Elevate Your Health Colorado Concussions in children: Do you know the symptoms?

After a collision while trying to catch a football in the backyard, your 12-year-old son sees stars and feels dizzy. A few minutes pass, and he seems back to normal. But before you put him back in the afternoon pickup game, call a timeout to look for symptoms of a concussion.

““We have started to pay more attention to how we treat children with concussions,” says Christy Barbee, MD, board-certified neurologist with Kaiser Permanente Colorado. “We are using more caution because mild head injuries can have long-lasting cognitive effects, especially in youth and with continued injury.”

The invisible injury

Concussions in children are more common than you might expect. In fact, as many as 3.8 million sports-related concussions occur in the United States each year, according to the Centers for Disease Control and Prevention.

A concussion occurs when the head sustains a blow hard enough to cause the brain to hit the skull. This causes the brain’s nerve fibers to stretch. Some symptoms of a concussion are immediate, while others may not be obvious right away. Symptoms of a concussion include:

• Nausea
• Blurred or double vision
• Disorientation
• Extreme fatigue
• Headaches lasting more than two weeks
• Light or sound sensitivity
• Changes in cognitive abilities and personality
   

“Your child might feel and look fine, but could display subtle symptoms like headache or problems with concentration,” Dr. Barbee notes. “They have a higher risk for cognitive problems and headaches later on if the brain doesn’t have time to recover.”

Diagnosing and treating concussions in children (and adults) can be complicated. CT and MRI scans can sometimes show bleeding or reveal small hemorrhages, but often appear normal with a mild to moderate concussion. Instead, neurologists and many primary care physicians use neurological testing to evaluate whether a concussion has occurred.

The test most widely used to diagnose a concussion is the ImPACT test. This computerized test evaluates attention span, verbal and visual memory, reaction time, and problem solving skills.

According to Dr. Barbee, neurological testing gives parents and physicians a baseline to treat the symptoms of concussion. “Since their brain isn’t fully developed, children seem to have a longer recovery time from head injuries, when compared to adults,” she says. “That’s why it’s so crucial to have the testing done soon after a head injury.”

Parents: Heads up!

What concerns most parents, including Dr. Barbee, who has two active sons, is not knowing when their child can return to their activities. The answer depends on the results of the cognitive testing and the symptoms you observe, she says. 

If a child returns to the game or his or her schoolwork without letting the brain heal, it could impede their learning. “After any head trauma, the brain almost has to reboot,” Dr. Barbee explains. “Lots of rest and gradually reintroducing normal activities is a good approach.”

Dr. Barbee suggests a few ways you can help your child safely recover from a concussion:

• Physical recovery
  Limit physical activity, and work back into activities. “Start with walking for 20 minutes, and let them work their way up to jogging, running, and sports drills as the days to weeks progress. Stop at each step to check for symptoms,” she says.
           
• Mental recovery
  Overstimulating the brain could slow recovery, make the brain more prone to future concussions or cause long-term learning issues. Talk to your child about how they’re feeling, and don’t let them push through headaches or visual problems. Let your child rest and slowly reintroduce schoolwork, reading and even watching television. 
  
  Remember, concussions can cause your child to be more tired or irritable for the first few days. Letting them sleep is good, but you will want to wake them up the first night after the injury every few hours to make sure they are responsive and not showing signs of bleeding or having lucid intervals. If your child has had a normal head CT scan, it is less important to wake them up often. Dr. Barbee explains it is not always necessary to have a head CT if the injury is mild and there are no symptoms. This will be up to you and your doctor to determine.
   

Find more tips on helping your child safely recover from a concussion at kp.org.