What is a concussion?

A concussion is a form of a traumatic brain injury that happens when the brain is shaken within the skull. Concussion is also known as mild traumatic brain injury (mTBI) but it does not typically result in structural brain injury identified on diagnostic imaging such as CT or MRI scans. The term mild does not diminish the impacts that concussion can have on your health and activities of daily living (ADLs).

While the majority of people recover within one month, in some cases symptoms resolve more slowly or may persist longer than expected. Prompt medical assessment and management can help diagnose concussions and ensure patients are provided with proper education and guidance as well as treatment as needed.

If you have suffered any trauma to your head and/or whiplash, and you experience symptoms of concussion, it is important to seek medical help. This includes if you have been in a traumatic accident; assaulted; fallen; or injured playing sports. National concussion guidelines recommend that all those with a suspected concussion undergo prompt medical assessment by a physician or nurse practitioner.

Topics in this section include:

Signs of a concussion

The following symptoms can occur after a concussion [1].

Please note: Most people will not experience all symptoms – but if you are experiencing symptoms after a physical injury, visit your doctor.

  • Headache/migraine
  • Dizziness and balance problems
  • Nausea
  • Fatigue
  • Sleep disturbance
  • Vision changes
  • Sensitivity to light or noise
  • Ringing in the ears
  • Seizure
  • Problems with smell/taste
  • Foggy-feeling
  • Difficulty remembering and focusing
  • Slower information processing
  • Trouble thinking clearly or finding your words
  • Difficulty making decisions or plans
  • Behavioural changes like depression, anxiety, irritability, aggression, or impulsivity

Who can diagnose a concussion?

There is no formal test to officially diagnose a concussion. A registered doctor or nurse practitioner are the medical professionals qualified to assess your symptoms to determine if you have a concussion.

Please note: there are some exceptions to this in Quebec and Manitoba. In Quebec, nurse practitioners are not able to make a concussion diagnosis. In Manitoba, physician assistants are licensed for medical assessments [2].

When to seek medical attention

You should see a doctor right away if you or someone you are caring for is experiencing the following symptoms after a traumatic event.

  • Significant neck pain or tenderness immediately after the injury
  • Double vision
  • Seizure or convulsion
  • Weakness or tingling/burning in arms and legs
  • Severe or increasing headache
  • Deteriorating conscious state
  • Repeated vomiting
  • Increase in restlessness, agitation or combative behaviour

If the person is experiencing these symptoms in extremes, call 911 and use emergency services.

For more information on treatment pathways after someone has sustained a concussion, see the full chart on the Concussion Awareness Training Tool. The difficulty with a concussion is that you may not recognize you have one right away. If you are experiencing symptoms of a concussion after an accident, instance of assault, or serious hit during sports, make an appointment to see a doctor.

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Physical effects

Many physical effects of brain injury can impact a person’s activities of daily living (ADLs). These effects include:

  • Ataxia (jerkiness) and coordination
  • Balance problems
  • Chronic (consistent) pain
  • Fatigue, difficulties with sleeping, and insomnia
  • Headaches
  • Impaired motor control and motor planning
  • Muscle tone
  • Paralysis or weakness
  • Perception and receiving sensory information (for example, phantom pain) and figuring out how to act on it
  • Sensory problems, such as sensations on the skin, touch, and vision

Explore our site to learn more about some of the most common physical effects of brain injury and physical rehabilitation.

Fatigue is the feeling of being extremely tired or having no energy or motivation. It is incredibly common after brain injury and can be caused by lack of sleep, stress, the amount of energy required to complete tasks, and pain.
Chronic pain
Pain is a complex issue, particularly when it’s long-term. Chronic pain can make symptoms of brain injury worse and prevent you from engaging in activities of daily living (ADLs).
Many physical effects of brain injury can make moving difficult. Changes in mobility can be difficult to adjust to, and can lead to increased risks of mental health challenges. Understanding mobility and engaging in physical rehabilitation are important steps to take in recovery.
Headaches can be painful, frustrating, and keep you from doing activities of daily living (ADLs).

Effects of brain injury

A brain injury is a life-changing event, and it can lead to a variety of short or long-term effects. Since no two brain injuries are the same, people will not always experience the same effects. In general, they can be grouped into the following categories.

Cognitive effects

Cognitive is a term used to describe thought processing and thinking. Cognitive effects of brain injury can include memory problems, changes in judgement and planning skills, and poor attention/focus.

Physical effects

After a brain injury, a person may have physical deficits that make it difficult to walk, get dressed, drive, and perform other activities of daily living (ADLs). Physical effects of brain injury can include balance problems, fatigue, and muscle weakness.

Behavioural effects

A person may exhibit different behaviours after brain injury that are uncharacteristic or new. They may also impact recovery and rehabilitation. Behavioural effects of brain injury include depression, anger, impulsivity and social dysfunction.

