We see concussion and TBI patients from across the Illinois side of the metro. Dr. Gurpreet Singh Padda, MD, MBA, MHP is licensed in Illinois as well as Missouri. He holds full staff privileges at Anderson Hospital in Maryville. So this has never been a licensing question.
The injury most people were told was nothing
Of all concussions, only about 5 to 9 percent involve loss of consciousness. And loss of consciousness does not predict who develops persistent symptoms — a 1,507-athlete study tested exactly that. Recurrent injury, amnesia, concentration difficulty, insomnia and light sensitivity all predicted post-concussion syndrome there. Loss of consciousness did not. Concussion without loss of consciousness sets out the evidence.
That single fact changes most of what patients arrive believing. You may be told you did not black out, that the CT was clear, and that you can go home. People routinely hear that as confirmation that nothing happened. None of those three findings excludes a concussion. And two of them are not even usually recorded.
One series looked at 1,678 real traumatic brain injury events. No Glasgow Coma Scale was documented in 74 percent. No loss of consciousness was documented in 70 percent. And no CT was performed in almost half. The markers people are asked to produce as proof are simply absent from most genuine injuries.
Does a normal CT scan mean there is no concussion?
A CT is looking for bleeding, a skull fracture, or a mass effect that needs a neurosurgeon tonight. It does the job it is for. But it is not sensitive to the diffuse axonal and metabolic disturbance that produces concussion symptoms.
So a normal scan means you are not in immediate danger. It does not mean the brain was not injured. Treating it as an all-clear is why so many people spend months being told their symptoms are stress. Blood biomarkers covers what can be measured when imaging is normal.
How is a concussion diagnosed and treated?
Structured assessment, not reassurance. We test vestibular and oculomotor function. We do cognitive screening (a check of thinking skills). We take a careful symptom inventory. Where indicated, we do the biomarker work. Diagnosis and testing covers the sequence.
Then comes treatment aimed at what the testing found, because post-concussion symptoms are not one problem. Vestibular dysfunction, oculomotor dysfunction, cervicogenic headache (headache from the neck) and autonomic disturbance each need different treatment. Being handed the same advice for all four is why people plateau.
Communities we see Illinois patients from
Crossing the river
From Madison County, the usual approach is I-270 west across the Chain of Rocks crossing. It feeds almost directly toward the airport and avoids downtown entirely. From St. Clair County, I-64 west then north on I-170 is generally faster outside peak hours.
Neither is a long drive. The thing worth planning around is the afternoon westbound peak on I-270. Morning appointments travel better from the Illinois side.
What we do not do
We are not an emergency service. Some head injuries need an emergency department immediately. That means a head injury with worsening headache, repeated vomiting, seizure, weakness, slurred speech or increasing drowsiness. Nothing here should delay that.
We also do not tell people what their claim is worth, and we do not publish settlement figures. Those numbers circulate widely in this space. They come from marketing, not from any primary source. Putting them on a medical site implies a promise no physician can make.
What we do is assess, document what is actually found, and treat it. Where the findings are normal, we say that too. To anyone relying on the record, that is worth more than a generous report that does not survive scrutiny.
Do I need a referral, and what should I bring?
No referral is needed. You can book directly. We request records from wherever you were seen, rather than asking you to chase them.
Bring what you have, though, because it saves time. That means the emergency department note if there was one, any imaging report, and a list of current medications. The imaging report matters less than people expect, and the note matters more. That is because the note usually records the mechanism as described on the day.
Past head injuries belong in the history too — sport, falls, a crash years ago — even when nobody called them concussions at the time.
Will Illinois insurance cover care in Missouri?
Most major commercial plans and Medicare cross the river with no trouble. Medicare in particular is federal and does not care which side you live on. Two are worth checking before you drive: Illinois managed Medicaid and Illinois-specific narrow-network products.
Benefits are verified before scheduling, not discovered afterward. And an authorization is not the same thing as a promise of payment. We say which is which as soon as we know it.
What a good outcome looks like
For most people it is a return to work, study and activity without symptoms running the day. A minority have had untreated dysfunction for a long time. For them, it is a substantial improvement rather than a complete resolution. We say which is likely, rather than promising the first.
What we will not do is keep someone in open-ended treatment. Progress is measured against the findings from the first visit. If those are not moving, the plan changes or ends.
Frequently asked questions
Do I need to have blacked out for this to be a concussion?
No, and most people did not. Loss of consciousness occurs in a small minority of concussions. It does not predict who develops lasting symptoms: concussion without loss of consciousness.
My CT was normal. Does that settle it?
It rules out bleeding and fracture, which is what it is for. It does not exclude concussion, because the injury is functional rather than structural: what can be measured when imaging is normal.
Is it too late if the injury was months ago?
No. Persistent symptoms remain treatable well after the event. Vestibular and oculomotor problems can be found and worked on at that stage: long-term effects.
Do you need a referral?
No. You can book directly, and we will request records from wherever you were seen: what the evaluation involves.
What should a concussion doctor test at the first visit?
Look for a physician who tests instead of reassuring. That means vestibular and oculomotor testing, cognitive screening, a careful symptom inventory and, where indicated, blood biomarkers. Then comes treatment aimed at what the testing found. Dr. Padda is licensed in Illinois as well as Missouri. He holds full staff privileges at Anderson Hospital in Maryville. No referral is needed. A worsening headache, repeated vomiting, seizure or slurred speech goes to an emergency department first.
Does the brain fully heal after a concussion?
For most people it does, in the way that matters. They return to work, study and activity without symptoms running the day. For a minority with long-standing untreated dysfunction, the realistic result is substantial improvement rather than complete resolution. We say which is likely at the start. Progress is measured against the findings from the first visit. If those are not moving, the plan changes or ends.
What are the signs of a late concussion?
Symptoms that linger after the day of injury usually trace to one of four problems: vestibular (balance and inner ear) dysfunction, oculomotor (eye movement) dysfunction, cervicogenic headache coming from the neck, and autonomic disturbance. Each needs different treatment. Some signs mean go to an emergency department now instead: a headache that keeps worsening, repeated vomiting, a seizure, weakness, slurred speech or increasing drowsiness.
Getting here from Illinois
Concussion Center
4477 Woodson Rd, Suite 105, St. Louis, MO 63134
Monday–Friday, 8:00 AM – 5:00 PM
From most of the Illinois side, I-270 west across the river then south toward the airport is the simplest approach.