Conditions & Treatments
- A to Z Guide

Concussions

Disease Information

Treatment & Care

What are the treatment options for a concussion?

Rest
The main part of any concussion treatment plan is rest – both physical and mental. Rest allows the brain to heal and gradually return to its normal level of function.

This means, for the time duration specified by her doctor, your child must:

remain quiet, undisturbed and stress-free
get plenty of sleep
stay away from the computer (avoid video games and marathon text-messaging sessions!)
(if applicable) avoid driving cars, riding bicycles or ATVs, or operating any type of machinery

Depending on the severity of her symptoms, your child may need to stay home from school for a few days. (Most children and teens will start to feel better within a couple of days, and nearly all will make a full recovery within a month – but some will take longer.) She should not read or do homework, as well as anything else calling for intense concentration, until given permission by her doctor.

If your child plays sports, she will be taken out of practice and games for a designated period of time (and she will have to sit out phys. ed. class and recreational exercise, too). Only when her doctor has examined her and given her the “all clear” should she resume her normal school, home and sports routines. Read more in our “Returning to sports” section below.

Medication
Although no medication can “cure” a concussion, your child’s doctor may prescribe medication to help manage her symptoms, such as headaches or difficulty sleeping.

Always follow the exact dosages and instructions you are given. If you have questions about any medication, or are concerned that your child may be experiencing side effects, never hesitate to call or see your doctor right away.

Complications

The most common complication of a concussion is a delayed or lengthy recovery. If your child's symptoms aren't getting any better after the first few days – or if they are becoming worse – he should see a doctor.

Rarely, a child with a concussion will experience serious complications.You should seek immediate emergency care if your child:

has blood or fluid coming out of her nose or ears
shows symptoms of a seizure
loses consciousness for several minutes
has worsening headaches
vomits repeatedly
experiences breathing difficulty
has trouble walking or standing
experiences a change in pupil size (one is bigger than the other, or both are abnormally enlarged)
starts slurring her speech or experiencing difficulty speaking
develops noticeable bruising or a large bump anywhere on her head

Returning to sports

If your child is involved in sports, it’s essential that she not resume practice or play until her symptoms have resolved, balance has been re-established and her pre-concussion brain functions have been restored. Doctors can assess her brain functions at multiple stages of recovery with neurocognitive testing, like the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) system used here at Children’s Hospital Boston.

Returning to sports after a concussion is a gradual process that takes place over a series of steps, and should always be directed and observed closely by your child’s doctor. The process typically looks something like this:

1. A period of absolute rest from any and all physical activity, until all concussion symptoms have disappeared. (This may take anywhere from a few days to several weeks, depending on your child’s individual symptoms and circumstances.)

2. Clearance to start light aerobic activity, such as walking or riding an exercise bike.

3. Clearance to resume warm-up activities related to the child’s sport (for example, jogging on a training track or swimming laps).

4. Clearance to take part in non-contact training drills.

5. Clearance to resume resistance training, gradually upping the level of difficulty with each session.

6. Clearance to return to full-contact training/practice. This can only begin after a doctor has deemed it safe.

7. Clearance to take part in games or meets.

If concussion symptoms re-emerge at any time during any of the steps, your child should see her doctor immediately. She may need to go back to the previous step (or several previous steps) until symptoms subside and her doctor gives the OK.

It’s critical that your child not rush to get back to the playing field before her brain has healed; returning too soon will increase her risk of suffering another concussion. And although second impact syndrome – caused by a concussion sustained while the brain is still recovering from a prior concussion – is rare, it can be life-threatening. Your student-athlete is undoubtedly passionate about her sport and her teammates … but nothing is more important than protecting her health.

Caution and patience are vital, and you are your child’s greatest advocate as she progresses in her healing. If your child’s coach, trainer or fellow athletes are pressuring her to return to play, refer them to the Centers for Disease Control (CDC) website on concussion, or remind them of Massachusetts State Law, which prohibits the return to athletics after a concussion until written clearance from a doctor has been obtained.

Monitoring and follow-up

How often your child will need to see his doctor for follow-up care after recovering from a concussion – and how long he will need to be monitored – depends on his individual circumstances (such as his age, the severity of his concussion, whether he plays sports) and the exact symptoms he experienced.

Some children will need only standard annual check-ups, while others may require ongoing assessments and neuropsychological testing. Ask your doctor for detailed follow-up recommendations.

Are concussions an “invisible epidemic”?
Recent news headlines have people asking if testing for a concussion can involve equipment as simple as a hockey puck. Read more.

Coping and support

In addition to the clinical information provided on this webpage, Children’s offers several other resources designed to give your child and family comfort, support and guidance.

Resources at Children’s Hospital Boston

Children’s Center for Families is dedicated to helping families locate the information and resources they need to better understand their child’s particular condition and take part in their care. All patients, families and health professionals are welcome to use the center’s services at no extra cost. The Center for Families is open Monday through Friday from 8 a.m. to 7 p.m., and on Saturdays from 9 a.m. to 1 p.m. Please call 617-355-6279 for more information.
Children’s Behavioral Medicine Clinic helps children who are being treated on an outpatient basis at the hospital—as well as their families—understand and cope with their feelings about:
- being sick
- facing uncomfortable procedures
- handling pain
- taking medication
- preparing for surgery
- changes in friendships and family relationships
- managing school while dealing with an illness
The Experience Journal was designed by Children’s psychiatrist-in-chief, David DeMaso, MD, and members of his team. This online collection features thoughts, reflections and advice from kids and caregivers about living with a variety of medical conditions, the “befores” and “afters” of surgery and going through many other medical experiences.
Children’s Department of Psychiatry offers a free booklet, “Helping Your Child with Medical Experiences: A Practical Parent Guide.” (Adobe Acrobat required to view and download) Topics in the booklet include:
- talking to your child about her condition
- preparing for surgery and hospitalization
- supporting siblings
- taking care of yourself during your child’s illness
- adjusting to life after treatment
The Children’s chaplaincy is a source of spiritual support for parents and family members. Our program includes nearly a dozen clergy members—representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions—who will listen to you, pray with you and help you observe your own faith practices during your child’s treatment.
Children's International Center is a resource for patients and families from countries outside the United States. The center can provide assistance with everything from reviewing medical records to setting up appointments and locating lodging. Contact the center by phone at 01-617-355-5209 or via e-mail at international.center@childrens.harvard.edu.

General guide for patients and families
Read our guide to essential information across the hospital.

Helpful links

Please note that neither Children’s Hospital Boston, the Department of Neurology nor the Division of Sports Medicine at Children’s unreservedly endorses all of the information found at the sites listed below. These links are provided as a resource.