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Head Concussions

Friday, May 17, 2013

A concussion is an injury to the brain caused by a bump or blow to the head. Anyone can have a concussion from a fall, an automobile accident, a collision while playing sports, or by being struck by a fast-moving object. A concussion can even occur when the body moves so suddenly and rapidly that the motion jolts the head back and forth very quickly. Concussions lead to about 500,000 Emergency Department visits each year for children under 14 years. This number does not include the children with concussions who are seen in offices and clinics. Concussions can be mild or severe, but all concussions in children need to be evaluated by a health care professional. It is important for parents (and coaches) to know the symptoms and treatment of concussion, as well as their prevention.

Symptoms

The symptoms of concussion range from subtle to obvious. The onset of concussion symptoms can occur immediately after the injury or hours, days, or weeks later and can last for days to months. Many athletes feel normal after a head injury, only to return to the game with a concussion. Most concussions do not cause a child to be “knocked out” or experience a loss of consciousness. Symptoms include:
  • Feeling dazed or stunned
  • Feeling mentally “foggy”
  • Trouble concentrating
  • Trouble remembering
  • Confused or forgetful about recent events
  • Slow to answer questions
  • Headache
  • Nausea or vomiting
  • Dizziness or balance problems
  • Double or blurry vision
  • Sensitivity to light and/or noise
  • Changes in mood—irritable, sad, emotional, nervous
  • Drowsiness
  • Sleeping more or less than usual
  • Trouble falling asleep
Symptoms in children that require immediate medical attention in the Emergency Department include:
  • Loss of consciousness
  • Worsening headache that does not go away
  • Numbness, weakness or loss of coordination
  • Repeated vomiting
  • Slurred speech
  • Severe drowsiness, unable to awake
  • One pupil (the black part in the eye) is larger than the other
  • A convulsion or seizure
  • Worsening confusion, restlessness, agitation or having unusual behavior
  • Cannot recognize the people around them
  • Won’t stop crying or unable to console
  • Refusal to nurse or eat (young children)

Treatment

All concussions are serious and need to be evaluated by a health care professional. The severity of the symptoms will determine if a visit to the Emergency Department is necessary. Young children and teens tend to recover from concussions more slowly than adults. Most children fully recover, without permanent issues. However, once a child suffers a concussion, there is a higher risk for a future concussion, and it may take longer to recover from it. A CT scan or MRI and special neurological tests may be done to determine the level of injury. Treatment includes complete rest from physical and mental activity, which may affect school attendance. Children should not return to regular activities and sports until allowed by a health care professional and all symptoms have resolved.

Prevention

Not all concussions can be prevented, but some can be avoided. Properly fitted helmets should be worn for any riding activities and contact sports. Restrain all passengers in the vehicle. Teach athletes the rules of the game and how to play a sport safely. Teach children to let a coach or parent know if they hit their head or are having symptoms of a concussion. Most importantly, the American Academy of Pediatrics recommends, “When in Doubt, Sit Them Out!"

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Kathy Kent
RN, ND, CPNP
Kathy Kent, RN, ND, CPNP, works as a certified PNP for Northpoint Pediatrics in Indianapolis, IN. She is also the owner of the BABY SQUAD, LLC, a company dedicated to educating parents in the care and safety of young children.
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