Concussion

A concussion is a mild injury to the brain caused by a significant blow or jolt to the head or neck that temporarily disrupts how the brain normally works. Children often bump or hit their heads without getting a concussion, so parents should monitor their child for development of symptoms after this type of injury. It is important to know that a child does not need to be "knocked out" or lose consciousness to have experienced a concussion. Studies show that only about 10% of all sport-related concussions involve loss of consciousness.

What are signs and symptoms of a concussion?

Signs and symptoms of a concussion can vary greatly. Most young people will recover completely from a concussion within a few weeks of injury. But, some youth can take longer to recover than others.

Physical

Headaches
Sick to stomach or vomiting
Dizziness or balance problems
Low energy or feeling run down
Trouble with vision
Bothered by light or noise
Sleeping problems

Thinking (cognitive)

Slowed thinking
Trouble paying attention
Difficulty remembering things
Acting "foggy"
Confusion
Changes in school performance

Behavioral or emotional

Irritability or grouchiness
Easily upset or frustrated
Nervousness
Sadness
Acting without thinking
Any other personality changes

Is a concussion a traumatic brain injury (TBI)?

A traumatic brain injury (TBI) is an injury to the brain from some type of outside force, such as a fall, collision or blow to the head. TBI ranges in severity from mild to severe. Concussions are classified as types of mild TBIs. Even though a concussion might be called a "mild" injury, parents and caregivers still must take it seriously because it is an injury to the brain.

There are a few ways that medical professionals can determine the severity of a TBI:

Duration of loss of consciousness
Length of amnesia (partial or total memory loss)
Length of mental status changes (confusion, disorientation)
Time it takes to follow commands
Brain imaging abnormalities such as bleeding, bruising or swelling of the brain

Though there are severity grades, each concussion should be taken seriously. A mild concussion and a moderate-severe concussion both run the risk of Second-Impact Syndrome.

Second-Impact Syndrome is a subsequent injury to the head while the athlete is still symptomatic and may occur from only a minor impact to the head or upper body. This syndrome is most likely to occur in individuals less than 20 years of age; symptoms occur due to a disruption of the brain's blood autoregulatory system resulting in a significant increase in intracranial pressure and potential herniation. Over the course of 15 seconds to several minutes, the condition of the athlete reduces severely and may lead to respiratory distress or result in a coma. This is a life-threatening condition that has a mortality rate of approximately 50%.

What is a moderate-severe traumatic brain injury?

A moderate-severe TBI is a more significant injury than a concussion and should be addressed differently in the home, school and community. A moderate-severe TBI often causes a loss of consciousness, as well as memory loss for several hours to days or weeks.

Children who experience a moderate-severe TBI often need hospitalization and will likely have abnormal findings on brain imaging. Although children with a mild TBI or concussion typically heal in a few days to weeks, individuals who have a moderate-severe TBI often take longer to recover and are likely to require increased support, supervision and overall care for months or longer.

Who gets concussions?

Concussions are common in collision sports such as hockey, football and lacrosse, but it's important to remember that young athletes can get concussions in any sport. Activities that include high speeds and contact or collision with opponents increase the risk of getting a concussion.

Athletes are not the only ones susceptible to concussions. Any child can get a concussion while doing everyday activities like riding bikes or scooters or playing on the playground.

What should I do if I suspect my child has a concussion?

Take your child aside immediately and assess the situation. If your child is an athlete, take them out of the game or practice immediately. Athletes should not return to play on the same day a concussion is suspected.
Ensure your child is evaluated by an appropriate healthcare provider. Do not try to judge the seriousness of the injury yourself.
If you witness a head injury to another child (not your own), tell their parents or guardians about the possible concussion.
Allow children and athletes to return to play, while following the policies and protocols in place for your sports organization, and only with permission from an appropriate healthcare professional, such as their primary care provider or a concussion specialist.

What should parents do in the first days after a concussion?

Serious medical problems after a mild head injury are rare, but they can occur. For this reason, a healthcare provider should always be involved in a child or teen's care after a concussion.

In the first one to two days after the injury, you should watch your child closely for worsening or severe symptoms. You can give acetaminophen (Tylenol) for headaches, but no other medications should be given during this time without a healthcare provider's approval.

Seek immediate medical help if your child has any of the following: