Carenotes > Concussion In Children

Concussion In Children

GENERAL INFORMATION:

What is a concussion? A concussion (kun-KUSH-un) is an injury to the tissue or blood vessels of the brain. It is also called a "closed head injury" or "mild traumatic brain injury" (MTBI). Concussions happen when the soft tissues of the brain are forced against the bone of the skull. The injury can cause the brain to have trouble working normally for a short time. Mild concussions are common in childhood and are usually not a serious problem. Concussions can be further described by the following categories:

• Grade 1: A mild concussion. Your child did not lose consciousness (was not "knocked out"). Your child may have been dazed or confused for a short time after the injury. Normal thinking and behavior returns within 20 minutes of the injury.
  
  
• Grade 2: Your child did not lose consciousness, but was not thinking clearly for more than 20 minutes after the injury. Also, your child may not remember what happened.
  
  
• Grade 3: Your child lost consciousness for a short time. Also, your child may not remember what happened.

What are possible causes of a concussion? A concussion is usually caused by a blow to the head. A concussion may happen because of a fall, a motor vehicle crash, or a sports injury. Sometimes being forcefully shaken may cause a concussion.

What are the signs and symptoms of a concussion? Every concussion is different. Right after the injury, your child may seem dazed, lose consciousness, or have a seizure (convulsion). Other symptoms may show up right away. Some symptoms may not happen for days or weeks after the concussion. Symptoms of a concussion may last anywhere from a few seconds to several weeks. After a concussion, most people get better within four weeks. After the injury, your child may have one or more of these symptoms:

• Mild to moderate headache.
  
  
• Dizziness or loss of balance.
  
  
• Nausea (feeling sick) or vomiting (throwing up).
  
  
• Change in mood (becomes restless, sad, or irritable).
  
  
• Change in the way your child plays or works at school.
  
  
• Trouble thinking, remembering things, or concentrating (giving full attention to one thing for a period of time).
  
  
• Ringing in the ears.
  
  
• Short-term loss of newly learned skills, such as toilet training.
  
  
• Drowsiness or decreased amount of energy.
  
  
• Change in normal sleeping pattern (sleeps more than usual or cannot sleep).

Symptoms of a concussion may be so minor that they are hard to notice. Some children may act fine, even if they feel different than normal. The concussion itself may make it hard for your child to know that something is different. You will need to ask your child if they have any symptoms. You will also need to watch your child more closely for a few weeks.

What signs and symptoms should concern me in the days following a concussion? It is common to have a headache or feel dizzy after a concussion. Some children who are thought to have minor concussions may have a more serious injury. The symptoms of a serious head injury may not show up right away. It is very important to watch your child for more serious symptoms after a concussion.

• Your child may be at higher risk of having a more serious head injury if he:
  
  
  • Had a previous head injury or concussion.
    
    
  • Is on medicine that thins his blood, or has a bleeding disorder.
    
    
  • Is less than one year old.
    
    
  • Has other neurologic (brain) problems.
    
    
  • Has difficulty walking and falls often.
    
    
  • Is active in high impact contact sports, like soccer and football.
  
  
• Call your child's caregiver if your child has any of the following symptoms:
  
  
  • Is harder to wake up than usual.
    
    
  • His symptoms or condition gets worse during the first several days after his injury.
    
    
  • Will not stop crying.
    
    
  • Will not eat.
    
    
  • Has headaches that are very bad, or that get worse in the days after the injury.
    
    
  • Concussion symptoms that last longer than six weeks after the injury.
  
  
• Your child should be seen in an emergency room, doctor's office, or clinic immediately if he shows signs of:
  
  
  • Increasing confusion, or a change in personality or behavior.
    
    
  • Blood or clear fluid coming out of the ears or nose.
    
    
  • Not knowing where he is, or does not recognize people that are familiar.
    
    
  • New problems with vision (blurry or double vision).
    
    
  • Repeated or forceful vomiting.
    
    
  • Slurred or confused speech.
    
    
  • Your child is an infant and has a bulging soft spot (fontanelle) on his head.
    
    
  • Weakness, loss of feeling, or new problems with coordination (balance and movement).
  
  
• Dial 9-1-1 or 0 (Operator) for an ambulance if your child has any of the following symptoms:
  
  
  • Pupils (black part in the center of the eye) are unequal in size, and this is new for your child.
    
    
  • Seizures (convulsions).
    
    
  • Cannot be woken up.
    
    
  • Stops responding to you or passes out (faints).

What can be done for my child after a concussion? Although your child needs to be seen by a doctor, usually no treatment is needed. The most important thing you can do for your child is to watch for signs of a more serious problem. Your child may need tests or to stay in the hospital for a short time. Your child may be sent home with special instructions. You may need to watch your child's symptoms for several weeks.

• If your child lost consciousness, a CT or MRI scan may be taken of your child's brain to check for a serious injury. Your child must be able to hold still for a short time for the test to be done. Your child may have a concussion even if it does not show up on the scan.
  
  
• Your child's caregiver may have x-rays taken of the neck or face if there is a chance of other injuries.
  
  
• Allow your child to get plenty of rest.
  
  
• Your child should only take medicine that his caregiver says is OK.
  
  
• Sometimes a blow to the head may cause bruising, swelling, or a cut on your child's skin. An ice pack may be used to decrease your child's pain and swelling. It is best to start using ice right after an injury and up to 24 to 48 hours afterwards. Do not use ice directly on the skin, or for longer than 20 minutes at a time. If ice is not covered or is put on one area of your child's body for too long, it may cause frostbite.
  
  
• Your child needs to be protected from another head injury for a period of time. It is dangerous to receive another concussion before the brain has recovered (gotten better) from the first one. Your child may not be able to play sports or do activities that may result in a blow to the head. Your child's caregiver will let you know when it is OK for your child to return to normal activities.
  
  
• Let your child's teachers, coaches, or daycare providers know about the injury and symptoms to watch for.

Will my child have any lasting effects from a concussion? Rarely, some people may develop post-concussion syndrome (PCS). Symptoms of PCS may not start for several weeks or months after an injury. Symptoms of PCS usually go away over time. Some people may need special treatment. Call your caregiver if your child has concussion symptoms for more than six weeks after the injury. Your child may have PCS if one or more of the following symptoms start or continue six weeks or more after the injury:

• Headache that will not go away.
  
  
• Dizziness or vision changes.
  
  
• Irritable, depressed, angers easily, or not able to control emotions.
  
  
• Problems with memory, planning, or thinking.

Risks:

• Your child may also have had other injuries at the same time as the concussion, like a neck or face injury. The longer your child was unconscious the more serious the concussion may be. The risk of serious problems are decreased if you and your child carefully follow your caregiver's advice.
  
  
• Each additional concussion your child has may increase his risk of having problems later in life. These problems may include poor coordination, or trouble thinking or concentrating. Having repeated concussions can be life threatening.

Where can I go for more information? You can contact one of the following national organizations for more information about concussions and head injuries:

• Brain Injury Association
  8201 Greensboro Drive
  McLean, VA 22102
  Phone: 1-703-761-0750
  Phone: 1-800-444-6443
  Web Address: http://www.biausa.org
  

• Centers for Disease Control and Prevention
  1600 Clifton Road
  Atlanta, GA 30333
  Phone: 1-404-6393311
  Phone: 1-800-3113435
  Web Address: http://www.cdc.gov
  

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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