Emotional effects

A person’s emotions and ability to process emotions may change after a brain injury. They may experience grief, mood swings, and more.

Brain aneurysm

A cerebral aneurysm is when there is a bulge in a weak area in a wall of an artery that may leak or rupture. A bulging artery puts pressure on the brain tissue or nerves depending on where it is located. If it bursts – or hemorrhages – blood will spill onto the tissue between the brain and the skull. This can lead to hemorrhagic stroke, brain damage or in rare cases, death.

Brain aneurysm causes

Causes and risk factors of a brain aneurysm include:

  • Age – older individuals are more likely to develop aneurysms
  • Excessive alcohol or drug use
  • Family history/genetics
  • Gender – specifically, females are more likely to develop aneurysms
  • High blood pressure
  • Past aneurysms
  • Smoking

Aneurysms can develop after head trauma or infection – but these causes aren’t as common.

Symptoms of aneurysm

In many cases, there will be no visible symptoms of an aneurysm. When symptoms do appear, it is because the brain aneurysm has burst. The symptoms will appear suddenly. Emergency services should be called at 9-1-1 immediately. First-responders are necessary because they may have to use life-saving measures quickly. Symptoms of an aneurysm include:

  • Sudden, severe headaches
  • Blurred vision
  • Changes in speech
  • Neck pain
  • Nausea
  • Sensitivity to light
  • Fainting
  • Seizures

Brain aneurysm treatment and recovery

An unruptured brain aneurysm is normally found during unrelated tests/screenings. A ruptured brain aneurysm will be diagnosed using computerized scans and dye tests. Once a ruptured brain injury is diagnosed, there are a few different treatment options. Doctors will recommend the one(s) best suited to your situation based on factors such as age, location and severity of the aneurysm. These treatment options include:

  • Open surgery which enables the surgeon to place a clip around the base of the aneurysm, preventing blood from entering it
  • Endovascular surgery which happens within the blood vessels. It’s a smaller, less-invasive surgery to implant shunts or coils

Alternatively, doctors may recommend observation and spend more time monitoring the aneurysm.

Coping with changes after a brain aneurysm

A brain aneurysm can have a variety of effects depending on how much blood there is and the damage it does to the brain tissue or other arteries. There can be changes to cognitive and physical abilities, vision, balance, and more. It’s important to keep in mind that treating the brain aneurysm will not reverse the effects it has caused.

That means that once you’re in recovery, you may have to learn new ways to complete activities of daily living (ADLs).

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Encephalitis (en-ceph-a-li-tis) is inflammation of the brain. It’s an uncommon non-traumatic brain injury, but can cause severe damage or even death.

Causes of encephalitis include bacteria, parasites (such as ticks), and viral infections. There are several different strains of encephalitis, often stemming from the different viruses (for example, the West Nile virus).

Symptoms of encephalitis

Symptoms of encephalitis include:

  • Confusion
  • Drowsiness
  • Fever
  • Headaches
  • Light sensitivity
  • Nausea
  • Stiffness in the neck

More serious symptoms include seizures, tremors and hallucinations.

Encephalitis vs. meningitis

The symptoms of encephalitis are similar to those of meningitis. That’s because both are inflammation in the brain. Inflammation of the membranes that surround the brain and spinal cord (called meninges) is meningitis, while encephalitis is inflammation of the brain tissue.

When to seek medical attention

Many of the symptoms for encephalitis overlap with more mild conditions, such as flu. But you should seek medical attention if the symptoms – particularly fever and confusion – appear suddenly without no clear cause.

Diagnosis of encephalitis

Doctors will use MRI or CT scans, electroencephalograms (EEG), or blood and spinal fluid tests to determine whether or not you have encephalitis.

Treatment of encephalitis

Treatment of encephalitis is dependent on the root cause and consultation with a medical team. Antiviral or antibiotic medications may be recommended to help reduce swelling and manage symptoms. Encephalitis can cause damage to the brain which can result in cognitive, behavioural, or physical changes – for example, trouble with memory, coordination or muscle weakness. Depending on the severity of damage to the brain, further treatment and rehabilitation may be needed.

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Brain tumour

A brain tumour is an abnormal growth of cells within or around the structure of the brain. They can impact all areas of the brain and change how a person thinks, feels, and reacts. There are over 120 types of brain tumours, ranging from non-malignant (non-cancerous) to malignant (harmful or cancerous). In some cases, brain tumours can put pressure on surrounding tissue, leading to long-term effects.

It is unknown what causes brain tumours, yet family history, age, environmental exposure may be risk factors.

Signs and symptoms of brain tumour

Brain tumour symptoms vary from person to person and may appear overtime or all at once. Not every type of brain tumour will generate the same symptoms. The symptoms may also occur with other conditions, so may not indicate a brain tumour.

