleeping more than usual, and trouble falling asleep.

Can Symptoms Start Hours or Days Later?

Concussion symptoms can start later than the injury itself. The CDC notes that some appear right away, while others may not appear for hours or days afterward.

That has a practical consequence. Feeling fine at the scene of a fall or a minor car accident does not settle the question, and a headache or fogginess that shows up the next morning can still be part of the same concussion. It is one reason to keep an eye on how you feel over the following days, and not only in the first hour.

Should You Rest or Stay Lightly Active After a Concussion?

Light activity, rather than strict rest in a dark room, is what current sport concussion guidance describes for the first day or two after a concussion.

The international consensus statement on concussion in sport, from the conference held in Amsterdam, says people can return to light-intensity physical activity, such as walking that does not more than mildly worsen symptoms, during the first 24 to 48 hours. That is a change from older advice built around total rest.

Two cautions apply. The statement was written for sport concussion, so it describes a general direction and is not a plan for your own injury. And if walking makes your symptoms clearly worse, that is useful information to bring to the clinician who examined you.

Light, Screens and Motion

Being bothered by light or noise and having vision problems are both on the CDC's symptom list, so screens, busy stores and car rides can be where symptoms show up first in a normal day. Noticing which settings bring them on is worth writing down, because it helps whoever evaluates you later see the pattern.

How Long Do Concussion Symptoms Last Before You Should Get Checked?

Concussion symptoms that last more than two weeks are a reason to get checked, and that is the threshold the NHS gives for seeing a doctor after a head injury.

That line sits alongside the emergency signs in the next section and never replaces them. A useful way to read your own situation is to ask which row of this table you are in.

If you are in the third row, the next step is an evaluation, booked when it suits you. If you are in the fourth, the next step is a 911 call.

Keeping a Simple Symptom Log

A short written record is the most useful thing to bring to an evaluation after the two-week mark. Each evening, note your two or three most noticeable symptoms, how they compared with the day before, how you slept and how much you moved. A log turns 'I still feel off' into a pattern you can show someone, and it makes the two-week question easier to answer honestly.

When Is a Concussion an Emergency?

A concussion becomes an emergency when danger signs appear, such as a headache that gets worse and does not go away, repeated vomiting, slurred speech or confusion, according to the CDC's list for adults.

For a fuller checklist you can keep on your phone, the guide to post-concussion red flags sets out when to pause, when to call and when to be seen urgently.

Why Do Concussion Symptoms Last Longer for Some People?

Concussion symptoms last longer in a small number of people, and MedlinePlus notes that the risk of long-term changes in the brain is higher after more than one brain injury. That second point is worth holding onto if this is not your first concussion.

Post-concussion syndrome is the name for recovery from a concussion that takes an unusually long time, with symptoms lasting much longer than usual, in some people four months, a year or even longer, as Cleveland Clinic describes it.

The condition has its own page on post-concussion syndrome and mild traumatic brain injury, which covers it in more depth than this article can.

Research on more serious presentations points in the same direction. In one large study of people seen at US level I trauma centers, the TRACK-TBI cohort published in JAMA Neurology, 53 percent of patients with mild TBI reported impairment 12 months after injury, compared with 38 percent of patients with orthopedic injuries. Those were trauma-center patients, so the figures do not describe every concussion. What they do show is that a mild TBI is not always benign.

When symptoms do linger, they can come from any of the CDC's groups, including dizziness or balance problems, vision problems, and feeling foggy or slowed down. The page on the long-term effects of head trauma looks at that longer path in detail.

In this video I talk about concussion and what can follow it.

What Does a Concussion Evaluation in Calabasas Involve?

A concussion evaluation in Calabasas at California Brain & Spine Center is a 120-minute neurodiagnostic assessment that looks at how your balance, eye movements, autonomic nervous system and thinking are working after the injury.

The purpose of the visit is to describe what is still going on in measurable terms, so that any plan that follows is built on findings. Depending on your symptoms, testing may include:

• Videonystagmography (VNG), which records how the eyes move as they track targets and respond to changes in head and body position
• Computerized assessment of postural stability, which measures how steady your balance is under different conditions
• Heart-rate variability, which gives a window on autonomic function, the system that manages heart rate and blood pressure
• Structured eye-movement and cognitive evaluations, which look at attention, processing and visual control

Care after the assessment may include neurological rehabilitation, when clinically appropriate after evaluation. This is functional neurology, which is different from medical neurology: I do not prescribe medication or read imaging as a diagnosis, and when someone needs medical neurology or emergency care, I say so and refer them.

What Patients Ask Me About Concussion Recovery Time

The question patients ask me most often about concussion recovery time is how long is too long to wait it out. My answer starts with the sources above: most adults feel better within a couple of weeks, and past two weeks is a reasonable point to be checked.

One question patients often ask me is whether symptoms that only showed up the day after the injury still count. They do, and the CDC says as much: some symptoms may not appear for hours or days. Another is whether resting completely in a dark room is the safest choice. The current sport consensus describes light activity instead, such as walking that does not more than mildly worsen symptoms, in the first day or two.

When someone comes in with lingering symptoms, what I look for is the pattern behind them: which systems are involved, what sets the symptoms off, and how they have changed since the injury. The assessment exists to answer exactly that.

"He took the time to perform a detailed evaluation, explain my condition, and create a personalized treatment plan."

From a Google review

I see adults from across Calabasas, Agoura Hills and the 101 corridor whose concussion symptoms have lasted longer than they expected. If you are nearby and past the two-week mark, the first step is a complimentary consultation, where we can talk through whether the full assessment makes sense for you.

Frequently Asked Questions About How Long Concussion Symptoms Last

These questions about how long concussion symptoms last come up often, and the short answers below rely on the same sources as the rest of this article.

If you came here wondering how long concussion symptoms last, I hope you can now place yourself: most adults feel better within a couple of weeks, recovery may take longer for some, and more than two weeks is the point to get checked. Anything getting worse quickly is an emergency.

I am Dr. Alireza Chizari, DC, DACNB, and if your symptoms have outlasted the usual course, I would be glad to look at them with you.

California Brain & Spine Center | (818) 649-5300 | Calabasas, CA 91302
Book online at californiabrainspine.janeapp.com

This content is for educational purposes only and is not medical advice. Consult a qualified healthcare provider about your specific situation.