Concussions
What Is a Concussion?
A concussion is a brain injury that affects the way the brain works and can lead to symptoms such as headache, dizziness, and confusion. Symptoms usually go away within a few days to a month with rest and a gradual return to school and regular activities. Sometimes, the symptoms last longer.
What Are the Signs & Symptoms of a Concussion?
Symptoms of a concussion might happen right after the head injury or develop over hours to days. They can include:
- headache
- confusion
- dizziness
- vision changes
- nausea and/or vomiting
- trouble walking and talking
- not remembering the injury
- not remembering before or after the injury
- feeling sluggish
Someone with a concussion also might have focus or learning problems, sleep problems, anxiety, or sadness.
Concussions can follow being knocked out (losing consciousness) from a head injury, but they can happen without a person being knocked out.
What Happens in a Concussion?
A concussion happens when the brain is injured. This can happen when the head is hit — for example, from a fall. But concussions also can happen without a blow to the head — for example, in a car accident when the head snaps forcefully forward and back. The strong movement causes chemical and blood flow changes in the brain. These changes lead to concussion symptoms.
How Do Kids and Teens Get Concussions?
Most concussions in kids and teens happen while playing sports. The risk is highest for cheerleaders and kids who play football, ice hockey, lacrosse, soccer, and field hockey.
Kids also can get a concussion from a car or bike accident, fall, fight, or anything that leads to a head injury.
How Are Concussions Diagnosed?
A child who has a head injury needs to be checked by a health care provider (such as a doctor, nurse practitioner, or physician assistant). To diagnose a concussion, the health care provider will:
- ask about how and when the head injury happened
- ask about symptoms
- test memory and concentration
- do an exam and test balance, coordination, and reflexes
Concussions do not show up on a CAT scan or MRI. Those tests might be done to look for other problems if someone:
- was knocked out
- keeps vomiting
- has a severe headache or a headache that gets worse
- was injured in a serious accident, such as from a car crash or very high fall
How Are Concussions Treated?
Healing from a mild concussion involves a gradual return to activities that finds a balance between doing too much and too little.
For the first day or two, your child should cut back on physical activities and those that take a lot of concentration (such as schoolwork). Have them relax at home. They can sleep if they feel tired. Calm activities such as talking to family and friends, reading, drawing, coloring, or playing a quiet game are OK. They should avoid all screen time (including TVs, computers, and smartphones) for the first 2 days after the concussion.
Usually within a day or so, they can start adding more activities, such as going for a walk. They should continue to avoid sports and any activity that could lead to another concussion. Symptoms don't have to be completely gone for your child to add activities. But if symptoms get worse with an activity, they need to take a break from it. They can try it again later that day or the next day, or try a less intense version of it.
Keep your child out of all sports and any activities that could lead to head injury (like rough play, or riding a bike or skateboard) until their symptoms are completely gone and they're cleared by a health care provider. It’s important to prevent another concussion because repeated concussions can have long-lasting, serious effects on the brain.
After a few days, your child should feel well enough to return to school. Work with your health care provider and a school team to create a plan for returning to school. Your child may need to start with a shorter day or a lighter workload.
Don't let your teen drive until your health care provider says it’s OK.
Other things that can help:
- When your child goes back to doing screen time, help them limit how much time they spend on it. Video games, , texting, watching TV, and using social media are likely to cause symptoms or make them worse.
- Make sure your child gets plenty of sleep. They should:
- Keep regular sleep and wake times.
- Avoid screen time or listening to loud music before bed.
- Avoid caffeine.
- For the first few days after the injury, if your child has a headache, they can take acetaminophen (Tylenol or a store brand) or ibuprofen (Advil, Motrin, or a store brand). Follow the directions on the label for how much to give and how often.
When Should I Call the Doctor?
Call your health care provider if your child:
- is not back in school by 5 days after the concussion
- isn't doing their usual level of schoolwork after being back to school for 2 weeks
- still needs medicine for headache a week or more after the injury
- has symptoms (such as headache, vomiting, confusion, or dizziness) that aren’t getting better or get worse
- still has symptoms 4 weeks after the concussion
- passes out
Go to the ER or call 911 if your child can’t be woken up or has a seizure.
What Else Should I Know?
Your child needs your support as they heal from the concussion. Help them add reasonable activities but also recognize when the body and brain need more time to heal. Never tell your child to “tough it out” if they have trouble with an activity. This can slow their recovery and may make the concussion symptoms worse.
Don’t let your child go back to sports before they're cleared to do so by a health care provider. Getting another head injury before the concussion is healed can be very dangerous.
The symptoms can be different with each concussion. Repeated concussions may even lead to permanent brain changes. Not all concussions can be prevented, but you can take steps to make another one less likely.
If your child does get another head injury, they need to stop the sport or activity and tell you, a coach, teacher, or trusted adult right away. Then call your health care provider, who might want to see your child.
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