Concussion without a knockout.

This journal is about the neck, but the neck does not travel alone. The same fraction of a second that strains the cervical spine moves the head, and the brain inside it, through the same violent arc. A reader who has been told this is a neck problem sometimes edits the head out of their own story: the fog is stress, the dizziness is bad sleep, the trouble reading is the headache. This entry exists to put the head back in.

No knockout required

The popular picture of a concussion involves a blow to the head and a loss of consciousness. The CDC's HEADS UP material is clear that neither is required. A concussion is a brain injury caused by a bump, blow, or jolt to the head, or by a hit to the body that makes the head move rapidly back and forth. That last clause describes a rear-end crash exactly. Most people who sustain one are not knocked out, and many never strike their head on anything. The head simply went where the neck took it.

What it can look like on an ordinary weekday

The symptoms readers describe are rarely dramatic. A fog that makes a familiar spreadsheet feel strange. Headaches. Dizziness on standing or turning. Sensitivity to light or to the noise of an open-plan office. Trouble sleeping, or sleeping far more than usual. Irritability that surprises the person feeling it. Difficulty concentrating through a meeting they would normally lead. Any one of these could be explained away. Together, after a crash, they belong on the chart.

The timing can mimic the neck's own lag. Some head symptoms are obvious at the scene; others only become clear when the person tries to do something cognitively demanding a day or two later. This is one more reason the first exam should happen this week rather than when the picture is fully formed.

Why you should say it on the phone

Missouri Injury Clinic publishes three lanes on moinjuryclinic.com: auto injuries, TBI and concussion rehab after acute injury, and sports injuries. For the second lane it names specific tools: vagus nerve stimulation, neurofeedback, Alpha Stim, sensory motor integration, exercise with oxygen, oculomotor rehabilitation, and cognitive rehabilitation using computerized brain-exercise software. This desk cannot tell you which of those, if any, would apply to you; that is what the examination is for. What the desk can say is that a clinic publishing that lane is one that expects to be told about head symptoms, so tell them. Say "my head was struck" or "I have felt foggy since the crash" when you call, and say it again in the room.

The emergency pattern, separately

There is a set of head symptoms that do not wait for a clinic appointment, and this desk lists them on every page because they matter more than anything else it publishes. Confusion or drowsiness that is getting worse rather than better. Repeated vomiting. A headache that is sudden and severe or that keeps intensifying. Weakness, numbness, or loss of coordination. Slurred speech. A seizure. One pupil larger than the other. Any of these after a crash is an emergency room trip now. A clinic is the wrong door for that, and a good clinic will say so and send you on.

One record, both structures

A first visit that examines the neck and hears about the head produces a single dated document describing both. That document is a care document first: it is how the next visit knows whether concentration is improving or the dizziness has resolved. It is also, if a claim ever becomes part of the story, the dated record everyone will ask for, and it is a far stronger document if the head symptoms were written down in week one rather than recalled in week six. Entry 08 explains what that record is and is not.

A reader does not need to decide whether they have a concussion. They need to describe what they are experiencing, in full, to a clinician who can examine them and write it down. That is the whole recommendation.

Concussion facts are drawn from the CDC HEADS UP program. Clinic lanes and tools are limited to what Missouri Injury Clinic publishes on moinjuryclinic.com. Educational, not medical advice.