What criteria should I use to determine whether a patient with a concussion requires referral to a specialist?

Refer to a specialist if the person has persistent or worsening clinical features related to the initial head injury, such as vomiting, headaches, or new-onset focal neurological signs, which may indicate a possible complication ¹.

Referral is indicated if there are persistent non-specific symptoms for more than 3 months after head injury, or concerns about the severity or nature of symptoms, including cognitive, emotional, or behavioural difficulties ².

Immediate referral to a hospital emergency department is necessary if there is evidence of ongoing or worsening clinical features, such as persistent vomiting, severe headaches, or new focal neurological signs ².

Referral should also be considered if there are signs of a developing neurological condition, such as a brain tumour, or if persistent or new-onset focal neurological signs are present, warranting specialist assessment ².