What is a Concussion?

A concussion is an injury to the brain from a blow to the head, face, neck or body. The sudden injury causes the brain to shake inside the skull.

You can get a concussion by running into another person or object, falling, or even from whiplash. This can occur during activities such as sports, or the sudden jolt of a motor vehicle accident. It can even happen during normal daily activity like hitting your head getting out of a car. You may not notice symptoms from the concussion right away. Sometimes symptoms do not show up for hours or days after the injury.

Some concussions will develop into post-concussion syndrome. This is a more complex disorder in which symptoms may be slower to resolve. Symptoms of post-concussion syndrome may include worsening or constant headache, dizziness, trouble concentrating, fatigue, or changes in mood. These symptoms may last for weeks and sometimes months after the initial injury.

Risk factors for post-concussion syndrome or slow recovery include recent concussion, previous concussion with long recovery, age at the time of injury (early adolescence for our population), mental health or behavioral concerns, and frequent exposure to high-risk or high-speed activities including riding a bike, contact-collision sports and roller coasters or rides.

With early identification, correct diagnosis and multidisciplinary treatment, most patients typically recover from a brain injury within one to three months.

What Are the Common Signs and Symptoms of Concussion?

You cannot see a concussion on an X-ray, CT scan or an MRI. Instead, a concussion may affect the way you think or feel. We call this a “functional disturbance.” Common signs and symptoms of a concussion are:

Physical Signs

• Headache(s)
• Sensitivity to light
• Sensitivity to sound
• Nausea or vomiting
• Feeling tired or drowsy
• Dizziness
• Loss of balance or trouble walking
• Ringing in ears
• Double or blurred vision
• Numbness or tingling
• Loss of consciousness

Cognitive Signs

• Feeling foggy
• Feeling slow
• Memory issues
• Unable to concentrate
• Trouble thinking clearly

Emotional Signs

• Irritable or fussiness
• More emotional than normal
• Sad or nervous

Sleeping Signs

• Change in sleeping pattern
• Trouble falling asleep
• Trouble staying asleep
• Sleeping more than usual
• Sleeping less than usual

These signs may look different for infants and toddlers. You may notice that your child has become more irritable, sleepy, or is unable to do some of the things that used to be able to do.

How Are Concussions Diagnosed?

Your child’s doctor will gather information on the history of injury and the symptoms after the injury. They will do a physical exam and test your child’s memory, vision, balance, coordination, concentration, muscle strength, reflexes and sensation.

Remember, someone who has had a brain injury may not show symptoms of concussion right away. It is important to watch them for several hours after injury to see if they begin to have any symptoms of concussion.

How Are Concussions Treated?

The early treatment for a brain injury is rest. This is for the body and brain. Athletes should not return to full contact activity until cleared by their doctor.

During recovery, it is important to remember to drink fluids throughout the day, eat balanced meals, keep a regular sleep schedule, and avoid screen time (cell phone, computer, watching TV). Keep the use of headache medicine (like ibuprofen or acetaminophen) to a minimum. These medicines can make your child’s symptoms worse.

Once your doctor feels it is safe to begin adding more activity to your child’s schedule, they will give your child a plan specific to their personal needs and goals. It is important for athletes to follow the advice of their doctor as they resume sports.

How Can I Prevent My Child from Having a Concussion?

Avoid activities that put your child at risk for brain injury soon after the first one. Examples include climbing trees, riding a bike or skateboard, or driving a car. Follow the guidelines below to help protect your child.

Babies

• Make sure that your baby or child rides in an approved child safety seat or booster seat each time they travel in a vehicle.
• Never place a baby on a chair, table or other high place while they are in a car seat or baby carrier.
• Use the safety straps on changing tables, grocery carts and highchairs.
• Don’t allow children to carry your baby.
• Do not use baby walkers that have wheels. These can tip over and cause harm. Use a baby activity center without wheels instead.
• Parenting can be exhausting and stressful, especially during infancy. Caring for yourself helps you take the best care of your baby. Parent self-care includes eating well, rest and using social support.

Toddlers

• Childproof your home to protect your child from falls.
• Secure large pieces of furniture, TVs and appliances to the floor to prevent them from tipping over on your child. Use anti-tip brackets if needed.
• Lock windows and screens. On upper floors, install safety bars that can keep your child from falling out of windows. These can be removed in case of fire.
• Use safety gates at the top and bottom of stairs until your child can go up and down safely on their own. Keep stairs free of clutter.
• Make sure your toddler wears an approved bike helmet and sits in an approved seat when riding on a bike with you.

Children

• Watch your child closely at the playground.
• Make sure play equipment is in good working order.
• The playground surface should be made of at least 12-inch-deep shredded rubber, mulch, or fine sand. Avoid harder surfaces like asphalt, concrete, grass and soil.
• Make sure your child wears the correct helmet when biking or playing a sport that requires it.

Older Children and Teens

• Make sure your child wears a seatbelt every time they ride in a vehicle. Children younger than 13 years of age are safer in the back seat.
• Make sure your child wears the correct helmet when riding a bike, skateboard or takes part in other active sports.
• All-terrain vehicles (ATVs) are a high-risk activity. Only teens aged 16 years or older should operate an ATV. They need to wear a motorcycle helmet and should never have a passenger on the ATV with them.

For Athletes

• Make sure to wear a helmet if indicated for sport at all times.
• Check that protective sports equipment fits properly.
• Remind your child to stay hydrated.
• Make sure that your child is properly conditioned for activity. Help monitor their sports schedule to avoid over-exertion and over-training.

When Should I Call a Doctor?

If you think your child has had a concussion or brain injury, make sure to get them evaluated by a healthcare provider before they return to activity. Once they have been evaluated, seek medical care if your child develops any new symptoms that your healthcare provider does not already know about. They should see a doctor if symptoms get worse, such as:

• Headache that worsens for no reason and does not get better with acetaminophen or ibuprofen
• Clear fluid or blood from the nose or ear
• Scalp swelling that gets bigger
• A seizure
• Is hard to wake up
• Repeated vomiting
• Acts differently than normal – examples are not playing, acting fussy, or is confused.
• Has weakness in the arms or legs or does not move them as usual
• Cannot recognize people or places
• Passes out

Call your doctor if you have any questions or concerns about how your child looks or feels.