Top 10 Things to Remember When Your Child Has Had a Concussion

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Has your child sustained a bang to the head which has left him/her dizzy and nauseous, maybe with blurry vision and/or a nasty headache? If so, this might mean your child has had a concussion.

Concussions are typically caused by a blow or jolt to the head, and result in injury to the brain. For this reason, concussions are now called mild traumatic brain injury (MTBI). While they might not be as immediately life-threatening as a skull fracture or bleeding in the brain, concussions can have lasting consequences, including memory problems, recurring headaches and mood disorders.

How concussions typically happen

Lauren Adler, MD, FAAP

Concussions can happen in just about any situation but most often occur in contact or collision sports such as football, basketball, soccer, lacrosse, wrestling and ice hockey. Concussions can also occur in non-contact activities such as skiing, snowboarding, bike riding, skateboarding, horseback riding and playing on a playground. They can also happen from a collision with the ground, a wall, a tree or a ball/object that has been thrown, hit or kicked.

The leading cause of concussion for kids? Falls.

With most concussions, the person is not knocked out (unconscious).

We’re seeing an increasing number of young patients with suspected concussions.

This might be due to more kids playing contact sports with an inherent risk of head injury, or on the positive side, it might mean that there is now greater awareness among parents, teachers and coaches of the symptoms of a concussion and the need to seek immediate medical attention. To learn more facts about concussions, click here.

Symptoms of concussion

The symptoms of a concussion usually happen right after the injury, but sometimes they show up hours or even days later. Someone who has had a concussion may report feeling normal before their brain has fully recovered, which is why it’s so important to closely monitor their symptoms and activity level.

The most common symptoms of concussion are:

  • headache
  • nausea
  • dizziness
  • balance problems
  • confusion
  • abnormal eye movements
  • feeling mentally “foggy”
  • difficulty concentrating and remembering
  • confusion about recent events
  • irritability
  • sadness/depression
  • sleeping more or less than usual
  • difficulty falling asleep

10 things to remember when your child has sustained a concussion

1) No return to athletic play the same day.
2) Minimal school (or no school) for 48 hours after the concussion.
3) Visit your child’s pediatrician within 48 hours.
4) Have your child try to get 10-14 hours extra sleep for several nights.
5) Do NOT wake your child up in the middle of the night.
6) Shorten your child’s school day.
7) Urge your child to take frequent rests throughout the day.
8) No physical activity until symptom-free.
9) Adherence to “Return to Learn” and “Return to Play” protocols (listed below).
10) Pursue physical therapy, occupational therapy and cognitive therapy if needed.

When to contact your child’s pediatrician

If your child has experienced a concussion, or even if you suspect that he/she has, it’s extremely important to contact your pediatrician right away. He/she will want to examine your child and possibly perform specific tests to determine the extent of the injury. He/she may also want to see your child once a week for the next several weeks.

You should seek immediate medical attention if your child:

  • Loses consciousness/can’t be awakened
  • Vomits repeatedly
  • Gets a headache that worsens, lasts for a long time, or is severe
  • Has weakness, numbness, trouble walking or poor coordination
  • Has difficulty recognizing familiar people
  • Is very confused
  • Has trouble talking or slurred speech
  • Foams at the mouth
  • Has a seizure (arms or legs shake uncontrollably)

Treatment and recovery

After a concussion, kids need to let their brains rest. That means cutting out as much unnecessary physical, mental and emotional stimulation as possible for 24-48 hours after an injury (maybe longer, depending on severity), then gradually reintroducing moderate physical and cognitive activity only after symptoms have improved.

How to prevent a concussion

Not all concussions can be prevented, but some can be avoided.

  • Helmets should ALWAYS be worn for sports that require them. They should fit correctly and be in good condition.
  • Athletes should be taught safe playing techniques and to follow the rules of the game.
  • Most importantly, kids who sustain any kind of blow to the head, either while playing a sport or in everyday life, need to let their parents, coach or teacher know if they have hit their head or are experiencing symptoms of a head injury — even if it means stopping play, missing out on a fun activity or having to re-schedule a big test.
  • Remember: Never ignore a head injury.

Returning to routine after sustaining a concussion

If your child has sustained a concussion, it’s very important to follow these guidelines before allowing him/her to return to school. They should not move on to the next stage until he/she experiences no symptoms at the current stage.

Return to Learn (school)
Stage 1: No cognitive activity (reading, studying, doing homework)
Stage 2: Class attendance
Stage 3: Class participation
Stage 4: Homework
Stage 5: Return to full academic work

Return to Play (sports)
Stage 1: Rest, no activity
Stage 2: 15-20 minutes of light aerobic activity such as stationary bike, brisk walking.
Stage 3: Sport-specific drills, such as throwing, fielding, hitting for baseball, or jogging, passing, kicking for soccer (typically part of warmup).
Stage 4: Non-contact practice. Athlete can participate in all aspects of practice except scrimmages or games.
Stage 5: Contact practice. Participation in all aspects of practice including scrimmages and games.
Stage 6: Athlete can participate in a game.

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Worried that your child may have sustained a concussion? Please come see us.

If your child has experienced a blow to the head and you’re concerned that it might be a concussion, please make an appointment with one of our Westchester Health Pediatrics pediatricians. We’ll examine him/her, possibly perform some tests, and then make an evaluation as to the seriousness of the injury and what steps to take next (including brain scans, if warranted). Our #1 goal is to help your child return to normal as soon, and as safely, as possible. Whenever, wherever you need us, we’re here for you.Make an appt

By Lauren Adler, MD, FAAP, a practicing pediatrician with Westchester Health Pediatrics, member of Northwell Health Physician Partners

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About the Author: ML Ball