How a concussion can cloud memory and focus after a car crash
Advice for adults from a brain injury rehabilitation perspective
You may feel foggy after a crash. Maybe you forget a conversation or have a hard time following what’s on a screen. Those changes can be scary, especially when you look fine on the outside. Brain injury rehab experts start by checking for dangerous changes. Next comes an exam if a concussion is possible. Then the focus turns to keeping daily demands manageable while you heal.
Doctors call a concussion a mild traumatic brain injury. The word “mild” refers to how the injury is first classified. It says nothing about how your symptoms feel. Don’t ignore them. Most people get better, though recovery moves at different speeds. Follow your own doctor’s instructions over any general advice. [1, 4]
Rule out an emergency first
Call emergency services or go to an emergency department now for any of these signs. A headache keeps getting worse and won’t go away. You vomit again and again or have a seizure. New weakness or numbness, slurred speech or growing confusion are warning signs too. So are unusual behavior, one pupil bigger than the other, passing out or trouble waking up. If you can’t drive safely, have someone else set up a ride. [2]
If you take a blood thinner and may have hurt your head, let a doctor know soon. Do this even if you feel fine. Get checked again if your symptoms are new or worse since an earlier exam. [2, 10]
You can get a concussion without hitting your head
In a crash, your head can whip around fast even if it never strikes the wheel or window. A jolt to the body can make the brain shift inside the skull. Most people who get a concussion never pass out. Symptoms may start right away. They can also become noticeable hours or days later. [1, 2, 3]
A doctor diagnoses a concussion by hearing how you got hurt, asking about symptoms and examining you. The exam may test your balance, eye movements, memory and attention. Other brain and nerve functions may be checked too. A CT scan is used when there’s worry about problems like bleeding. A normal scan doesn’t rule out a concussion on its own. Neither does a decision that you don’t need a scan. [1, 3]
Signs that may show up
- Thinking and memory: You may feel slow or foggy or lose track of a conversation. Reading may take longer. New information may slip away. Planning or switching from one task to another can be hard. [2, 6]
- Body symptoms: These can include headache, dizziness, nausea, balance problems and tiredness. Some people have blurry vision or are bothered by light or noise. [2]
- Mood and sleep: You may feel irritable, anxious or sad. You might sleep more or less than usual or struggle to fall asleep. [2]
These symptoms are real. Still, a list of symptoms can’t tell you what is causing them. Pain, bad sleep, medicines and the upset that follows a scary crash can also affect memory and focus. A concussion and traumatic stress can happen at the same time. A doctor can help sort out each cause so every one gets attention. [6, 8]
Why your memory may seem to let you down
Memory starts with paying attention. Your brain may be working hard to keep up with noise, pain, worry or a crowd of voices. When it is, new information may not sink in well. Later it can seem like your memory failed, when the information never got stored firmly in the first place. You might also have a blank spot around the crash itself. Tell a doctor about any memory gap, confusion or repeated questions after the crash. [3, 6]
Don’t push yourself to piece together every second of the crash. Write down what you know and mark what you aren’t sure about. Ask someone you trust to help keep track of instructions and appointments. A gap in memory is a reason to get checked. It’s no reason to blame yourself.
