# Concussion - Category: acute - Review status: reviewed (every claim checked against a document named on this page) - Sources: MSF Essential Drugs 2024 - paracetamol (oral) - Verified date: 2026-08 ## Verified against - MSF Essential Drugs 2024 - paracetamol (oral) - Concussion - disease-level clinical article (concussion-clinical.txt) ## Treatment metadata - Paracetamol — 500 mg — oral.solid - Referral & safety-netting (no drug therapy) ## Complete treatment card ```text CONCUSSION Sources: MSF Essential Drugs 2024 - paracetamol (oral) Review status: REVIEWED against MSF Essential Drugs 2024 - paracetamol (oral), Concussion - disease- level clinical article (concussion-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - Cognitive symptoms include confusion, disorientation, amnesia, mental fogginess, and trouble concentrating [confusion · memory loss · poor concentration] - Physical symptoms include headache, dizziness, balance problems, and visual changes [dizziness · headache · unsteadiness] - Sleep-related complaints include drowsiness and either more or less sleep than usual, or trouble falling asleep [drowsiness] - Over 90% of patients diagnosed with concussion never lose consciousness, though a loss of consciousness signals a potentially more serious injury [loss of consciousness] - Symptoms do not always start right after the injury and can appear hours to days later - A history of more numerous, severe, or longer-lasting prior concussions predicts a longer recovery from this one SIGNS - what you find (3) - Exam should closely check the head and neck for any structural injury - A full neurologic exam covers strength, sensation, reflexes, eye movements including saccades and nystagmus, and balance testing [nystagmus] - Cognitive testing should formally assess orientation and higher-level thinking TESTS (6) - Concussion remains a clinical diagnosis; there is no single defining finding or minimum symptom count required - The SCAT6 tool helps assess athletes on the sideline after a possible head injury, with a child version for ages 5 to 12 - Severe headache, seizures, focal deficits, loss of consciousness, or worsening mental status should prompt an emergency evaluation for a more serious injury - A normal head CT scan does not rule out a concussion - PECARN criteria and the Canadian Head CT Rule are decision tools used to decide whether imaging is needed - MRI can be considered when concussion symptoms persist beyond 7 days IF NOT THIS - what else fits (2) - Right after the injury, more severe alternatives such as a cervical spine injury, brain bleed, or skull fracture must be considered - Persisting symptoms can overlap with pre-existing headache disorders, anxiety, depression, PTSD, ADHD, or sleep problems, complicating the diagnosis Score Glasgow Coma Scale - How depressed is this level of consciousness? Source StatPearls "Concussion" - disease-level clinical article Status traced to the source above 1. PARACETAMOL [1st line] Adult 1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever Peds 15 mg/kg/dose [child max 500 mg] (Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.) 3kg -> 45 mg/dose 4kg -> 60 mg/dose 5kg -> 75 mg/dose 6kg -> 90 mg/dose 7kg -> 105 mg/dose 8kg -> 120 mg/dose 9kg -> 135 mg/dose 10kg -> 150 mg/dose 11kg -> 165 mg/dose 12kg -> 180 mg/dose 13kg -> 195 mg/dose 14kg -> 210 mg/dose 15kg -> 225 mg/dose 16kg -> 240 mg/dose 17kg -> 255 mg/dose 18kg -> 270 mg/dose 19kg -> 285 mg/dose 20kg -> 300 mg/dose 21kg -> 315 mg/dose 22kg -> 330 mg/dose 23kg -> 345 mg/dose 24kg -> 360 mg/dose 25kg -> 375 mg/dose 26kg -> 390 mg/dose 27kg -> 405 mg/dose 28kg -> 420 mg/dose 29kg -> 435 mg/dose 30kg -> 450 mg/dose 31kg -> 465 mg/dose 32kg -> 480 mg/dose 33kg -> 495 mg/dose 34kg -> 500 mg/dose (capped) 35kg -> 500 mg/dose (capped) 36kg -> 500 mg/dose (capped) 37kg -> 500 mg/dose (capped) 38kg -> 500 mg/dose (capped) 39kg -> 500 mg/dose (capped) 40kg -> 500 mg/dose (capped) 41kg -> 500 mg/dose (capped) 42kg -> 500 mg/dose (capped) 43kg -> 500 mg/dose (capped) 44kg -> 500 mg/dose (capped) 45kg -> 500 mg/dose (capped) 46kg -> 500 mg/dose (capped) 47kg -> 500 mg/dose (capped) 48kg -> 500 mg/dose (capped) 49kg -> 500 mg/dose (capped) 50kg -> 500 mg/dose (capped) Source MSF Essential Drugs 2024 - paracetamol (oral) Why Symptomatic relief of the pain and fever only. It does not treat the cause, and the dose is the same whatever the cause is. Caution Relief only - it does not treat what is causing the pain or fever. Check every other product the patient is taking for paracetamol; combination cold and flu preparations are the usual route to an accidental overdose. Reduce the dose in significant liver disease, chronic alcohol use, or low body weight. RED FLAG - Worsening headache or repeated vomiting, increasing drowsiness or difficulty rousing the patient, a seizure after the injury, unequal pupils or new focal weakness, or clear fluid leaking from the nose or ear (possible skull fracture): refer for emergency assessment. Egypt FEBRIMOL 500 MG 20 TAB. PHARCO 3.50 EGP (0.17/unit) CETAMOL 500 MG 20 TABS. MEMPHIS 8.00 EGP (0.40/unit) PARACETAMOL-MUP 500MG B.P. 20 TABS. MUP 13.00 EGP (0.65/unit) CETAL 500 MG 20 TABS. EIPICO 24.00 EGP (1.20/unit) ARKADOLOW 500 MG 30 F.C. TABS. UTOPIA 42.00 EGP (1.40/unit) PARAMOL 500MG 20 TAB. MISR 38.00 EGP (1.90/unit) ADOL 500MG 24 CAPLETS JULPHAR 32.00 EGP AUGICETAMIDE 500 MG 20 SACHETS AUG PHARMA 50.00 EGP FEBRIMOL ORAL DROPS 20 ML PHARCO 4.00 EGP -> ? strength differs, ? different route - not oral solid THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA 5.00 EGP -> ? strength differs, ? different route - not oral solid 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Concussion - disease-level clinical article (concussion-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Send to the emergency department, as a severe head injury: a seizure, headache that is severe, any focal neurological deficit, consciousness lost, mental state declining, or symptoms that keep getting worse. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)