Everything you need to know about concussions
Concussions, or what most doctors now call “Mild Traumatic Brain Injury” are one of the most common sports injuries in the United States. Approximately 1.6–3.8 million sports and recreation-related traumatic brain injuries occur in the United States each year, and many believe the figure is much higher due to significant under-reporting or unrecognized injury.
Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious. Once considered to be a little more than a “ding” or a “bell-ringer,” concussions are now known to have potentially harmful cumulative effects, resulting in long-term changes in brain function.
What is a concussion?
A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.
What are the signs and symptoms of a concussion?
The most common symptoms of concussion include headache, confusion, disorientation, decreased information processing (feeling ‘foggy’ ‘slow’ or ‘out of it’), loss of equilibrium, and visual or auditory disruptions, such as being more sensitive to sounds, bright lights or having blurred vision.
The signs and symptoms generally show up soon after the injury. However, you may not know how serious the injury is and some symptoms may not show up for hours or days after the injury occurs.
In trying to make the diagnosis of concussion, medical providers or athletic trainers on the sidelines will analyze for these Symptoms of concussions (things patients report they experience):
- Headache or “pressure” in the head.
- Nausea or vomiting.
- Balance problems or dizziness
- Double or blurry vision.
- Bothered by light or noise.
- Feeling sluggish, hazy, foggy, or groggy.
- Confusion, concentration, or memory problems.
- Just “not feeling right,” or “feeling down”.
And actual signs of concussions that they observe:
- Can’t recall events prior to or after a hit or fall.
- Appears dazed or stunned.
- Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.
- Moves clumsily.
- Answers questions slowly.
- Loses consciousness (even briefly).
- Shows mood, behavior, or personality changes
So, what do I do if I think my child has had a concussion?
If a concussion happens while playing sports, you should:
- Remove the child from play.
- Keep the child out of play the day of the injury until a medical provider, experienced in evaluating for concussion, says he or she is symptom-free and it’s OK to return to play.
Children or teens who return to play too soon—while the brain is still healing—risk a greater chance of having a repeat concussion. It’s better to miss one or two games than the whole season.
When do I need to bring my child to urgent care? Or to the emergency department?
It’s not always possible to predict exactly whether your child should go to the ED right away, see a provider in an urgent care office the next day, or just rest at home. So, whenever you are not sure, it’s always better to have your child evaluated by a medical professional, who has expertise in caring for youth concussions or head injuries, right away.
In general, any person with a head injury associated with loss of consciousness, seizures, prolonged confusion or amnesia, neck pain, vomiting, or numbness or weakness in the arms or legs should be transported right away via ambulance to the ED. Other potential warning signs of serious brain injury include:
- One pupil is larger than the other.
- Drowsiness or inability to wake up.
- A headache that gets worse and does not go away.
- Slurred speech, weakness, numbness, or decreased coordination.
- Repeated vomiting or nausea, convulsions, or seizures (shaking or twitching).
- Unusual behavior, increased confusion, restlessness, or agitation.
- Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously
Rest is key to helping the brain heal
Rest is very important after a concussion because it helps the brain heal. Your child or teen may need to limit activities while he or she is recovering from a concussion. Physical activities or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games may cause concussion symptoms (such as headache or tiredness) to come back or get worse.
After a concussion, physical and cognitive activities—such as concentration and learning—should be carefully watched by a medical provider. As the days go by, your child or teen can expect to slowly feel better.
Recovering from a concussion
When your child’s or teen’s medical provider says they are well enough, make sure they return to their normal activities slowly, not all at once.
Talk with their medical provider about when your child or teen should return to school and other activities and how you can help him or her deal with any challenges during their recovery. For example, your child may need to spend less time at school, rest often, or be given more time to take tests.
If your child or teen already had a medical condition at the time of their concussion (such as ADHD or chronic headaches), it may take longer for them to recover. Anxiety and depression may also make it harder to adjust to the symptoms of a concussion.
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