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Concussions

Concussions Concussions

A concussion is any injury to the brain that disrupts normal brain function typically on a temporary basis. Concussions are usually caused by a blow or jolt to the head but may occur from a hit to the body that produces a reflex force to the head.

The following is information from the American Academy of Pediatrics about concussions, including guidance on treatment and prevention.

When do concussions occur?

Concussions can happen in any sport but more often occur in collision sports, such as football, rugby, or ice hockey. They also are common in contact sports that don't require helmets, such as soccer, basketball, wrestling, cheerleading, and lacrosse. Many concussions also occur outside organized sports. For example, a child riding a bike or skateboard can fall down and hit their head on the street or an obstacle.

Symptoms

The symptoms of a concussion range from subtle to obvious and usually happen right after the injury but some may take hours to a few days to develop. Athletes who have had concussions may report feeling normal before their brain has fully recovered. With most concussions, the player is not knocked out or unconscious.

Symptoms of a concussion include the following:

  • Headache

  • Nausea or vomiting

  • Dizziness or balance problems

  • Double or blurry vision

  • Sensitivity to light

  • Sensitivity to noise

  • Feeling dazed or stunned

  • Feeling mentally "foggy"

  • Trouble concentrating

  • Trouble remembering

  • Confused or forgetful about recent events

  • Slow to answer questions

  • Changes in mood—irritable, sad, emotional, nervous

  • Drowsiness

  • Sleeping more or less than usual

  • Trouble falling asleep

  • What to do if you suspect a concussion

Concussions should be taken seriously and all athletes with suspected concussions should not return to full sports practice or participation until cleared by a doctor. A doctor can confirm the diagnosis of concussion and decide when it is OK for the athlete to return to play. Athletes who continue to play after their injury are at increased risk for worse symptoms, a more prolonged recovery and more serious injury to the brain if additional head injuries occur while recovering.

No one knows how many concussions are too many before permanent damage occurs. Repeated concussions are of greater concern, especially if each one takes longer to resolve or if a repeat concussion occurs from a light blow. The evaluating doctor needs to know about all prior concussions, including those that occurred outside of a sports setting, in order to make proper recommendations regarding return to play and future sports participation.

Treatment

The best treatment for a concussion is reducing physical and mental activity. Children should be monitored often, but there is no need for wake-up checks during sleep. School attendance and work may need to be modified with tests and projects postponed. Students need to be excused from gym class or recess activities. Light physical exertion may be recommended to improve recovery. Physical therapy may be initiated as some problems associated with concussion may need active rehabilitation. Any progressive worsening of concussion symptoms or changes in behavior should be immediately reported to your doctor.

Returning to physical activity

Recovery time from concussion is variable with each injury but may be prolonged in athletes who continue to play immediately after their concussion. An athlete may feel better and want to return to play before their brain has completely recovered. Given the uncertain and unpredictable time frame for recovery, all formal sports activity should be suspended until symptoms have completely resolved at rest. A stepwise return to physical activity can begin once the athlete has clearance from their doctor. Having an athletic trainer, if available, involved in monitoring this plan can be very helpful. It is important to pay close attention to worsening symptoms (like increasing headache, nausea, or dizziness) while completing the activity progression. Any concussion-related symptoms that return with exertion are a clear indicator that the concussion has not healed. Final clearance to return to full activity should also be at the direction of a physician.

Prevention

Not all concussions can be prevented, but some may be avoided. Helmets should be worn for any riding activities (like horseback, all-terrain vehicle [ATV], motorbike, bike, skateboard, or snowboard) or contact sports (like football, hockey, or lacrosse). Helmets should fit appropriately and be in good condition. Athletes should be taught safe playing techniques and to follow the rules of the game. Most importantly, every athlete needs to know how crucial it is to let their coach, athletic trainer, or parent know if they have hit their head or have symptoms of a head injury—even if it means stopping play. Never ignore a head injury, no matter how minor.

"When in Doubt, Sit Them Out!"

Additional Information:


Last Updated
11/11/2018
Source
Adapted from Care of the Young Athlete Patient Education Handouts (Copyright © 2010 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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