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Heads Up

For some, the term concussion conjures an image of an athlete knocked unconscious on the field. But concussions can happen in a variety of ways and often without any loss of consciousness. In fact, of the thousands of children diagnosed with concussions each year, only half are sports-related.

Sometimes called a mild traumatic brain injury, a concussion occurs when a direct blow to the head or body causes the soft tissue of the brain to knock against the skull’s bony surface. Whether they are mild or severe, all concussions can harm the way the brain works. Injuries from motor vehicle crashes, falls, bike accidents and sports are common causes.

According to Dr. Sarah Gaskill, a pediatric neurosurgeon at St. Joseph’s Children’s Hospital, signs of a concussion can develop immediately after an injury or may not appear until days or even weeks later. The most common symptoms are:

  • Headache
  • Nausea and vomiting
  • Changes in vision or hearing
  • Dizziness
  • Sensitivity to light and sound
  • Feeling sluggish or lethargic
  • Sleeping more or less than usual
  • Difficulty falling asleep
  • Trouble remembering events right before or after injury
  • Difficulty concentrating
  • Forgetfulness
  • Confusion
  • More emotional
  • Irritability
  • Sadness or depression
  • Nervousness or anxiety
  • Defiant

“Concussions can have a more serious effect on a developing brain and need to be addressed correctly, Dr. Gaskill notes. “If you suspect your child has a concussion, it’s important to seek medical attention.”

In addition to a physician exam, your child’s physician will likely perform neurocognitive tests that determine how well the brain is functioning. Be sure to call 911 if your child loses consciousness after a head injury or experiences seizures, bloody or clear fluid from ears/nose, bruising under the eyes or behind the ears, slurred speech, repeated vomiting or inability to recognize people or places.

Initial treatment for a concussion is rest, both mental and physical, to allow the brain time to heal. If your child has a concussion, activities that exert the brain or body, including homework, driving, parties and computer use, should be avoided until your physician says it is safe.

“I often tell parents, ‘If your child isn’t bored after a concussion, you’re not doing your job,’ ” says Dr. Gaskill. Besides making symptoms worse, Dr. Gaskill warns that too much physical and mental exertion may place your child at risk for a second concussion.

“Having another concussion before your child has fully recovered from the first one is dangerous. The second injury, even a minor one, can cause brain swelling that increases the chances for paralysis, permanent brain damage or even death.”

To decrease your child’s chance for developing a concussion, St. Joseph’s Children’s Hospital suggests:

  • Use child safety seats and seat belts. Car crashes are a major cause of concussion and other brain injuries for children. When riding in motor vehicles, all occupants should use age-appropriate restraints such as child safety seats, booster seats and seat belts.
  • Require helmet use whenever children ride bikes, skates, scooters or participate in other wheeled activities. Helmet use not only reduces the risk of concussions it also reduces risk for severe brain injury by 88 percent. Enforce a simple rule – wear a helmet or don’t ride! Adults should model proper behavior by wearing a helmet too.
  • Ensure children follow their coach’s rules for safety and the rules of the sport. Encourage them to practice good sportsmanship at all times. Make sure they wear the right protective equipment for their activity. Protective equipment should fit properly, be well-maintained and worn consistently and correctly.
  • If a sport-related concussion occurs, remove the child from the activity and do not return to play until instructed by a medical professional familiar with concussion management. Statistics show that young athletes with a history of concussion are six times more likely to have another concussion.

While most children recover soon, a small percentage may have lingering effects for months to a year later. Be sure to discuss any concern you have regarding your child’s recovery with your physician.

For more information on keeping your kids safe and healthy, visit

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