# Headquarters Health

AI-enabled proactive concussion care via telehealth

- Team: Orestis Skoutellas (co-founder), Lucas Johnston (CEO)
- Founded: 2024
- Invested: 2025
- Links: [Website](https://www.headquarters.health), [LinkedIn](https://www.linkedin.com/in/orestisskoutellas/)
- Field: The body and the brain

## The problem: How do you know when a young athlete's brain is ready to play again?

### What a concussion is

A concussion, also called a mild traumatic brain injury, is a head injury that temporarily affects how the brain works. The signs are a grab bag: headache, dizziness, trouble thinking, poor sleep, shaky balance, nausea, blurred vision, mood changes. Getting knocked out is not required. Fewer than 10% of sports concussions in children involve any loss of consciousness.

Scans don't help much. Routine imaging is not needed to diagnose a concussion and is, by definition, normal afterwards. A CT or MRI is there to rule out something worse. There is no validated blood or urine test for concussion in children either. So diagnosis comes down to a clinician's evaluation, sometimes helped by structured tools such as the SCAT5.

Most children and adults recover fully, usually within days to weeks. Athletes come back through graded steps: first a day or two of relative rest, then more activity bit by bit. If symptoms flare, they drop back a step for at least another 24 hours.

### Why it is hard

**No test says done.** There is no single physical test, blood test or scan that shows when someone has fully recovered. There isn't even one universally accepted definition of a concussion. Deciding when to go back is a judgment built from symptoms and exams, and judgments can be leaned on. Many head injury deaths and cases of permanent brain damage in high school sports have followed a clearance from a doctor pressured by an athlete or parents in a hurry, while school staff thought the player was still symptomatic.

**Kids keep quiet.** Only about half of concussed teenagers report their symptoms. Asked why, high school athletes of both sexes said a concussion wasn't serious enough to tell a medical professional about. A hidden injury can't be managed.

**Nobody on the sideline.** Plenty of schools have nobody medical at practice. 34% of US high schools have no access to an athletic trainer at all, and only 37% of public schools have a full-time one. Access to an athletic trainer is also one of the factors linked to whether students report symptoms in the first place.

**The long tail.** Up to a third of people with a concussion have symptoms that drag on, which in children and adolescents means lasting four weeks or more. How bad things are in the first few days is a strong predictor of who ends up there. Physiotherapy can help with lingering balance problems and headaches, and cognitive behavioural therapy with mood and sleep.

### What Headquarters Health is after

Every US state and the District of Columbia has a youth concussion law. All require an athlete with a suspected concussion to come out of play immediately, and all require medical clearance before they go back. Only eight states mandate a graduated return-to-play progression. The laws require the steps; they don't supply the people. At a school with no trainer and no specialist nearby, someone still has to do the evaluation and sign off.

Headquarters Health wants to close that gap by making specialist concussion care reachable anywhere. Its evaluations are virtual or in person with board-certified clinicians, and the service is "available in every US state via telehealth."

### How they go at it

**A before picture.** Athletes can take a self-administered digital baseline before the season, covering cognition, balance and oculomotor tasks, to give clinicians something to compare against after an injury.

**Evaluation from anywhere.** After a knock, a structured clinical intake and symptom scoring feed into a clinician's review, done by video or face to face.

**Everyone on one page.** Recovery runs on stepwise return-to-play and return-to-learn plans set per patient, with a shared timeline so the athletic trainer, clinician and family all see the same progress.

### Still open

Can a video call stand in for the exam room? In one small study of 16 people with concussion and 20 controls, telehealth versions of vestibular, eye convergence, autonomic and neck tests agreed well with in-person ones. Tracking smooth eye movements agreed less well, and the authors say larger samples are needed.

Do baseline tests earn their keep? Pre-season testing gives a point of comparison, but it may not reduce risk or change return to play, and it is not suggested for most children and adults. Only Hawaii's concussion law requires it.

How much rest is right? Current guidance keeps rest to 48 hours at most, and aerobic exercise brought in early and built up gradually is associated with faster recovery and less risk of lingering symptoms.

### Words used here

- **mild traumatic brain injury**: The medical name for a concussion: a head injury that disrupts brain function for a while without visible damage on a scan.
- **SCAT5**: The Sport Concussion Assessment Tool, a standard checklist of symptoms, memory, balance and neurological checks.
- **athletic trainer**: A licensed health professional who covers school and team sports, often the first to assess an injured player.
- **return-to-play**: The staged path back to full sport after a concussion, moving up a level only while symptoms stay quiet.
- **oculomotor**: To do with eye movements, which concussions often disturb.
- **vestibular**: To do with the inner-ear balance system and how it works with the eyes.

## About Headquarters Health

Headquarters Health is reimagining concussion care through AI-powered telehealth, addressing a massive compliance gap: every high school in the US is legally required to have proper return-to-play protocols for youth traumatic brain injuries, but most lack the infrastructure to actually deliver them.

The company's platform enables youth sports organizations to meet compliance obligations while ensuring proper medical assessment and care for student athletes. Based in San Francisco.

## Sources

1. [Concussion](https://en.wikipedia.org/wiki/Concussion), Wikipedia
2. [Factors Related to Concussion Knowledge, Attitudes, and Reporting Behaviors in US High School Athletes: A Systematic Review](https://europepmc.org/article/MED/35075658), Journal of School Health (via Europe PMC)
3. [Gender Differences in Concussion Reporting Among High School Athletes](https://europepmc.org/article/MED/27233957), Sports Health (via Europe PMC)
4. [Study: 34% of high schools have no access to athletic trainers](https://training-conditioning.com/news/study-34-percent-high-schools-have-no-access-to-athletic-trainers/), Training & Conditioning
5. [Sports-related concussion laws in the United States in children and adolescents: an updated cross-sectional review of state statutes](https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2026.1.PEDS25540/article-10.3171-2026.1.PEDS25540.xml), Journal of Neurosurgery: Pediatrics
6. [Headquarters Health: Concussion care, made accessible](https://www.headquarters.health), Headquarters Health
7. [Product: how Headquarters delivers concussion care](https://www.headquarters.health/product), Headquarters Health
8. [Validating telehealth assessment of physical concussion symptoms](https://europepmc.org/article/MED/42108573), Brain Impairment (via Europe PMC)
9. [Legal Perspectives, Recommendations on State Concussion Laws](https://www.nfhs.org/stories/legal-perspectives-recommendations-on-state-concussion-laws), National Federation of State High School Associations