Day 14 of a concussion — rest is not the plan

Two weeks of dark-room rest is the concussion plan the evidence retired. The Amsterdam consensus and the Buffalo group’s randomized trials point the same way: relative rest for a day or two, then sub-symptom-threshold aerobic exercise set by a measured heart-rate ceiling, with return-to-learn graded in parallel. What you do with it: test the threshold, prescribe under it, put the school accommodations in writing, and treat any worsening picture as a medical review, not more rest.

• Worsening headache with vomiting, drowsiness or a new deficit — same-day medical review, not another week of waiting
• Symptoms unchanged or worsening after four weeks — this is the persisting-symptoms pathway, not more rest

• Four months of concussion — the woman who cannot workTier 2
• Dizzy in the supermarket aisleTier 2

This page carries the case’s first decision. The full sequence — every decision, the examination by domain, and the debrief that grades you — is in the drill, and the library is included with membership.