Concussions are a form of mild traumatic brain injury caused by a blow to the head or body, a fall or another injury that shakes the brain inside the skull. Sports injuries account for the majority of concussions in children. Other common ways a concussion may occur are from falls, playground injuries, bicycle accidents or from motor vehicle accidents. Across the country, concussions account for more than 500,000 ER visits each year.
A concussion is an interruption in brain function that results in many different types of symptoms. You don’t have to lose consciousness to have a concussion. The most common symptoms are headache, nausea and vomiting. Other symptoms include memory loss, balance disruption, difficulty concentrating, light and noise sensitivity, sleep disturbances and mood instability. Symptoms can range from mild to severe and can last for hours or for months.
CT and MRI scans often are ordered to make sure the brain is not bruised or bleeding, but many times these imaging tests are unnecessary. Children may be admitted to the hospital for observation if there is a concern for dehydration or the need for nausea medicine, but most children remain at home after a concussion.
There are no medicines to treat concussions. Many children may require medicine to treat persistent headaches or nausea, such as Tylenol and Motrin. It also is encouraged that children wear bicycle helmets, avoid trampolines and are properly restrained in vehicles to prevent additional head injury, since the brain is more sensitive to damage after a concussion has occurred.
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Concussions are treated with “brain rest.” This includes minimizing TV, phone and computer time as well as ensuring adequate amounts of sleep. Watch for signs such as declining grades, poor sleep or mood changes, as these are signs of persistent concussive symptoms that may need further attention.
Seek emergency care right away if you are watching a child after a concussion and their headache gets worse, they have weakness or decreased coordination, slurred speech, extreme drowsiness, one pupil that is larger than the other, seizures, trouble recognizing people or places, or increased confusion, restlessness or agitation.
Many children do not report their symptoms to anyone because of fear of being removed from the team or not being allowed to play, or because they do not realize they have been injured. Coaches and family members as well may not realize the child has been injured. Should your child sustain a concussion, it is recommended that they are removed from play and should be released only by a health care provider to play sports once they have passed an examination confirming the concussion is resolved.
Kim Molik is a pediatric surgeon with the Wesley Pediatric Surgery Clinic and is Wesley’s pediatric trauma medical director.