Pediatric Concussion Care

A concussion is a mild form of a traumatic brain injury (TBI) caused by an impact to the head. This impact is not forceful enough to fracture the skull or cause massive injury. However, it causes the brain to move and bump against the skull, resulting in mild injury. This injury may disrupt brain functions and cause drowsiness, memory loss, sudden emotional changes and poor balance. Fortunately, most concussions are not life-threatening and patients usually make a full recovery. Still, the effects of a concussive brain injury can be serious and cause long-term problems.

Any incident that results in a blow to the head — such as a fall, a motor vehicle accident, a sports-related injury or an object striking the head — can cause a concussion. Even if your child does not lose consciousness or the injury does not seem serious, they may have suffered some harm to the brain.

A child may exhibit a variety of symptoms immediately after the injury.

Urgent symptoms that require immediate evaluation in an emergency department:

• Loss of consciousness (passing out from the injury, which can last as briefly as a few seconds or up to several minutes)
• Amnesia (memory loss of the event, the events leading up to the injury or to the events after the injury)

Symptoms that are less urgent — but still significant — may include:

• Confusion
• Drowsiness and fatigue
• Headaches
• Vision problems (blurriness, double vision, “seeing stars”)
• Dizziness or problems with balance
• Nausea and vomiting
• Sensitivity to sound or light

If your child experiences these symptoms after getting a head injury, contact your health care provider or bring your child to an emergency room. It is important to have your child evaluated by a physician within one to two days after a head injury.

Your child may continue to have symptoms for weeks after their injury. This is called a post-concussive state or post-concussive syndrome. Those symptoms may include:

• Being short-tempered or easily agitated
• Sleeping too much or too little
• Difficulty falling to sleep
• Problems with concentration
• Memory loss
• Headaches
• Dizziness
• Blurry vision
• Showing more emotion
• Sadness
• Having trouble with daily activities in school or work

Whether your child is seen in an emergency department or in a clinic, a concussion is usually diagnosed based on patient-reported symptoms and neuropsychological assessments (tests to assess concentration, memory, problem solving, etc.). Although a concussion cannot be seen on a CT scan of the brain, this imaging test may be performed in order to rule out a more serious brain injury.

The brain needs to heal after a concussion, which takes time. Until symptoms are resolved, recovery should include:

• Getting plenty of rest, which may include staying home from school and reducing daily stress
• Avoiding physical activity that could cause another concussion, such as contact sports, playing outdoors and rough play

A full recovery from a concussion can take several months or longer.

Once your child has had a concussion, it is important to take precautions against having another one. Studies show that individuals who have repeated concussions may have serious lasting complications such as:

• Chronic memory loss
• Difficulty with concentration
• Headaches

When news stories feature popular athletes experiencing long-term effects of multiple concussion injuries, the general public pays more attention to this important health concern. Our neurosurgeons are at the forefront of this national discussion — actively encouraging academic research, community advocacy, education and collaborations to promote positive change for injury assessment and improved long-term outcomes.

There is no standard time period for resuming physical activities after a concussion. However, complete recovery is crucial before taking part in activities that could create a risk for a second concussion. We recommend a health care provider evaluates your child before they return to sports and other physical activity. In Illinois, state law requires high school athletes who sustain a concussion or head injury during a practice or game be given medical clearance before returning to competitive sports.