when to be concerned about a concussion

in this article:

• What is a concussion?
• What are the symptoms of a concussion?
• When should a parent be concerned about a concussion?
• What is the treatment for a concussion?

From spirited games on the playground to organized sports, the potential for head injuries, including concussions, is a reality for many kids during childhood and adolescence. While concussions are often discussed, there are still many misconceptions about what they are and what they are not.

We talked to Lora Scott, MD, chief, division of sports medicine to learn more about concussions, symptoms, treatment and when to be concerned.

what is a concussion? 

A concussion is an injury to the brain which causes a short-term shift in brain chemicals. This leads to temporary symptoms and temporary changes in how the brain works. When someone has a concussion there is no structural injury which can be seen through imaging, like a CT scan.

Kids and teens who follow their health care provider's recommendations usually feel better within a few weeks of the concussion.

how does a concussion happen?

Concussions occur when there is a force delivered to the head or body which causes the brain to 'jostle' inside the skull. This is similar to a person or object moving inside the car when it comes to an abrupt stop.

what are the symptoms of a concussion?

There are many possible symptoms of a concussion, but they fall into four main categories:

1. Physical symptoms (headache, dizziness, nausea, neck pain)
2. Mental symptoms (forgetfulness, difficulty concentrating, confusion)
3. Sleep symptoms (difficulty sleeping, increased fatigue, sleeping more than usual)
4. Emotional symptoms (more mood swings, changes in personality)

People do not need all the symptoms to have a concussion. Some patients may only have one or two symptoms.

when should a parent be concerned about a concussion?

Parents should be concerned about any head injury which causes symptoms. Symptoms can show up immediately or may evolve over 24-48 hours. If concerned, parents should make an appointment with a sports medicine provider or other concussion specialist to get a clear diagnosis and treatment plan.

what is the treatment for a concussion?

Immediate treatment involves resting the brain. The more a patient rests during the first 24-48 hours, the faster the recovery. After 48 hours, rest is used to manage symptoms but will not speed recovery. The brain recovers on its own, without any additional intervention. We use doctor visits to help a child navigate school and sports during the recovery process.

how can concussions be avoided?

There is no guaranteed method to prevent concussions other than never being active. This is not recommended due to the more severe health consequences of inactivity. The best advice is to use appropriate safety gear for the sport, which fits correctly. While these do not prevent concussions, they will reduce the risk of more severe injuries like skull fractures and brain bleeds. The other recommendation is to ensure a concussion has fully healed before returning to sports. While recovering, it is easier to get a second injury because of balance problems and slowed reaction times. The second injury is typically significantly worse than the first and can cause permanent brain damage or death in the most extreme cases.

final thoughts

Ohio law requires any athlete who has a head injury, plus signs or symptoms of possible concussion, to be removed from play for the rest of the day. Not all of them actually have concussions. However, concussions can take a day or two to present themselves. This law is a precaution to prevent more serious second injuries. I love seeing patients who follow this rule and end up not having a concussion! They are my favorite ones to clear and send right back to their activities.

Some symptoms of concussion are common in the general population, even without an injury. When a child with one of these symptoms, like headaches, has an injury plus a change in their symptom pattern, we treat it like it’s a concussion and watch for them to return to their normal pattern.

To visit a sports medicine provider for a suspected concussion, fill out this form to request an appointment. A Dayton Children’s representative will respond within 48 hours to schedule your child with the appropriate provider.