Concussions (page 2)

The term concussion conjures up the image of someone knocked unconscious while playing sports. But concussions — temporary loss of brain function — can happen with any head injury, often without any loss of consciousness.

A concussion is also known as a mild traumatic brain injury. Although we usually hear about head injuries in athletes, many occur off the playing field in car and bicycle accidents, in fights, and even minor falls.

Kids who sustain concussions usually recover within a week or two without lasting health problems by following certain precautions and taking a breather from sports.

But a child with an undiagnosed concussion can be at risk for brain damage and even disability.

Anyone who sustains a head injury should stop participating and be removed from the activity or sport. Even without a loss of consciousness, it's important to watch for symptoms of a concussion.

Common initial symptoms include:

• a change in level of alertness
• extreme sleepiness
• a bad headache
• confusion
• repeated vomiting
• seizure

Someone with these symptoms should be taken to the emergency room.

About Concussions

The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. The brain can move around inside the skull and even bang against it. If the brain does bang against the skull — for example, due to a fall on a sidewalk or a whiplash-type of injury — it can be bruised, blood vessels can be torn, and the nerves inside the brain can be injured. These injuries can lead to a concussion.

Many different systems have been used to grade or describe concussions. The severity of a concussion is determined by how long signs and symptoms last and so can only be known after someone has recovered. The longer the symptoms of changes in brain function, the more severe the concussion.

Signs and Symptoms of a Concussion

Someone with a concussion may lose consciousness, but this doesn't happen in every case. In fact, a brief loss of consciousness or "blacking out" isn't a factor in determining concussion severity.

Other signs of a concussion include:

• headache
• sleepiness or difficulty falling asleep
• feeling confused and dazed
• difficulty concentrating, thinking, or making decisions
• dizziness
• difficulty with coordination or balance (such as being able to catch a ball or other easy tasks)
• trouble remembering things, such as what happened right before or after the injury
• blurred vision
• slurred speech or saying things that don't make sense
• nausea and vomiting
• feeling anxious or irritable for no apparent reason

Concussion symptoms may not appear initially and can develop over the first 24-72 hours. Anyone showing any of these signs should be seen by a doctor. Young kids can have the same concussion symptoms as older kids and adults, but changes in mood and behavior may be more subtle.

Call an ambulance or go to the ER right away if, after a head injury, your child:

• can't be awakened
• has one pupil — the dark part of the eye — that's larger than the other
• has convulsions or seizures
• has slurred speech
• seems to be getting more confused, restless, or agitated

Though most kids recover quickly from concussions, some symptoms — including memory loss, headaches, and problems with concentration — may linger for several weeks or months. Nearly 15% of kids age 5 and older have symptoms and/or changes in functioning lasting 3 months or longer. It's important to watch for these symptoms and contact your doctor if they persist.

Preventing Concussions

All kids should wear properly fitting, appropriate headgear and safety equipment when biking, rollerblading, skateboarding, snowboarding or skiing, and playing contact sports. Safety gear has been shown to reduce the occurrence of severe head trauma.

Childproofing your home will go a long way toward keeping an infant or toddler safe from concussions and other injuries. Babies reach, grasp, roll, sit, and eventually crawl, pull up, "cruise" along furniture, and walk. Toddlers may pull themselves up using table legs; they'll use bureaus and dressers as jungle gyms; they'll reach for whatever they can see.

All of these activities can result in a head injury that leads to a concussion. Be sure your child has a safe place to play and explore, and never leave a baby or toddler unattended.

The time you spend taking these safety precautions — and getting your kids into the habit of abiding by your safety rules and regulations — will help keep your family safe and sound!

Reviewed by: Rochelle Haas, MD, and Kate M. Cronan, MD
Date reviewed: January 2011