Concussion in children: Warning signs, protocol, and treatment

A survey published in 2017, looking at more than 13,000 adolescents in the United States, found that almost one-fifth reported having had a concussion at least once.

In this article, we will look at the warning signs and how to spot concussion in a child, plus what to do if you think a child has concussion.

What is concussion?

Concussion is a type of brain injury that happens when a blow to the head or body causes the brain to move in its surrounding fluid.

The brain can twist or knock against the skull, temporarily affecting how a child thinks and acts.

Concussion is a mild form of traumatic brain injury or TBI.

Signs and symptoms of concussion in children

It may not be a hard hit that causes a concussion. In most cases, the child does not lose consciousness.

Signs of concussion may not be obvious. They can be physical such as a headache, but may also show in the way the child acts or feels.

People should look for the following warning signs of concussion in children:

  • headache
  • sleepiness
  • feeling like they are in a fog
  • feeling sick or vomiting
  • sensitivity to noise or light
  • seeming irritable
  • sleeping more or less than usual
  • feeling depressed or sad
  • feeling dizzy or having problems with balance
  • unable to think properly or concentrate

The signs of concussion do not necessarily develop right after impact. Some can take hours or even days to appear. Parents and caregivers must, therefore, keep a watchful eye on the child for some time after they hit their head.

The child or teen may not always be aware of their symptoms, and so adults need to watch for signs that the child may not report.

When checking for signs of concussion, people can ask questions, such as, does the child:

  • seem confused or dazed
  • struggle to answer questions
  • have no memory of what happened before or after the knock
  • move clumsily
  • remember the score or the game if injured during sport

Concussion in babies and toddlers

Babies and very young children may not be able to tell you what is wrong. As well as all of the signs above, people should also watch for a young child who is:

  • unable or unwilling to nurse or eat
  • crying and will not be comforted
  • losing interest in toys
  • losing new skills, such as toilet training

What people do at home to help a child recover from concussion is vital. Steps to take include:

  • make sure the child has physical rest and avoids sports or physical activity.
  • allow the child to rest mentally, too. They should not do anything that needs a lot of concentration, such as school work. Limit their screen time, such as video games and television.

Many children experience disturbed sleep after a concussion. They may sleep more than usual or find it hard to fall asleep or to sleep through the night. Caregivers can help by:

  • removing distractions from the bedroom
  • encouraging regular sleep routines, with no sleepovers or late nights

Headaches are the most common problem after a concussion. Simple analgesics can help, but people should check with their doctor.

How can a child’s school help?

The child’s school can help by:

  • providing rest breaks during or between classes
  • allowing a shorter school day
  • giving more time for homework and assignments
  • postponing tests
  • providing a quiet area if a child is sensitive to noise

After a few days of rest, the child can gradually return to their usual activities. Typically, they should not return to sports or vigorous physical activity until they have no symptoms at rest.

Any child or adult can have a concussion, though some groups are more likely to experience concussion than others, and for various reasons.

According to the Centers for Disease Control and Prevention (CDC), falls are the most likely cause of TBI diagnosed in the emergency room in infants aged 4 years and under.

Children aged 5–14 years old are prone to TBI from both falling and being struck by something or against something.

Young athletes seem to face an exceptionally high risk of concussion, especially those playing certain sports, including women’s soccer, football, basketball, and ice hockey.

Dangers of another concussion

Many states have concussion laws preventing people from returning to sports until doctors have given them medical clearance.

Children are at greater risk of receiving another injury to the brain during the period after a concussion.

The brain is particularly vulnerable during childhood and adolescence. A second concussion during this period is much more dangerous than the first. Chemical changes in the brain make it more sensitive to stress or another injury while it is recovering.

Outlook

Most children will recover fully from a concussion. But for some, the effects can be serious and long-lasting.

The risk of severe complications is why people should always take a concussion in a child or teenager seriously, and the more adults who are aware of the signs, the better.

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