What every parent should know about concussions

A concussion is a mild traumatic brain injury caused by a blow to the head or a hit to the body.

Although the brain is cushioned by fluid, a strong force can cause it to twist or hit the inner walls of the skull. The impact can stretch nerve fibers in the brain and trigger a chain of chemical changes that lead to concussion symptoms.

Concussions are serious injuries, but unlike an illness or broken bone, they can be challenging to detect. Young children may struggle to explain their symptoms, and older kids, especially athletes, may be inclined to dismiss them.

Why children experience concussions differently

It’s important to know that even a mild hit can be serious, especially for children whose brains are still developing. Some kids are more likely to have trouble, such as those who have had prior concussions or those who have learning problems, mental health issues or neurological conditions.

Recognizing childhood concussion symptoms

After a concussion, symptoms can feel unpredictable — and that’s normal. They’re often strongest a day or two after the injury, and they can shift as healing begins. Every child’s experience is different, and age plays a big role in recovery.

When a kid has a concussion, symptoms can show up in different ways: physically, mentally, emotionally and even in how they sleep.

Physical symptoms:

• sensitivity to light or noise
• dizziness or balance issues
• headaches or nausea

Mental symptoms:

• trouble concentrating
• feeling foggy or slowed down
• memory problems

Emotional symptoms:

• irritability or mood swings
• anxiety or nervousness
• sadness or emotional feelings

Sleep-related symptoms:

• sleeping more or less than usual
• trouble falling asleep
• feeling unusually tired

Commonly reported signs

Common signs of concussion in school-aged athletes include appearing dazed, stunned or confused about what’s happening around them. They may appear clumsy and respond slowly to questions and commands. A brief loss of consciousness is also a warning sign of a concussion.

Delayed effects of concussion

Concussion signs and symptoms may not show up right away. They can take hours or days to appear or be noticed.

As a parent or caregiver, you know what's normal for your child and what's not. Watch for changes in how they act or feel. If symptoms worsen, contact their health care provider.

What to do after a suspected concussion

All U.S. states now mandate immediate removal from playing organized sports when a concussion is suspected. Minnesota, Wisconsin and other states also require clearance from a healthcare provider before returning to activity after a concussion diagnosis.

Immediate actions to take

If you suspect your child has suffered a concussion, remove them from play and get a medical evaluation. Monitor them closely for new or worsening symptoms of concussion. Avoid giving aspirin or ibuprofen in the first 24 hours, since they can mask some symptoms and/or create a risk for bleeding in the brain.

When to seek immediate medical attention

Call 911 or go to your nearest emergency department if you notice any of the following danger signs following a blow or jolt to the head:

• loss of consciousness or seizures
• severe or worsening headache
• repeated vomiting or slurred speech
• confusion or inability to recognize people and places
• vision changes or unequal pupils

Should a child sleep after hitting their head?

Rest is essential for recovery, and sleep plays a crucial role in helping the brain heal. Generally, it’s okay for a teen with a mild concussion to sleep — if symptoms aren’t worsening.

Before your child goes to bed, check that their symptoms aren’t getting worse and that there are no warning signs. If you're unsure about letting them sleep, call your child’s doctor for advice.

Guiding children through recovery

Concussion treatment requires rest and rehabilitation. If your child has a concussion, help them rest — both physically and mentally. Keep them away from rough play, limit screen time and follow their health care provider’s instructions.

Ease them back into school and other activities. Encourage them to be patient and remind them that returning to routines too soon can increase the risk of future problems.

How long does it take to recover from a concussion?

Typically, children require at least a few days of rest following a concussion, followed by a gradual return to school, work, and sports. A child’s medical history — including whether they’ve had concussions before or if they have other medical problems — can also affect how long it takes to feel better. It takes most children and teens a few months to fully recover.

An athlete’s recovery plan is best developed in collaboration with their physician or concussion specialist, who has the experience and training to diagnose, manage and treat sports concussions.

Long-term effects of childhood concussion

Concussions can affect children differently from adults because they can impact the brain during key developmental periods, which can alter developmental trajectories over time. Although most children recover well physically, some may experience changes in behavior and cognition that are not immediately recognized.

Can a childhood concussion have an impact even later in life?

A history of concussions increases the chance for a longer recovery, as does a blow to the head that creates several symptoms. A child with multiple concussions also has a greater chance of experiencing chronic health problems later in life.

Some people develop persistent, post-concussive symptoms, such as headaches, dizziness and memory issues, which can last for months or even years. Such symptoms should be evaluated by a health care provider with experience in concussion management.

Concussion prevention

A helmet is essential for reducing the risk of a serious brain injury or skull fracture while bicycling, skateboarding, skiing, snowboarding, riding a scooter or participating in contact sports like tackle football.

Ensure your child always wears the correct helmet for their activity and that it fits properly. Replace helmets that have been damaged. Be cautious of a product that may overstate injury-prevention benefits, such as a claim that it can prevent all concussions.

Talk to your child before the issue comes up about the seriousness of concussions and the need for treatment if one happens.

Baseline testing

Baseline concussion testing can help families and doctors better understand and track concussions. Screening, including one called ImPACT testing (Immediate Post-concussion Assessment and Cognitive Testing), assesses brain function before a head injury occurs.

The test measures several things, including:

• attention span
• working memory
• sustained and selective attention time
• non-verbal problem solving
• reaction time

If a concussion happens, the same test can be administered again. The results from the two tests can be compared to determine the extent of an injury.