• Worsening headache that does not subside
• Weakness, numbness, decreased coordination
• Repeated vomiting or nausea
• Slurred speech
• Change in mental status- drowsy, stupor
• Unequal pupils
• Convulsions, seizure

• Cannot recognize people or places
• Increasing confusion, agitation
• Unusual behavior
• Loss of consciousness
• Prolonged crying in children
• Child will not eat

Initial Evaluation Services

• Clinical Interview – Patients will undergo a clinical interview with an HSS provider to review patient symptoms and gather important information related to the injury and the patient’s clinical history.
• Physical Examination – Patients will undergo a standard physical examination (vital signs) to assess injury and symptoms.
• Balance Assessment – Concussions may impact a patient’s static or dynamic balance. Patients may undergo a variety of balance and gait assessments to evaluate symptoms and coordination.
• Vestibular and Ocular Motor Screening – Vestibular and ocular dysfunction is common after traumatic brain injuries. Concussion patients often complain of dizziness, fogginess and feelings of fatigue and detachment. A brief clinical screening tool is used to help identify additional vestibular and ocular motor dysfunction and is used in conjunction with symptom reporting, a neurocognitive assessment and cervical/exertion screening.
• Neurological Testing – Patients may be asked to undergo additional neurological testing, including but not limited to: computerized neurocognitive testing.
• Symptom Evaluation – HSS clinicians will incorporate findings from clinical interviews, physical examinations, neurological testing, balance assessments and vestibular and ocular motor screenings to better establish a diagnosis and prognosis. A treatment and rehabilitation plan as well as return to play expectations will be communicated.

Further Treatment

• Vestibular and Ocular Motor Therapy – An exercise-based treatment designed to promote vestibular adaptation and substitution, particularly following a traumatic brain injury. This therapy will help enhance gaze stability, postural stability, improve symptoms of vertigo and assist patients to return to daily active life.
• Return-to-Play Progression Therapy – A progressive increase of training and activity intensity aligned to a patient’s recovery: Baseline (No symptoms), Light Aerobic Activity, Moderate Activity, Heavy, Non-Contact Activity, Practice & Full Contact, Competition
• Pain Management – Certain pain medications are not appropriate during the immediate post-injury stages. HSS clinicians will advise on a safe and evidence-based approach to pain management during the various stages of concussion treatment and recovery.
• Medication Management – Certain medications are not advised during the onset of concussion symptoms. HSS clinicians will advise and assist patients with proper medication management during their concussion treatment and recovery.
• Sports Psychology – Sports psychology is an important element of any return-to-play treatment plan. HSS Westchester offers sports psychology services on-site by appointment.
• Physical Therapy and Rehabilitation – HSS Westchester maintains state-of-the-art and comprehensive physical therapy and rehabilitation services on-site. Our therapists are trained to assist patients with concussion rehabilitation and will align with HSS physicians to develop a safe and appropriate care plan.
• Integrative Medicine – HSS Westchester maintains a variety of integrative services, including massage therapy, on-site. HSS physicians will incorporate integrative medicine services into a patient’s concussion treatment plan.