Signs of a Concussion in Children
More children are being diagnosed with concussions each year, with multiple factors being attributed to the increase. More children are playing competitive, contact sports at earlier ages. In addition, the media has made people more aware of the associated risks of a concussion. Every parent of a child playing contact sports should be knowledgeable about the signs of concussions and how to prevent and treat them.
What is a Concussion?
A concussion is a traumatic injury to the brain. It is caused by a blow to the head, a fall, jolt or another accident that injures the brain inside the skull. It is not a bruise to the brain, which is called a cerebral contusion. A concussion is an injury which can make a person’s physical, cognitive, and emotional behaviors irregular. The brain is normally protected by fluid that surrounds it, acting like a cushion or shock absorber. But if the head is hit hard or suffers a jolt, the brain can crash into the skull. According to the New York Times, "This can cause brain cells to become depolarized and fire all their neurotransmitters at once in an unhealthy cascade, flooding the brain with chemicals and deadening certain receptors linked to learning and memory."
Signs of a Concussion in Kids
In children, signs of a concussion may be difficult to determine. Just because your child did not pass out, does not mean he didn't sustain a concussion. According to the Mayo Clinic, if your child receives a blow to the head watch for these signs:
- Headache or a feeling of pressure in the head
- Temporary loss of consciousness
- Confusion or feeling as if in a fog
- Amnesia surrounding the traumatic event
- Dizziness or "seeing stars"
- Ringing in the ears
- Nausea or vomiting
- Slurred speech
- Blurry vision
Some concussion symptoms may be apparent after several hours or even days. Be sure to watch for concentration and memory complaints, irritability and feeling more emotional, sensitivity to light and noise, trouble sleeping, and disorders of taste and smell.
When my son had a concussion, his face looked grayish or ash. None of my research noted this particular look, but I have heard from other parents who have witnessed the same look on their child's face after receiving a concussion. My son also had a severe headache, nausea and his pupils were different sizes. He did not have an immediate reaction to light sensitivity, but three days later, he could not tolerate bright light. Each child may react differently. My son was not moody (other than being upset that he was missing a hockey tournament) but he was exhausted for about two weeks,
As a parent, it is imperative to know the signs of a concussion and discuss them with your child. A concussion is serious; your child must be honest with you. Their future health depends on it.
Talk to Your Child About Concussions
When to See a Doctor for a Head Injury
According to the Mayo Clinic, if any of the following symptoms occur, seek emergency medical treatment:
- A headache that gets worse over time
- Changes in behavior, including irritability or fussiness
- Changes in physical coordination, including stumbling or clumsiness
- Confusion or disorientation
- Slurred speech or other changes in speech
- Vision or eye disturbances, including pupils that are bigger than normal (dilated pupils) or pupils of unequal sizes
- Changes in breathing pattern
- Lasting or recurrent dizziness
- Blood or fluid discharge from the nose or ears
Unless immediate medical attention is required, have your young athlete see a doctor within two days of sustaining any head injury. If you are unclear based on your child's symptoms, call your doctor. It is imperative that your child not return to play until being cleared by a physician, preferably trained in concussion care.
How to Treat a Concussion
When a player sustains a concussion, he should be restricted from all physical activity until he is completely symptom free. Physical exercise can worsen the symptoms. In addition, it is imperative not to risk sustaining another concussion while the brain is still healing from the current one. Mental exertion should be avoided as well--including video games, reading, homework, watching TV and using a computer. Anything that tires the brain should be minimized. The brain needs time and rest to heal. Your doctor will provide guidelines to this based on your child's condition.
Most symptoms of a concussion go away in seven to ten days, although some athletes may take weeks or even months to recover. A repeat concussion that occurs before the brain recovers from the first—usually within a short time period (hours, days, weeks)—can slow recovery or increase the chances for long-term problems. It is imperative to allow the brain to completely heal before risking the chance of a subsequent injury. Research in the last decade clearly indicates concussions can have long-term effects on the brain.
Can Mouthgaurds Prevent Concussions?
No, there is no scientific evidence to suggest that mouthguards play any role in preventing head trauma. The role of a mouthguard is to protect the face and dental structure.
