Concussions and Children

Concussions and Children


Judy LiBy Judy Li, DO, Pediatric Neurology, Valley Medical Center

A concussion is a type of brain injury that can occur when the head hits an object or a moving object strikes the head. Sports-related concussions are a major public health concern. It is estimated that 1.6-3.8 million injuries occur each year in the United States. A concussion can cause a number of symptoms which include:

• Cognitive changes: Poor concentration, slow thinking, memory loss, confusion, loss of consciousness, dazed appearance
• Physical changes: Headache, nausea or vomiting, sensitivity to light or sound, dizziness, slurred speech, blurry vision, changes to balance or coordination
• Mood changes: Depression, anxiety, personality changes, trouble controlling emotions
• Sleep changes: Drowsiness, insomnia, feeling hazy or groggy, frequent awakenings

The symptoms often begin right after injury, but sometimes may not appear until the person starts exercising again. Often, children experience concussion symptoms for much longer compared to adults. Concussions can also occur when the head experiences a sudden impact without being hit directly such as a blow to the neck or upper body.

Are there sports that put my child at a higher risk of concussion?
Concussions can occur in many sports, but are most common in high-speed, contact sports. Football, rugby, hockey and soccer pose the greatest risk. Studies have shown that concussion risk is greater in females than in males playing soccer or basketball. There is not enough evidence to show different risks by gender for other sports. Once someone has experienced a concussion, he or she is at greater risk of having another one.

When can my child return to play?
A child can return to play when:
• All symptoms have resolved, especially after medications have been stopped
• The child has been cleared by a licensed professional trained in managing concussion

The child should avoid any activities that make symptoms worse or increase the risk of a second concussion. Every child is different, so be sure to discuss your child’s care plan with your healthcare professional. There is no set time for recovery. There is also no evidence that complete “brain rest” is necessary. There is new evidence that too much rest can actually cause more symptoms in teenagers.

What should I do if I think my child has had a concussion?
It is important that if a concussion is suspected, the child should be removed from play immediately and be evaluated by a licensed healthcare professional. For immediate attention, bring your child to an emergency room or urgent care for an evaluation. If symptoms persist, it is important to follow-up with your child’s pediatrician or primary care provider. In some cases, you may need to be referred to see a neurologist or sports medicine physician who can provide more specialized care for your child’s concussion.

This column is for general information, and any specific questions or concerns regarding this topic should be brought to your physician.