Many of us and our children enjoy an active lifestyle. While staying active and participating in sports has significant benefits, there are some inherent risks for injury, such as concussion. Whether taking a fall off of a bike, a tumble on the ski hill, or a big hit on the football field or hockey rink, a blow to the head can lead to injuries that can significantly impact a person’s life if not treated properly.
You and your child may be fearful and nervous about attempting to return to sports after suffering a concussion. Those feelings are normal. Knowing what a concussion is, how to recognize the signs and symptoms of concussion, and when and where to seek treatment for a suspected injury can provide the peace of mind you and your child need to safely get back into the sports and activities they love.
What is a Concussion?
A concussion is a temporary brain injury caused by an impact or trauma that leads to brain movement within the skull. It is not a structural injury to the brain and does not cause bleeding, bruising, or swelling. Concussion causes an overall disruption of normal brain function, leading to a wide range of signs and symptoms.
Importance of Recognizing and Treating a Concussion
Many people with neurological symptoms after a head trauma do not seek appropriate care right away or at all. It is important to understand that a forceful blow to the head or body can cause multiple issues beyond concussion. Seeing an expert as soon as possible allows for appropriate diagnoses to be made and comprehensive treatment to be initiated from the beginning.
With proper treatment for concussion and all other overlapping issues, there should be a complete recovery without any long-lasting or permanent effects or impairments. Continuing to play sports while concussed, or delaying the appropriate treatment for any injury, can lead to an increased risk of further and more significant injuries. Chronic effects on a person’s ability to function due to long-term symptoms may occur, including:
- Visual discomfort
- Difficulty sleeping
- Memory problems
- Decreased attention
- Mood changes
- Loss of coordination/balance
How to Recognize a Concussion
Signs and symptoms of concussion typically start immediately or soon after the impact and evolve over hours to days. Many of the signs and symptoms of a concussion may seem minor or can overlap with things people commonly feel for other reasons. For instance, many people will feel fatigue or drowsiness if they do not sleep well or have a busy/stressful day. Similarly, headaches are frequently triggered by things like dehydration, skipping meals, poor sleep and stress. Some symptoms may start off mild but may increase or change in the hours and days after an injury. It is not your responsibility to diagnose a concussion on your own — recognizing possible concussion signs and symptoms and seeking out expert care from the start is the best defensive play in ensuring proper healing of your child’s brain.
Possible Concussion Signs and Symptoms
- Headache or head pressure
- Memory problems
- Sensitivity to light and/or sound
- Not “feeling right”
- Nausea and/or vomiting
- Feeling tired or fatigued
- Balance problems or dizziness
- Mood changes
- Feeling sluggish, foggy, or slowed down
- Loss of consciousness
- Confusion or slowed responses
- Dazed or stunned look
- Inability to recall events prior to or after the hit
If you find yourself Googling “how to tell if my child has a concussion,” you need to seek medical help for a proper diagnosis. When it comes to the brain, you can never be too cautious.
Severe Warning Signs After Head Injury
- Prolonged loss of consciousness
- Severe drowsiness or unresponsiveness
- A headache that gets worse
- Slurred speech
- Weakness or numbness
- Repeated vomiting
- Convulsions or seizures (shaking or twitching)
- Unusual behavior, such as increased confusion, restlessness or agitation
- Significant facial or posterior head bruising
- Obvious skull fracture or deformity
These may be signs of a more serious injury, including fractures or bleeding (hematoma) that can develop inside the skull after a head trauma. Skull/facial bone fractures and bleeding inside the skull pose a serious health risk and if you notice any of these signs it is a medical emergency and you should call 9-1-1 immediately.
How is a Concussion Diagnosed?
The best practice is to seek a diagnosis from a physician with experience in the diagnosis and treatment of all neurological conditions and expertise in concussion management as soon as possible, ideally within 24-48 hours of when the suspected injury occurred. This will ensure proper diagnosis and proper treatment. Unless your child is experiencing severe symptoms, there is no need to go to an urgent care or the emergency room.
Cognitive and Neurological Function
There is no one specific test to diagnose a concussion and the diagnosis should be made primarily based on a comprehensive history and neurological examination. Therefore, a healthcare provider who has experience working with concussion and all other neurological conditions is your best choice. They will be able to perform a complete evaluation, including running any necessary tests for an accurate diagnosis. This may include evaluation of cognitive (memory, attention, concentration) and neurological function (vision, hearing, strength, reflexes, sensation, balance, coordination).
Diagnostic imaging tests are not helpful for diagnosing or ruling out a concussion. However, imaging can be a crucial part of ruling out more significant injuries or conditions (fractures, bleeding, etc.). A cranial computerized tomography (CT) scan is the standard test used to assess the brain right after injury to visualize bleeding or broken bones. Magnetic resonance imaging (MRI) may be used to assess for structural changes in the brain (small areas of bleeding, contusions, diffuse axonal injury, atrophy, etc.).
A concussion baseline evaluation is done in order to get a snapshot of an individual’s brain and neurological function at a point in time when they are healthy. Getting this evaluation done prior to a sport season can help doctors accurately diagnose a concussion by using it as a comparison if an injury is suspected later. Knowing how your child’s brain functions when healthy can give them an advantage in making a fast and complete recovery.
Treatment Options for a Concussion
The old approach to concussion was to avoid all activity until symptoms are gone. This strategy does not work and is no longer recommended. The overall treatment should be active and focused on symptom management and a gradual rehabilitation process. Be sure your child drinks plenty of water, eats nutritious meals and continues with regular sleep patterns early on to limit symptoms. If symptoms are particularly uncomfortable, rest and modifying activity may be beneficial for comfort.
The First 24 to 48 Hours
If your child feels they need to rest and minimize activity, it is okay to let them. However, if they feel like they can continue with regular activities, excluding sports, then they may do so based on comfort. Remember that even though a person is experiencing symptoms that may increase with certain activities, it is okay to continue with those activities as long as they are still comfortable. An increase in symptoms with activity does not mean the injury is getting worse or that you are prolonging the injury – the only way to worsen the injury is by a repeat head trauma. The decision about what activities can safely be done early on can be complicated; and, when in doubt, check with your physician for guidance.
Only use acetaminophen (Tylenol) for any pain within the first 24 hours. After that, any other over-the-counter pain medications may be used, and often NSAIDs (ibuprofen, naproxen) can be more effective for managing headaches and pain after injury.
Once the correct diagnosis has been made, your child’s physician should come up with a comprehensive and individualized treatment plan that provides guidance on managing symptoms and safely and efficiently returning to activity, including screens, school, work, and eventually physical activity and sports. At SMG, we use an active rehabilitation approach from beginning to end and find that to be most beneficial in the treatment of concussion.
Your child’s SMG physician will often be assisted by physical therapists and athletic trainers. This team-based and holistic approach will help you and your child feel comfortable getting back into a daily routine and returning to play after a concussion. The treatment of concussion is no longer a one-size-fits-all method. We work to find the best path for your child.
If you suspect your child has a concussion, schedule an appointment to begin working on an individualized treatment plan. The brain is of utmost importance, and so is your child’s ability to get back to the activities they love.