SIGNS AND SYMPTOMS OF CONCUSSION
Concussions can appear in many different ways. Listed below are
some of the signs and symptoms frequently associated with concussions.
Most signs, symptoms and abnormalities after a concussion
fall into the four categories listed below. A coach, parent or
other person who knows the athlete well can often detect these
problems by observing the athlete and/or by asking a few relevant
questions of the athlete, official or a teammate who was on
the field or court at the time of the concussion. Below are some
suggested observations and questions a non-medical individual
can use to help determine whether an athlete has suffered a concussion
and how urgently he or she should be sent for appropriate
1. PROBLEMS IN BRAIN FUNCTION:
a. Confused state – dazed look, vacant stare or confusion
about what happened or is happening.
b. Memory problems – can’t remember assignment on play,
opponent, score of game, or period of the game; can’t
remember how or with whom he or she traveled to the
game, what he or she was wearing, what was eaten for
c. Symptoms reported by athlete – Headache, nausea or vomiting;
blurred or double vision; oversensitivity to sound, light
or touch; ringing in ears; feeling foggy or groggy; dizziness.
d. Lack of sustained attention – difficulty sustaining focus
adequately to complete a task, a coherent thought or a conversation.
2. SPEED OF BRAIN FUNCTION: Slow response to questions,
slow slurred speech, incoherent speech, slow body movements
and slow reaction time.
3. UNUSUAL BEHAVIORS: Behaving in a combative, aggressive
or very silly manner; atypical behavior for the individual;
repeatedly asking the same question over and over; restless
and irritable behavior with constant motion and attempts to
return to play; reactions that seem out of proportion and inappropriate;
and having trouble resting or “finding a comfortable
4. PROBLEMS WITH BALANCE AND COORDINATION:
Dizziness, slow clumsy movements, inability to walk a straight
line or balance on one foot with eyes closed.
IF NO MEDICAL PERSONNEL ARE ON HAND AND AN
INJURED ATHLETE HAS ANY OF THE ABOVE SYMPTOMS,
HE OR SHE SHOULD BE SENT FOR APPROPRIATE MEDICAL
CHECKING FOR CONCUSSION
The presence of any of the signs or symptoms that are listed in this
brochure suggest a concussion has most likely occurred. In addition
to observation and direct questioning for symptoms, medical professionals
have a number of other instruments to evaluate attention,
processing speed, memory, balance, reaction time, and ability to
think and analyze information (called executive brain function).
These are the brain functions that are most likely to be adversely
affected by a concussion and most likely to persist during the post
If an athlete seems “clear” he or she should be exercised enough to
increase the heart rate and then evaluate if any symptoms return
before allowing that athlete to practice or play.
Computerized tests that can evaluate brain function are now being
used by some medical professionals at all levels of sports from youth
to professional and elite teams. They provide an additional tool to
assist physicians in determining when a concussed athlete appears
to have healed enough to return to school and play. This is especially
helpful when dealing with those athletes denying symptoms in
order to play sooner.
For non-medical personnel, the Centers for Disease Control and
Prevention (CDC) has also developed a tool kit (“Heads Up:
Concussion in High School Sports”), which has been made available
to all high schools, and has information for coaches, athletes and
parents. The NFHS is proud to be a co-sponsor of this initiative.
Although all concussions cannot be prevented, many can be minimized
or avoided. Proper coaching techniques, good officiating of
the existing rules, and use of properly fitted equipment can minimize
the risk of head injury. Although the NFHS advocates the use of
mouthguards in nearly all sports and mandates them in some, there
is no convincing scientific data that their use will prevent concussions.
Prepared by NFHS Sports Medicine Advisory Committee. 2009
NFHS. Concussions. 2008 NFHS Sports Medicine Handbook (Third
Edition). 2008: 77-82.
National Federation of State
High School Associations
PO Box 690 | Indianapolis, Indiana 46206
Phone: 317-972-6900 | Fax: 317.822.5700
PDF – A Parent_s Guide to Concussions in Sports
PDF – 2009 NFHS Concussion Brochure_7_7
PDF – Concussion Checklist