Maryville patients get concussion and TBI evaluation and treatment at our Woodson Road clinic in St. Louis. It is around forty minutes away via I-55/70 and I-270 west. The visit picks up where an emergency visit stops. We test vestibular (balance), oculomotor (eye movement) and cognitive function. Then we start the graded rehabilitation that shortens recovery.
Maryville is where Anderson Hospital sits. Dr. Gurpreet Singh Padda, MD, MBA, MHP holds full staff privileges there. For a head injury, that matters mainly because of what an emergency visit is and is not designed to do.
What the emergency department was actually checking
An emergency assessment after a head injury looks for the things that need intervention tonight: a bleed, a fracture, a worsening level of consciousness. It does that job well. It is not designed to do anything else.
It is not an assessment of vestibular function, oculomotor function, or cognition. It is not a plan for the following six weeks. Being discharged means you are not in immediate danger. It does not mean you were uninjured. The two are routinely mixed up at the point of discharge.
In practice, the markers people later rely on are often not in the record at all. In a large series of confirmed brain injuries, nearly three-quarters of cases had no Glasgow Coma Scale (the standard score for level of consciousness) documented.
A credential you can check locally
Dr. Padda is licensed in Illinois. He is on the medical staff at Anderson Hospital, 6800 State Route 162 in Maryville, with full privileges. You can verify that inside your own state.
The evaluation itself takes place at the Woodson Road office in Missouri, where the testing is set up. The privileges are a credential, not a second location. We say that plainly so nobody arrives at the wrong building.
What happens in the gap
The weeks between an emergency discharge and a proper assessment are where recovery is most often lost. Symptoms evolve. Nothing is documented. And the person is told to rest — which, beyond the first day or two, makes matters worse rather than better.
A structured evaluation in that window finds which systems are actually affected. It also starts the graded rehabilitation that shortens recovery. How treatment is structured sets out that graded plan.
Loss of consciousness happens in only about 5 to 9 percent of concussions. It also does not predict who develops persistent symptoms. A 1,507-athlete study found that recurrent injury, amnesia, concentration difficulty, insomnia and light sensitivity all predicted post-concussion syndrome. Loss of consciousness did not. Concussion without loss of consciousness sets out the evidence.
Children and adolescents
The principles are the same, but the thresholds are not. Younger patients take longer to recover on average. They are less able to describe what they are feeling. And they are under school and sports pressure to return before they should.
For most of them, the return-to-learn side matters more than return-to-play. It is also the one most often left to the family to work out alone. Specific written guidance is what makes it workable.
A second injury before the first has healed is the outcome everyone is trying to avoid. It is the reason clearance is based on testing, not on how a teenager says they feel.
Why a repeat injury matters so much
Prior concussion is among the strongest predictors of a longer recovery from the next one. The effect adds up over time; it does not reset between injuries.
That is why the history matters as much as the current event. It is why we ask about falls, sport, collisions and assaults going back years. When asked directly, roughly a third of athletes report an earlier concussion that was never diagnosed.
It is also why clearance is conservative. Returning slightly late has a small cost. Returning too early does not.
Older adults, and why the threshold is different
In an older adult, a fall with a head strike carries different risks. This is especially true for anyone on anticoagulation (blood thinners). The threshold for imaging is lower, not higher.
Recovery also tends to be slower. The symptoms are more easily blamed on age or on existing conditions. Balance impairment after a head injury raises the risk of the next fall. So assessing and treating it is a fall-prevention measure as much as a concussion one.
The medication review nobody does
After a head injury, the medication list is worth going through carefully. Sedating drugs, some blood pressure agents and anything affecting balance all interact with post-concussion symptoms. They also interact with fall risk.
That review is often the single most useful intervention in an older patient. It is rarely done, because everyone assumes someone else has done it.
What families notice first
Partners and family usually report the change before the patient does. What they describe is rarely headache. It is a shorter temper, losing the thread in conversation, pulling back from busy situations, and sleeping differently.
Those observations are diagnostic, and they belong in the history. We ask for them directly. That is because the injured person is the least reliable observer of exactly these changes.
If there was no scan at all
Common, and not a problem for the assessment. In large series of confirmed brain injuries, around half had no CT performed. That is because imaging is indicated for suspected bleeding, not for diagnosing concussion.
So its absence is not evidence against injury. Its presence would not have confirmed one either. The diagnosis is clinical. The testing that matters is the testing of function.
Common questions
I was discharged from the emergency department. Do I still need this?
If symptoms persist beyond a few days, yes. An emergency visit rules out danger. It does not assess the systems that produce ongoing symptoms.
Will I be seen at Anderson Hospital?
No. The privileges are a credential. The evaluation is at 4477 Woodson Rd, Suite 105 in Missouri, where the testing is.
Is complete rest the right approach?
Only for the first day or two. Prolonged rest delays recovery, and graded return does better: treatment.
How far is the clinic from Maryville?
Around forty minutes via I-55/70 and I-270 west, to 4477 Woodson Rd, Suite 105 beside Lambert Airport.
Getting here from Maryville
Concussion Center
4477 Woodson Rd, Suite 105, St. Louis, MO 63134
Monday–Friday, 8:00 AM – 5:00 PM
From Maryville, I-55/70 west to I-270 west — around forty minutes.
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