It should not, and that is the useful part of the answer. Persistent symptoms after concussion typically plateau and then improve over weeks to months. Symptoms that are genuinely worsening usually point to a specific driver that can be identified and treated rather than to the original injury deteriorating.
It should not, and that is the useful part of the answer. Persistent symptoms after concussion typically plateau and then improve over weeks to months. Symptoms that are genuinely worsening usually point to a specific driver that can be identified and treated rather than to the original injury deteriorating.
The injury itself is a single event, and the brain is not sustaining fresh damage in the weeks afterwards. So a trajectory that is heading the wrong way is informative. In practice it is nearly always one of a short list: disrupted sleep, which amplifies every other symptom; headache being driven into a chronic pattern by frequent painkiller use; an untreated vestibular problem; neck injury sustained in the same incident producing cervicogenic headache; low mood or anxiety, which are common after concussion and worsen cognition measurably; or a return to activity that was too fast.
Sleep comes first because it is both the commonest and the most tractable. Medication overuse headache is next, and it is easy to miss because the person is doing the sensible thing of treating a headache. Vestibular symptoms respond to targeted rehabilitation rather than to rest. Neck pain from the same injury is frequently overlooked entirely. Mood and anxiety deserve direct enquiry rather than being treated as an understandable reaction. Each of these is treatable, which is why the label matters less than the list.
A small number of features change the situation and should not be watched: a headache that is progressively worsening and worse when lying flat or on straining, new or worsening weakness, numbness, double vision or speech difficulty, a new seizure, repeated vomiting, increasing drowsiness or confusion, or any deterioration in someone taking anticoagulants. These need urgent assessment rather than a clinic appointment. Imaging, where indicated, is arranged at an imaging centre or hospital.
Complete rest beyond the first day or two is no longer advised and tends to prolong symptoms. Graded return to activity, cognitive and physical, kept just below the level that provokes symptoms, is the approach with the most support. Treating sleep, reducing acute painkiller frequency, vestibular rehabilitation where indicated, addressing neck pain and treating mood are the specific levers. Adults 18 and older are seen at either office; this practice provides no emergency or inpatient care.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: traumatic brain injury; MedlinePlus: concussion; National Institute of Neurological Disorders and Stroke.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.