Caution for Concussion Baseline Testing
In order for baseline concussion tests to be accurate, they must be performed by a trained health professional in a quiet test environment. Many sports organizations are offering free baseline testing to teams through the cooperation of entrepreneurial health professionals. Performing tests on multiple kids at one time in a crowded environment is not conducive of an accurate test. Also, keep in mind that if your child suffers a concussion, you will want to have him treated by a doctor located convenient to you, who hopefully knows your child. If the baseline test your child took resides at a doctor's office that you do not typically go to, it will not do you any good.
Are There Ways to Prevent a Concussion?
In sports, especially high impact, contact sports, there is nothing you can do to prevent a concussion for your child, short of not playing the sport. However, there are things you can do to minimize the risk.
Purchase a Good Helmet
Regardless of the sport, the helmet is the most important piece of sports gear you can buy for your athlete. Concussions in prepubescent children can have longer lasting effects, so make sure to get a good fitting helmet. When purchasing a helmet, have an expert assist you in obtaining the proper fit and selection of brand of helmet. For ice hockey, Cascade Sports uses a patented Seven Technology that has been tested for maximum compression performance.
In hockey, once a player has incurred a concussion, the helmet should be replaced. A helmet can only absorb so many hits before it starts losing its effectiveness. However, each sport has a different type of helmet that is designed specifically for that sport. Take the time to do research before you go to the store to purchase a helmet. Ratings for football helmets can be found at http://www.sbes.vt.edu through the National Impact Database.
Know Your Sport
One way to minimize a child's risk of a concussion is to have the proper coaching to teach kids the right, safe way to play the sport. In hockey, players need to be taught the correct way to give a body check as well as how to best position themselves to receive one. Ditto for football--learn how to give a tackle with your shoulder, not your head. It's true for any sport, make sure your child has a coach who is able to teach the basic fundamentals to lessen injury.
Strengthen Neck Muscles
Additional research needs to be done, but initial studies from West Virginia University's Neurosurgery Department are finding that stronger neck muscles may help reduce the risk of damage from a concussion. In theory, having stronger neck muscles can reduce the amount the head moves when it is impacted.
Concussion Baseline Testing
Many sports medicine doctors are advocating for baseline concussion testing. This exam uses a series of tests to assess an athlete’s balance and brain function including motor skills, reaction time, memory and impulse control. It also tests for the presence of any head trauma symptoms. If a doctor has access to child's baseline test, then should that child incur a head injury, the doctor will be able to more accurately diagnose the level of the concussion. A baseline test is ideally performed in the off-season.
Download a Concussion App
- App Store - Concussion Recognition & Response: Coach & Pare...
The Concussion Recognition & Response™ app is a new tool that helps coaches and parents recognize whether an individual is exhibiting/reporting the signs and symptoms of a suspected concussion.
A Concussion App for Smart Phones
Many youth hockey organizations are trying to be proactive to reduce head trauma in their leagues Raleigh Youth Hockey Association (RYHA) provides each coach in the league with an app for their smart phone. The Concussion Recognition & Response™ app is a new tool that helps coaches on the bench readily determine whether a player is exhibiting signs and symptoms of a concussion. The app allows a coach to access, in less than five minutes, a player's condition to determine if immediate medical attention is necessary and whether to remove the child from further play.
Do You Think Body Checking Should be Allowed for Hockey Players Younger Than 14?
High Risk Sports for a Concussion
Among high school athletes, football is the sport with the highest amount of concussions for males; for females, it is soccer. Other contact sports such as lacrosse and ice hockey have high concussion rates as well, but since they are mainly club sports, they do not have the same reporting standards. There is minimal data reported on middle school athletes. According to the Sports Concussion Institute, five to ten percent of athletes will experience a concussion in any given sport.
The New York Times: Head Injuries in Football, 8/14/12: http://topics.nytimes.com/top/reference/timestopics/subjects/f/football/head_injuries/index.html
The Mayo Clinic: http://www.mayoclinic.com/health/concussion
The Concussion Institute: http://concussiontreatment.com
Concussions are Serious Business
Gone are the days of brushing off a bump to the head and hearing, "He had his bell rung." Parents must be wise in their assessment of a child's injury and seek medical advice. My son's hockey coaches have always been quite responsible in removing a child from play if there is a suspected head injury--sometimes more than the parents. Why risk a child's future health for a youth sport? Be smart--take a concussion seriously.