{"id":9745,"date":"2026-01-17T11:02:34","date_gmt":"2026-01-17T10:02:34","guid":{"rendered":"https:\/\/neurohirurgija.in.rs\/?page_id=9745"},"modified":"2026-06-19T11:37:41","modified_gmt":"2026-06-19T09:37:41","slug":"concussion","status":"publish","type":"page","link":"https:\/\/neurohirurgija.in.rs\/en\/concussion\/","title":{"rendered":"Concussion \u2014 Symptoms, MRI Findings, Recovery, and Medicolegal Significance"},"content":{"rendered":"\n
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\n Author:<\/span>\n \n Dr. Zeljko Kojadinovic, MD, PhD\n <\/a>\n \u2014 Consultant Neurosurgeon\n <\/div>\n\n
\n Specialized Experience:<\/span>\n 30 years of clinical expertise in neurosurgery.\n <\/div>\n\n
\n Last medically reviewed:<\/span>\n June 11, 2026\n <\/div>\n<\/div>\n\n\n\n
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Who this page is for<\/h3>\n\n

\n This page is for patients who have had a concussion or mild traumatic brain injury<\/strong> after a fall, car accident, sports injury, assault, or whiplash \u2014 and who continue to have headaches, brain fog, dizziness, fatigue, memory problems, or emotional changes<\/strong> despite being told that their CT or MRI is \u201cnormal.\u201d\n <\/p>\n\n

\n It is also for patients and families who have been given conflicting opinions<\/strong> about whether the injury was \u201cjust a concussion\u201d or whether there may be underlying axonal injury<\/strong> that routine imaging cannot detect. In such cases, specialized MRI sequences and expert interpretation may be required to clarify the true extent of the injury.\n <\/p>\n\n

\n Persistent symptoms do not mean the brain is permanently damaged<\/strong> \u2014 but they do mean that the injury has not yet fully resolved. In many cases, symptoms continue because microscopic brain injury, network disruption, or delayed recovery mechanisms have not been properly identified<\/strong>. A \n telehealth consultation<\/a> allows detailed review of symptoms and imaging to determine whether the concussion is uncomplicated<\/strong> or represents a complicated brain injury<\/strong>, and what this means for recovery, work, daily life, and legal or insurance issues.\n <\/p>\n<\/div>\n\n\n\n\n\n

\n When patients usually seek a neurosurgical second opinion for concussion\n <\/div>\n\n
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\u2022 Symptoms persist weeks or months despite being told imaging is \u201cnormal\u201d<\/div>\n
\u2022 Headache, brain fog, dizziness, or cognitive problems do not resolve<\/div>\n
\u2022 MRI findings are unclear or different doctors give conflicting opinions<\/div>\n
\u2022 There is concern about diffuse axonal injury or a complicated concussion<\/div>\n
\u2022 The medical classification of the injury has implications for work capacity, insurance, or disability assessment<\/div>\n <\/div>\n\n
\n Persistent post-concussion symptoms may require expert interpretation of imaging and\n clinical findings to distinguish uncomplicated concussion from structural brain injury.\n This distinction can be medically important and, in some cases, relevant for formal injury\n classification.\n If you need a clear, individualized neurosurgical assessment, you can request a telehealth\n second opinion here:\n \n Request Telehealth Second Opinion\n <\/a>\n <\/div>\n\n<\/div>\n\n\n\n
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\n Concussion \u2014 Quick Summary (Read This First)\n <\/h3>\n\n
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  • Concussion is a real brain injury even when CT\/MRI are \u201cnormal\u201d.<\/strong> In most cases it is mainly a functional disturbance of brain networks, not visible structural damage.<\/li>\n\n
  • Persistent symptoms (weeks to months) do not automatically mean permanent brain damage,<\/strong> but they do mean recovery is incomplete and the true driver of symptoms must be identified.<\/li>\n\n
  • Clinically, concussion may present in three commonly observed patterns:<\/strong> (1) uncomplicated concussion with normal routine imaging, (2) complicated mild TBI („complicated concussion) with micro-DAI \/ microbleeds<\/strong> detectable only on advanced MRI, and (3) \u201cconcussion + associated injuries\u201d (tSAH, SDH\/EDH, contusions, skull fracture).<\/li>\n\n
  • Routine MRI often cannot detect microscopic axonal injury.<\/strong> Advanced sequences may be needed when symptoms persist or when reports conflict.<\/li>\n\n
  • Headaches after concussion are frequently not caused by ongoing \u201cbrain bleeding\u201d<\/strong> but by treatable sources such as cervical muscle spasm, cervicogenic headache, or occipital nerve irritation.<\/li>\n\n
  • In medicolegal terminology, what is sometimes referred to as \u201ccomplicated concussion\u201d corresponds to a complicated mild traumatic brain injury (mTBI) \u2014 meaning that structural injury is documented on CT or MRI (such as DAI, microbleeds, hemorrhage, contusion, or skull fracture), even if the initial Glasgow Coma Scale score was 13\u201315 and loss of consciousness was minimal or absent.<\/strong><\/li>\n\n
  • A neurosurgical telehealth second opinion helps most<\/strong> when symptoms persist, imaging reports conflict, DAI is suspected, or clear documentation is needed for work capacity, insurance, or disability classification.<\/li>\n\n
  • Use the Contents box<\/strong> to jump directly to the sections you need: MRI\/DAI, prognosis, persistent symptoms, headache causes, medicolegal classification, and telehealth review.<\/li>\n <\/ul>\n<\/div>\n\n

    \n Most readers only need the Quick Summary plus the sections on MRI\/DAI<\/strong>, Prognosis<\/strong>, and Medicolegal classification<\/strong>. The rest is for deeper understanding.\n<\/p>\n\n\n\n