About Concussions

A concussion is a brain injury resulting from trauma to the head and can vary in severity. All concussions must be treated with the same initial caution to allow the brain time to heal.

Concussion symptoms are commonly divided into four groups: physical, cognitive, emotional, and sleep.

Physical symptoms include:

• Headache (the most common concussion symptom)
• Nausea
• Vomiting
• Balance problems
• Fatigue
• Sensitivity to light or noise.

Cognitive symptoms include:

• Feeling foggy or slowed down
• Problems concentrating or remembering
• Feeling confused

Emotional symptoms include:

• More emotional than normal
• Irritable
• Anxious
• Nervous

Children may also have significant problems with sleep. They can either be drowsy despite sleeping more than normal or they can be sleeping less and have difficulty falling asleep. These symptoms are the brain’s way of showing it has been injured and should be taken seriously.

Any head injury associated with the following symptoms should be evaluated in the emergency department:

• Repeated vomiting
• Loss of consciousness (blacking out) longer than a few seconds
• Neck pain
• Severe headache that gets worse over time
• Memory difficulties
• Seizure activity (convulsions)
• Unsteady gait or slurred speech
• Weakness or numbness in extremities
• Unusual behavior
• Concerns for a skull fracture
• Changes in how awake or interactive the individual is

Most other head injuries without these symptoms may be evaluated as soon as possible by a physician trained in the diagnosis and management of pediatric concussion. This may be your son or daughter’s primary care physician, neurologist, neurosurgeon, or a primary care sports medicine physician who specializes in the care of athletes. If it is a sports-related injury, and a trained medical personnel is on-site, they may provide an immediate assessment.

Most young children recover in seven to 10 days from a first concussion. Teens and collegiate athletes may recover in as little as five to seven days, but in all children who are still developing and growing, a conservative approach is best. Additional concussions generally increase the amount of time required for the child to recover, quite easily doubling the amount of rest needed. Child athletes should not return to a sports-related activity until they are able to return to school and participate in other cognitive tasks without any return of symptoms.

In addition, there are risks that can lead to death, including second-impact syndrome, which can occur if a child returns to sport and sustains another injury to the brain prior to completely recovering from the first injury. The long-term effects of concussion, especially multiple concussions in pediatric and adolescent athletes, are unknown. Permanent deficits, however, are seen in upwards of 10 percent to 15 percent of children who suffer even one mild concussion.