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If a person develops signs of neurological injury, such as repeated vomiting, seizure activity, loss of consciousness, unequal pupil size, confusion or slurred speech, immediate medical attention is necessary to rule out serious brain trauma. If there is any suspicion of a concussion during sporting activity, an athlete or child should be removed from play to watch and assess behavior, and in many states medical clearance is necessary to legally return to play. There is currently no diagnostic test for the presence of a concussion. Presence of a whiplash associated with the concussion further complicates the diagnosis and suddenly symptoms limit the ability to participate in life activities. Dizziness encourages a person to refrain from moving the head, and leads to neck stiffness and headaches. Failure to effectively compensate with the use of visual references and being aware of the surface on which one is sitting or standing results in dizziness and a sense of instability.

If the vestibular system is delivering inaccurate information to the brain about the head’s position in space, the brain must rely on visual input and joint sensors (proprioception) to feel the body in space. Reliance on the visual system for balance can result in eyestrain and tension headaches. Relying upon vision alone as the primary source of balance often leads to fatigue and difficulty performing routine daily activities. This means that the visual system becomes the most reliable system to quickly assess one’s position in space and to remain balanced.

When vestibular information is inaccurate, the brain most often relies on visual input to stabilize the head on the body. Trauma to the brain can result in abnormal vestibular system functioning, and the brain can receive abnormal signals regarding the position and movement of the head in space. If more than one concussion occurs, the symptoms are typically worse and recovery time is increased. We are less likely to see something, like a ball, coming toward the head during this vulnerable period. This is because reaction time and brain processing are not normal. Current research on athletes shows that nerve signals in the brain are disrupted for 30 days after a single concussion, and during this time frame people are more likely to have another injury if engaged in sport activities. Loss of consciousness and nausea at the time of injury are signs that rotational forces have occurred. If the body is traveling forward or facing forward in a still position, and a force occurs off center, the brain sustains a rotational sheer force, which causes more trauma to brain structures and therefore a more severe concussion. There is typically a rotational force, as would occur if one were struck on the right or left side of the forehead. Rarely does an accident of this nature occur in a true head-on or forward/backward direction. These events all cause quick deceleration of the head and shifting of delicate brain tissue inside the skull. This can occur in dancers and gymnasts due to rapid movement, or during an auto accident where there appears to be no head trauma.