Concussion Screening and Management
The Concussion Program at HSS Westchester provides expert and comprehensive care to patients suffering from concussions. Every concussion is unique, and patients are evaluated and treated by a multidisciplinary team of experts to target all of the different symptoms that arise after a head injury. HSS Westchester offers highly specialized treatment and provides the multi-faceted care needed to return our patients to sport and physical activity as safely and quickly as possible.
What is a Concussion?
A concussion is a mild traumatic brain injury caused by a bump or blow to the head or a blow to the body with the force transmitted to the head. It can happen during any activity. A concussion can affect the normal function of the brain. You do not need to lose consciousness to have a concussion.
If you have or are observed to have the danger signs listed below, please dial 911 or head to your nearest ER.
- 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
Getting appropriate care will help you recover as quickly and safely as possible. Recovery from concussion may include resting your brain from normal cognitive activities. You may need to gradually return to normal routines while your brain heals. Recovery is different for each person but limiting activities to levels that will not increase concussion symptoms is the primary goal.
If you do not have any concussion danger signs and would like to make an appointment with a physician specialized in the evaluation of concussions, headaches, or head trauma, please call the HSS Concussion Helpline during normal business hours: 877-542-9398
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.
- 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.
Initial Evaluation Providers
Further Care Providers