Common symptoms of a brain tumour include:

  • Behavioural changes
  • Cognitive changes
  • Dizziness or unsteadiness
  • Double or blurred vision
  • Frequent headaches
  • Hearing impairment
  • Morning nausea and vomiting
  • Seizures
  • Weakness or paralysis

Symptoms of a brain tumour will depend on the size and location of the tumour, and not everyone will experience all the symptoms listed.

A brain tumour is diagnosed by using a combination of neurological exams, magnetic resonance imaging (MRI) and computed tomography (CT) scans.

Treatment for brain tumour

Doctors will determine the best treatment for a brain tumour based on factors like:

  • Age
  • Overall health
  • Tumour location
  • Tumour size
  • Tumour type

For malignant tumours (such as cancer), surgery, radiation, chemotherapy, and immunotherapy are the most recommended treatments. For more information about cancerous tumours, including metastatic cancer, visit the Brain Tumour Foundation of Canada website.

In cases where surgery is not possible or the brain tumour is not doing any harm or causing any major symptoms, , doctors may recommend monitoring the tumour before making additional treatment decisions; this is called a “wait and see approach”. It’s important to discuss your available treatment options with the healthcare professionals about treatment.

Brain tumour recurrence

Sometimes a brain tumour can become ‘active’ again. This could indicate growth or change in the tumour. Normally this is discovered during routine checkups. If your tumour does come back or become active again, your healthcare team will determine the best course of treatment.

Tips for living with brain tumour

Ask for help & access support
You may need help from family, friends, or caregivers to complete activities of daily living (ADLs), get to appointments, or to run errands. But unless you ask, your circle of supporters may not know how best to help you. If there is something you need, you should always ask.

There are many ways to access support, whether that is one-on-one support, or attend a virtual brain tumour support group. Gain peer support in a safe, relaxed atmosphere from the comfort of your home.

Ask questions of your healthcare team
Your healthcare team has a wealth of knowledge about brain tumours, and they can help you learn all you can about yours. They can also keep you informed of treatment options and clinical trials for which you may be eligible.
Find ways to cope with cognitive, behavioural, and physical effects
The brain tumour may be altering your cognitive, behavioural, and physical abilities. This affects your activities of daily living (ADLs) and can mean that you can’t do things the same way you used to before your brain tumour.

There are ways to cope with those changes. For example, if you are experiencing memory problems, writing things down can help you keep track of tasks.

Learn about finding your new normal
With a brain tumour diagnosis comes a lot of change in your life. Nothing may ever be quite the same again. It will take time to adjust to your new normal, and you will experience strong emotions – even grief.

Learning what to expect when things are changing for you is a good way to pick up coping methods that can make transitions easier.

Take care of your physical health
A brain tumour is a health condition that can have many effects on mind and body. Eating a healthy balanced diet, exercising safely, and getting appropriate rest are great ways to take care of yourself.


Brain Tumour Foundation of Canada offers many programs, services, and support for anyone affected by a brain tumour. Their handbooks provide information about treatment options, long-term effects, and an overview of brain tumours. These handbooks are available in English and French (print copy shipped free in Canada or available electronically)

Adult Brain Tumour Handbook
Adult Brain Tumour Patient Handbook cover image

Order handbook

Non-Malignant Brain Tumour
Non-Malignant Brain Tumour Patient Handbook cover image

Order handbook

Pediatric Brain Tumour
Pediatric Brain Tumour Patient Handbook cover image

Order handbook

Brain Tumour Caregiver Handbook
Caregiver Brain Tumour Handbook cover image

Order handbook

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Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:

  • The product or service promises a quick fix
  • Sound too good to be true
  • Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
  • Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
  • The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
  • Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based 

Always proceed with caution and with the advice of your medical team. 


A person with a first-time concussion typically recovers fully within a few days to weeks after the injury. No two concussions are the same. This means that recovery is different for everyone.

The Ontario Neurotrauma Foundation guidelines for Concussion/ mTBI and Persistent Symptoms was developed to improve patient care by creating a framework that can be implemented by healthcare professionals to effectively identify and treat individuals with persistent symptoms following a concussion/mTBI.

The patient version of the Guidelines for Concussion/mTBI and Persistent Symptoms is for adults over the age of 18. These were developed to make communication between healthcare provider and patient easier. Starting in 2019 these guidelines will become living guidelines to ensure that the most current research literature is incorporated into the recommendations.

Topics in this section include:

Concussion recovery tips

The symptoms you experience can be difficult to manage and have an impact on your daily life. Some symptoms may come and go, and your recovery may take longer than expected. It can be frustrating, debilitating, and scary. You’re not alone – recovery can be challenging for many people. With the right education and support, you’ll be able to face those challenges and make positive progress.