Your first day or two
If you suspect a concussion and haven’t been examined, reach a health care provider as soon as you can. If you were diagnosed with one, book a follow up visit. Ask for written advice on activity, medicines and driving. [1, 4, 9]
Brief periods of rest can help when symptoms are at their worst. Sleep, eat on a regular schedule and drink fluids. Pick quiet activities you can handle. Stay away from sports or anything else that could lead to another head injury. [1, 4, 9]
Resting doesn’t require days in a dark room. After about one or two days, most people can start easing back into light physical and mental activity. A short walk or a brief chat are examples. If something makes your symptoms clearly worse, do it less hard or for less time. Then try again more slowly. If you were given stricter instructions for your injuries, follow those. [4]
If you’re unsure of the plan, ask before you take medicine for a headache or other symptoms. Skip alcohol until your doctor says it’s safe. Medicines, alcohol, dizziness and slower reactions can all affect your recovery. They can also make driving less safe. [4, 9]
Ways to lighten the load on your brain
Try to cut down how much your brain has to hold at one time. There’s no need to prove you can push through. Pick the ideas below that suit your life:
- Keep important details in one spot. Log appointments, medicine times, questions and calls about your claim in one notebook or phone note. Set calendar alerts for tasks with a deadline. [6]
- Tackle one hard task at a time. Turn off alerts and move somewhere quieter. Finish one small step before you start the next. [6]
- Ask to have information written down. At a medical visit, say the plan back in your own words. You can also ask someone who came with you to take notes. [6]
- Split work into short chunks, with rest breaks that fit your symptoms. No set number of minutes works for everyone. If symptoms start to build, stop. Come back to the task at a lower level. [4, 6]
- Give important things a regular home. A simple habit for where your keys, medicines and papers go can head off mistakes you could avoid. [6]
- Look for patterns. Write down which tasks set off symptoms and what eases them. A few good notes beat testing yourself all the time. [4]
Getting back behind the wheel and on the job
Do not drive if you are dizzy, slowed down, confused or unusually sleepy. The same applies if your vision is off or a medicine is affecting you. Ask your doctor when it’s safe for you to drive. Asking matters most because traffic can require you to react fast. [5]
Your return to work or school depends on your symptoms and the tasks you do. A desk job, child care, working up high and running machinery each make different demands on attention and safety. Ask for guidance in writing. Short term supports may include a shorter day, a quiet space or rest breaks. Fewer tasks at once, written instructions or extra time may also help. [4, 7]
Some tasks affect other people’s safety. Examples include driving for work, watching children on your own or using equipment. Tell your doctor exactly what those tasks involve. Go beyond asking “Can I go back?” Also ask “Which parts can I do safely now, and what should change for a while?”
If recovery is slower than expected
Many people get better within weeks. Contact your doctor if your symptoms are getting worse. Do the same if they haven’t improved after two to three weeks. If symptoms are badly disrupting daily life, don’t wait that long. At a follow up visit, your doctor can review headache, dizziness, vision and sleep together. Mood, pain, medicines and thinking can be part of the same review. [4]
Lasting symptoms aren’t automatically a sign of permanent brain damage. Still, they call for a plan. Depending on the problem, your doctor may suggest a specific treatment or send you to a specialist. A rehabilitation doctor, a neurologist or a physical, occupational or speech therapist may help with certain problems. A neuropsychologist may help too. [6]
Also bring up nightmares, fear or feeling on edge since the crash. These can show up alongside concussion symptoms. Getting help for sleep problems and emotional distress may make it easier to concentrate, too. [8]
What to ask at your next appointment
- Given the crash and my symptoms, how likely is a concussion? What else might be adding to my symptoms?
- Which symptoms mean I should be checked again right away?
- Which activities can I go back to now? What should I skip because it could lead to another injury?
- What’s my plan for driving, work, school, exercise and caring for others?
- If I don’t get better, when should I call you? Which specialist might help?
Bring a brief timeline of your symptoms, your medicine list and your discharge papers. Add one or two examples of tasks that are harder for you now. If questions slip your mind during the visit, hand over your written list. [3, 4]
Take thinking problems seriously, even without a blow to the head
You can’t always see a concussion. Trouble remembering or focusing needs attention, even if you didn’t hit your head or pass out. Watch for emergency signs and get checked. Lean on simple supports and ease back into activity a little at a time. If your recovery stalls, ask your doctor to look closely at everything that may be affecting you.
Sources and further reading
- 1CDC about concussion
- 2CDC concussion symptoms
- 3MedlinePlus concussion tests
- 4CDC recovery guidance
- 5CDC return to activities
- 6MSKTC thinking after TBI
- 7CDC TBI at work
- 8VA TBI and traumatic stress
- 9MedlinePlus concussion discharge
- 10CDC older adults and TBI
This information is meant to educate in general terms. Your own doctor’s instructions should guide your recovery.
Keep learning
Safe Driving Resource Center
Guides, self-checks and articles for drivers, parents of new drivers, and families recovering after a crash.
