Can You Fly With a Concussion After a Car Accident?

You were in a car accident, your head is still pounding, and you have a flight booked for later this week. Maybe you were visiting Palm Beach County, maybe you are flying out for work. Now you are wondering whether getting on a plane with a concussion is a bad idea.

The short answer: often you can fly with a concussion, but only after the injury has been checked, the warning signs have been ruled out, and your symptoms are steady or getting better. In the research so far, flying soon after a concussion has not been shown to slow recovery, though the trip can make you feel worse. The bigger danger is flying with a more serious injury nobody has looked for yet.

A crash can also bring a sore neck, symptoms that show up late, and an insurance clock. If you were hurt in Palm Beach County, our car accident injury clinic can see you the same day.

What flying actually does to a concussed brain

Airplane cabins are pressurized, but not to sea level. The CDC's air travel guidance says cabins are typically kept at the equivalent of 6,000 to 8,000 feet above sea level, and the FAA limit is 8,000 feet. There is less oxygen in each breath than on the ground. The CDC notes that most healthy travelers do not notice it.

For someone with a fresh concussion, the travel itself can also make symptoms harder to manage:

• Noise and bright light in the airport and the cabin, which can make headaches and light sensitivity worse.

• Pressure changes during takeoff and landing, felt in the ears and head.

• Dehydration and lost sleep, both of which can make concussion symptoms feel worse.

• Stress and screens: crowds, gate changes, and hours of reading or scrolling.

Any of these can leave you feeling worse after a flight, which is why timing and planning matter.

Red-flag symptoms that mean do not board

A concussion is a mild brain injury. Bleeding in or around the brain, or a skull fracture, is a different and more serious injury, and it changes the flying question completely. Call 911 or go to the ER, and do not get on a plane, if you or someone with you notices:

• A headache that gets worse and does not go away

• Weakness, numbness, decreased coordination, or a seizure

• Repeated vomiting

• Slurred speech or unusual behavior

• One pupil larger than the other

• Confusion, restlessness, agitation, or not recognizing people or places

• Passing out, looking very drowsy, or being hard to wake

These are the CDC's danger signs for adults. For the full list of everyday concussion symptoms, see our guide to concussion after a car accident.

How soon is too soon to fly?

The CDC's air travel guidance does not set a waiting period after a concussion, so the decision is individual. The research is limited, but it is somewhat reassuring.

The largest study we know of, published in JAMA Network Open in 2020, followed college athletes and military cadets after concussion. The 92 who flew within 72 hours of their injury recovered at about the same pace as those who did not fly. People who flew also did not report more severe symptoms.

That study has real limits. Most of the flights were short, around two hours. Few people flew within the first few hours after injury. And young athletes are not the same as adults hurt in a car crash, who may also have neck injuries. So the sensible approach is still to wait until you have been checked, the red flags are ruled out, and your symptoms are stable or improving. If symptoms are getting worse, the flight can wait.

Why a car accident concussion is different

You do not have to hit your head to get a concussion in a crash. A hard jolt that snaps the head back and forth can do it, which is also how whiplash happens. That is why the two can show up together.

• Your neck may be hurt too. Lifting a suitcase into an overhead bin, sleeping upright, and sitting still for hours can all aggravate a neck injury.

• Symptoms can start late. The CDC notes some concussion symptoms may not appear for hours or days. Feeling fine at the scene does not mean you are fine. Our guide on how long after a car accident pain can start explains why.

• There is paperwork. A crash injury usually becomes an insurance claim. It is simpler to get your exam documented before you leave town than to arrange it later from another state.

How doctors rule out a bleed or fracture

Nobody can tell you whether a concussion is "just" a concussion by looking at you across a counter. It starts with a hands-on exam: how the crash happened, whether you lost consciousness, your symptoms and when they started, and a neurological check of your balance, vision, strength, and reflexes.

A CT scan does not diagnose a concussion, and not every concussion needs one. Doctors use imaging when the exam or the details of the crash raise concern about bleeding or a fracture. At Primary & Urgent Care Center we offer same-day CT imaging for Palm Beach County, with STAT reads within 3 hours when a scan is needed, and on-site digital X-ray at all four of our locations for other injuries from the crash.

What to bring to a pre-flight evaluation

1. Your flight details: date, time, and how long you will be in the air.

2. A symptom timeline: what you felt at the scene, that night, and today.

3. The crash details: where you were sitting, whether airbags deployed, whether you hit your head.

4. Your insurance and any police report number, so your visit is documented properly.

5. A list of your medications, including anything you took for pain after the accident.

Ask for a copy of your visit notes before you leave. If your symptoms change after you get home, the next doctor will want to see them.

If you do fly: before, during, and after

Before the flight

• Rest the day before, and go easy on screens.

• Do not drive yourself to the airport if you still feel foggy, dizzy, or slow. Get a ride.

• Travel with someone if you can, and ask your airline about help getting through the airport.

• Pack light, or check your bag so you are not lifting it overhead with a sore neck.

During the flight

• Drink water and skip alcohol.

• Use earplugs or noise-canceling headphones, and sunglasses or an eye mask.

• Support your neck if you sleep, and get up to move when it is safe to.

After you land

• Plan a quiet first day, since symptoms can flare after travel.

• If any red-flag symptom appears, go to the nearest ER. Do not wait to see if it passes.

"I feel fine and my flight is tomorrow"

This is a common reason people skip an exam, and it is the reason to get one. Delayed symptoms are normal after a crash, and a quick evaluation before a flight is far easier than dealing with a worsening headache at 35,000 feet or in a city where you have no doctor.

We take walk-ins and same-day appointments Monday to Friday, 9am to 6pm, and Saturday, 9am to 4pm. We are closed on Sunday, so if you are flying out on a Monday morning, come in Saturday. If you have any red-flag symptom, on any day, go to the ER.

Florida's 14-day PIP rule

If you carry Florida PIP (Personal Injury Protection) coverage, you generally need to get initial medical care within 14 days of the crash to use those benefits. The clock starts on the date of the accident, not the day your symptoms began. Our guide to Florida's 14-day PIP rule explains how it works. If you are visiting from out of state, Florida PIP may still cover you, for example through a rental car's policy or the policy on a Florida car you were riding in. Which policy pays depends on the details, so check with your insurer or the rental company, and get seen within the 14 days to be safe.

The bottom line

Flying with a concussion is often possible once a doctor has checked you, the warning signs are ruled out, and you are getting better, not worse. A car crash makes that exam more important, not less, because of the neck, the delayed symptoms, and the paperwork.

If you were hurt in a crash in Palm Beach County and have a trip coming up, walk in to our car accident injury clinic before you fly.