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Children and Concussions

A concussion is a brain injury that can temporarily impair normal brain function. The severity of a concussion can range from mild to severe.

What causes concussions? Normally, the brain floats within the skull, surrounded by a protective cushioning of spinal fluid. While the skull protects the brain from injury, it cannot absorb the full force of a traumatic impact.

Any sudden blow to the head, or even a rapid deceleration when driving, can cause a concussion. As the brain bounces against the inner wall of the skull, blood vessels can be torn, nerve fibers can be stretched and the brain can be bruised. Each of these can lead to bleeding and swelling within the skull.

Symptoms of Concussion

Early symptoms of a concussion include headache, dizziness, disorientation, changes in memory or concentration, tiredness, nausea and vomiting.

Persistent symptoms include a headache that won't go away (even with acetaminophen), memory and concentration problems, poor attention span, intolerance to light or loud noises, ringing in the ears, depression and irritability.

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It is often assumed that concussions involve a loss of consciousness. However, this is not true. In most cases, a person who suffers a concussion never loses consciousness.

Even with a mild concussion it's possible to have symptoms. A week after suffering a concussion, a person can be sensitive to light, or be irritable or anxious about things that didn't cause anxiety before.

When to Seek Treatment for Your Child's Concussion

When seeking treatment for concussion, it is important not to overreact or under-react. If you are unsure whether your child requires medical care for symptoms mentioned above, you should call your pediatrician or take your child to the emergency department.

Early symptoms that do not go away — or a blow to the head that results in loss of consciousness for more than a few seconds — should be evaluated by a physician, either in the physician's office or the emergency department. Further, persistent symptoms that show up later also should be evaluated by a medical professional.

In fact, the American Academy of Pediatrics (AAP) recommends that you call your pediatrician for advice if your child receives anything more than a light bump on the head. Learn more about seeking treatment for head injuries on the AAP's web site.

Young Children and Concussions

Because infants and toddlers cannot communicate how they feel, concussions can be challenging to diagnose for the youngest children. If you suspect that your young child has had a concussion, look for the following nonverbal clues:

  • Listlessness and becoming tired easily.
  • Unusual irritability and crankiness.
  • Changes in eating or sleeping habits.
  • Loss of interest in favorite toys.
  • Inability to maintain balance when walking.

It is important to remember that children may be sleepy because they have exhausted themselves crying. Even so, they will be easy to arouse. Seek medical attention if your child will not awaken easily or if he or she seems disoriented, or acts inappropriately when awake.

Treatment for Concussion: Taking It Easy

Overall, the best treatment for concussion is rest. Physicians recommend taking a respite from all physical and mental activity — as well as monitoring for new symptoms — for at least two weeks following a concussion. Suffering another injury before the first injury heals can set a person up for a lengthier recovery and more problems in the future.

To evaluate a head injury, physicians today are less likely to order a CT scan for mild concussions with no loss of consciousness, no nausea and no vomiting, especially in young children. Certainly, a CT scan will be ordered if it is necessary. However, lifelong exposure to radiation must be considered, as well.

Life After Concussion

Recovery guidelines have changed significantly in recent years. In sports, it once was common for coaches to rush injured players back into the game. Likewise, it was recommended to wake a person every two hours after a concussion, and not let them sleep. Neither should be practiced today.

The care in the weeks following a concussion is so important that both John C. Lincoln Deer Valley Hospital and North Mountain Hospital provide patients with an extensive packet of information on mild and traumatic brain injuries and work with organizations, such as the Brain Injury Association of Arizona, to provide support and help for patients.

Thankfully, most people do not have any long-term effects from concussion, especially when recovery recommendations are followed.

The Importance of Prevention

Each year in Arizona, more than 35,000 adults and children visit the emergency department for brain injuries, including concussions, according to the Arizona Department of Health Services. Approximately 5,000 of these persons are hospitalized.

The majority of these visits are caused by unintentional accidents — a fall, collision, sports injury or something falling on the head, such as furniture, during a move. Although everyone is at risk, toddlers, teen boys, seniors and military professionals are most vulnerable.

Most of these accidents are predictable and preventable. Simply being aware of your environment is the first step to prevention.

Preventing Brain Injuries

The Brain Injury Association of Arizona offers these tips for preventing concussions and other brain injuries:

  • Always use a seatbelt.
  • Use age-appropriate car seats for infants, toddlers and preschoolers. Read about John C. Lincoln Hospitals' child safety seat program.
  • Protect playground surfaces with sand, rubber or woodchips.
  • Be aware of the environment to reduce risk of falls, particularly for toddlers and for the elderly.
  • Wear a helmet on anything with wheels, even in hot weather, and for sports such as football.