Could this be concussion?

[Warrg]

Yesterday I suffered mild blow to the head. I have hit my head many times before, much harder than yesterday and yet, I've never experienced any symptoms that might be indicative of concussion. Yesterday, however, I felt a bit dizzy for a few minutes immediately after having been hit. Also, 15 minutes following the blow, I started to feel a bit nauseated. The nausea lasted for few hours, but it was really mild, so mild in fact that I haven't thought for a single moment that I might throw up. When I went to bed I started to feel dizzy again. Dizziness seemed to be triggered by my changing  position while in bed. This morning I felt fine until I went to bed to have some rest. This is when dizziness came back again. I still feel light-headed. Taking everything into account, could this be classified as concussion? Just to point out: I didn't lose consciousnesses even for a moment, I didn't experience headache, my pupils are responsive to light changes,my mental state isn't altered (nor it was immediately after the blow), I have recollection of everything that happened prior and after the blow,  The only thing that's bothering me is the fact that almost 24 hours after being hit, very mild dizziness persists.I considered going into ER, but I figured it might be unnecessary since I'm not feeling dizzy all the time and when I do it is not intensive. My point is that the symptoms I have experienced do not interfere with my daily routine, but since the symptoms present are usually associated with concussion I'm wondering if I should, nevertheless, see doctor. I'm aware that this is, in worst case scenario, mild concussion, but I'm unsure whether I meet criteria for actually getting that diagnosis. I would really appreciate advices. ER is quite far away, so I wouldn't want to go, just to find out that I'm perfectly fine. Thanks in advance.  

[Adult Neurology, M.D.]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I cannot tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

After getting hit on the head, you can certainly have a concussion. There are multiple grading scales for concussion. The American Academy of Neurology scale is graded on a scale of 1 to 3, where grade 3 has any loss of consciousness. Grade 2 is with any symptoms lasting more than 15 minutes. If there is any loss of consciousness or alteration in mentation or neurological deficit, labeling the injury as traumatic brain injury would also be appropriate.  

Post-concussive symptoms may include headache, dizziness, memory challenges, difficulties with concentration, fatigue, depression, anxiety, and increased or decrease in sleep.  They can persist for weeks after the concussion. So the dizziness and mild nausea you are describing can certainly fit with a mild concussion.

One thing to worry about after any sort of trauma to the head or neck is a dissection: a small tear in the blood vessels that travel up the neck to the brain. This can occur spontaneously in people with certain conditions that affect the blood vessels, after neck trauma, or after chiropractic manipulation of the neck. The pain is often but not always associated with some sort of neurologic deficit as a dissection can often lead to a stroke. A dissection is diagnosed with a specific type of MRI test (MRA with fat saturation) or an CT angiogram.

I would recommend having yourself evaluated by your primary care physician within a few days to ensure you have a normal exam. However, if you develop neck pain, worsening headache, nausea, dizziness, new onset weakness, imbalance or speech problems, please seek medical attention urgently.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[Warrg]

Thank you very much for your answer. Even though symptoms resolved soon after posting this question, I will pay my doctor a visit, in order to ensure everything is fine. Thanks once again, your answer was very helpful.