21 Aug 2023

Discharge Advice – Head Injury

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Understanding Your Injury

You have sustained a head injury. Based on our assessment today, this is most consistent with a concussion (a mild traumatic brain injury).

A concussion occurs when a blow to the head or body causes the brain to move rapidly inside the skull. This movement temporarily affects how the brain functions. It does not usually show up on standard scans.

Concussion affects brain function, not brain structure. Most people recover fully, but symptoms can last days to weeks. A small number take longer.

You were stable at the time of assessment. However, symptoms can evolve over the next 24–48 hours.

You were assessed for:

  • Loss of consciousness
  • Memory disturbance
  • Confusion
  • Headache
  • Nausea or vomiting
  • Neck pain
  • Neurological symptoms
  • Motor and sensory signs of brain injury

No red flags requiring hospital transfer were identified at this time.

Common symptoms include:

  • Headache
  • Dizziness or balance problems
  • Nausea
  • Sensitivity to light or noise
  • Blurred vision
  • Feeling slowed down
  • Poor concentration
  • Fatigue
  • Irritability or low mood
  • Sleep disturbance

Symptoms often fluctuate. It is normal to feel better one day and worse the next.

Most adults improve significantly within 7–14 days, but recovery may take up to 4 weeks.

It is not normal for symptoms to steadily worsen.

🚨 Call 000 or go to the nearest Emergency Department if:

  • Increasing drowsiness or difficulty waking
  • Repeated vomiting
  • Severe or worsening headache
  • Confusion or unusual behaviour
  • Weakness, numbness, or difficulty speaking
  • Seizure
  • Neck stiffness with fever
  • Double vision

These symptoms may indicate a more serious brain injury.

  • Rest quietly at home
  • Have a responsible adult monitor you
  • Paracetamol is preferred for headache
  • Avoid anti-inflammatory medications unless advised
  • Avoid alcohol
  • Avoid driving
  • Avoid strenuous activity

You do not need to be woken overnight unless instructed, but someone should be nearby.

After 24–48 hours of relative rest:

  • Gradually resume light activity
  • Avoid complete inactivity beyond 48 hours
  • Increase activity only if symptoms do not worsen
  • Reduce screen time if symptoms flare
  • Prioritise good sleep

If symptoms increase, step back to the previous level for 24 hours.

You must follow a stepwise return-to-activity plan:

  • Symptom-limited activity
  • Light aerobic exercise
  • Sport-specific exercise (no risk of head impact)
  • Non-contact training
  • Full-contact training (after medical clearance)
  • Return to competition

Each stage should last at least 24 hours.

If symptoms return, drop back one stage.

Equestrian Australia Requirement

Under Equestrian Australia regulations:
  • Minimum 21-day stand-down from competition
  • Medical clearance required before returning to competition
  • Replace helmet after any significant impact
You must be able to:
  • Mount safely
  • Maintain rein control
  • Perform an emergency dismount
  • Demonstrate normal balance and reaction time

Return to work depends on symptom control and safety requirements of your role.

See your GP or sports doctor within 5–7 days.

Seek earlier review (within 24–48 hours) if:

  • Symptoms are not improving
  • You struggle to return to normal activity
  • Mood or sleep is significantly affected

Formal concussion clinics may be helpful if symptoms persist beyond 2–4 weeks.

  • In Australia, call Healthdirect 1800 022 222 for 24-hour advice.
  • Contact your GP
  • or, if appropriate, attend your local Emergency Department

This advice is based on current Australian concussion and sports medicine guidance, including AIS and Equestrian Australia recommendations.

Version 1.0
Review date: February 2026
Next review due: February 2027

NB: This information has been prepared with reference to the most up to date Australian standards and guidance in relevant sports medicine fields. It is prepared in good faith, however is only intended for use as explicitly directed by a DeployED health practitioner. It does not replace medical advice, nor does it purport to be perfect. If you have any doubts about the advice here, please consult your own doctor. If you have not been sent here by us, then this is not for you and DeployED accepts no responsibility for any outcomes which come to pass from your use of this information.

Follow Dr Stuart McLay:

Emergency Physician

Dr Stuart McLay is passionate about the delivery of exceptional care, everywhere. He is the founder of DeployED, a Fellow of the Australasian College of Emergency Medicine (FACEM - an Emergency Physician), a Core trainee of the College for Intensive Care Medicine, and a Mass Gathering Medicine / Expedition Medicine enthusiast. He's also a husband to 1, and father to 3, and a great annoyance to many.