Here are some ways you can proactively assist your concussion recovery. You should make sure to listen to your doctor if they have more specifics steps for your recovery plan.

Appropriate rest and activity
The concussion guidelines say you should slowly become more active after 24 – 48 hours of rest. This is a change from ‘cocoon therapy’ – the practice of long periods of rest in low lighting with little to no activity.  Recent research indicates that long periods of rest may do more harm than good [1].

Daily activities of living should be re-introduced gradually. Overtime as symptoms decrease, the more active you can become [2]. You should always consult with your doctor before resuming activity that includes a significant risk of injury. If your symptoms get worse when you’re active, try scaling back. Every person has a threshold for activity, and it may take awhile to find yours.

There is no set timeline for when you’re supposed to be able to return to regular activity. The important thing is that you take your time and consult with your doctor.

Return to work gradually
Like with physical activity, your return to work should be gradual, building up over time. Depending on the severity of your concussion, your return to work could begin a few days to a few weeks after your injury. You should make sure to talk with your employer about your concussion, any symptoms you’re still experiencing, and how best to transition back to your full responsibilities [3].

Keep a journal of how you’re feeling both at and after work. This will help track your symptoms and whether you’re ready to take a step forward and increase your workload. While working, you should take frequent breaks to give your brain time to rest. You should also plan for additional time to finish tasks and try to find a quiet environment to complete your work.

If you’re ready to return to work, but need a little help getting the process started, visit the return to work section for tips and resources.

Ask for help
If you are having trouble with household tasks like cooking or cleaning, ask a family member or friend for assistance. Return to activities gradually according to doctor recommendations.
Bring someone with you to appointments
When you experience a concussion, symptoms can make it difficult for you to keep track of information or get to appointments. Bringing a friend or family member with you to appointments can be helpful. They can write down information and communicate with your medical team.

Risk factors

There are several risk factors that are taken into consideration when doctors are mapping out your recovery.

  • History of previous brain injury
  • Previous neurological or psychiatric problems
  • Effects of other health issues like medications, bodily injuries, etc.
  • Anxiety
  • Depression
  • Insomnia
  • The number of symptoms you are experiencing
Personal or environmental factors that may negatively affect recovery
  • Mechanism of injury (e.g. motor vehicle accident, assault)
  • Significant delays or not returning to work following the injury
  • Being a student
  • Life stressors
  • Older age
  • Lack of social support
  • Female gender
  • Lower resilience
  • Returning to a contact sport too early
Multiple concussions and second impact syndrome
Getting another concussion while still recovering from a previous one may increase the risk for long-term problems. Second impact syndrome is an extremely rare event where a second concussion in close succession to a previous, not yet healed concussion leads to uncontrolled brain swelling. Most reported cases have been in teenagers and young adults. In a few cases worldwide, it has even been linked to death [4].

It’s important to fully heal from a first concussion before returning to any sport or activity that could put you at high risk of getting another. When you do return to a sport or activity, you should speak with your coach/leadership team about safety precautions.

What if my symptoms aren’t going away?

All these factors will impact how quickly you recover from your concussion [5].

If you still have symptoms 1 month after your initial injury, these are called persistent symptoms (sometimes referred to as prolonged symptoms or post-concussion syndrome). Every person’s recovery is different, so don’t be alarmed if you do have some symptoms after the 1-month period. Talk to your doctor about what symptoms you are experiencing.

Persistent symptoms include:

  • Headaches
  • Fatigue or difficulty with sleep
  • Unsteadiness or decreased balance
  • Memory or concentration difficulties

If you’re experiencing seizures, slurred speech, or numbness you should consult with your doctor prior to the 1-month mark.

Prolonged symptoms can affect your daily life and make it difficult for you to perform regular activities. Your doctor may want to do more tests and check in with you more often if it turns out you have persistent symptoms. Their tests and medical investigations will tell them how best to manage your symptoms. Check the ONF guide for more information on managing prolonged symptoms.

What is Chronic Traumatic Encephalopathy (CTE)?

CTE is a neurodegenerative disease that has been found posthumously in a small number of athletes and veterans with a history of multiple head injuries. Research is continually evolving on CTE.

Private concussion clinics

There are many private concussion clinics across Canada offering a wide variety of concussion recovery methods and therapies. These private clinics have no federal or provincial oversight or regulations and there are no assurances of the services they provide. When figuring out whether a private clinic is right for you, ask the following questions [6]:

  • Does the clinic have a medical doctor?
  • Does the clinic have a team of licensed health care professionals?
  • Does the clinic follow the most up-to-date standards of care for managing a concussion?
  • What tools, tests and recommendations is the clinic using?

Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:

  • The product or service promises a quick fix
  • Sound too good to be true
  • Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
  • Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
  • The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
  • Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based 

Always proceed with caution and with the advice of your medical team. 

See sources