Concussions

What is a concussion?

A concussion is a type of traumatic brain injury caused by a rapid acceleration of the brain. Concussions are often the result of a direct hit to the head but can also result from any blow to neck, face or body that places a rotational force on the brain. The symptoms, which include headaches and trouble with concentration, memory and balance, are usually temporary.

You’ve probably heard about athletes having a concussion and needing to sit out a game or even the rest of the season. But concussions happen to plenty of non-athletes, too. In fact, millions of children have a concussion each year. Most children recover completely within several weeks. 

How worried should parents be about concussions?

If you think your child may have suffered a concussion, it’s important to seek treatment right away. Even if the injury or symptoms seem minor, they need to be checked by a doctor. Most concussions don’t cause a loss of consciousness. In some cases, a child who seems fine at first will develop symptoms later. 

If your child has any of the following symptoms, seek emergency care right away:
blood or fluid coming out of their nose or ears
symptoms of a seizure
lost consciousness (passing out)
worsening headaches
repeated vomiting
trouble breathing 
trouble walking or standing
a change in pupil size (one is bigger than the other, or both are unusually large)
slurring words or trouble speaking
noticeable bruising or a large bump anywhere on the head

Most kids, if their concussions are managed properly and they avoid risky situations until they’ve fully recovered, will be fine. Typically, children fully recover from sports-related concussions within 10 days. Most regain normal brain function and do just as well in school and at sports as before. However, some patients take months to recover completely. Children who get a second concussion before fully recovering from the first are at risk for serious, long-term problems.

What are the long-term problems of a concussion?

The most common long-term problem is delayed or incomplete recovery. This can happen after multiple concussions, or when a child has another concussion before fully recovering from a previous one. In some cases, repeated concussions can cause massive brain swelling and permanent brain damage. Such cases are extremely rare, however.

Recently, something called chronic traumatic encephalopathy (CTE) has been described in pro athletes, like wrestlers and football players. After multiple concussions, they went on to have serious depression and struggle with memory and basic activities of daily living. Boston Children’s Hospital is leading a 5-year study of former NFL football players that aims to shed light on the long-term neurological health of these players. We believe, this study will help us develop better treatment and prevention methods for athletes of all ages. 

Who is at the greatest risk for long-term problems after a concussion?

People who have already sustained a concussion are at greater risk for subsequent concussions. The effects are likely to accumulate, in other words, each concussion causes more severe symptoms and requires longer recovery times.

If your child has just one concussion, you probably won't see a change in their physical or intellectual abilities. If they have multiple concussions, the risk for long-term changes increases. Every child is different, however, and there is no way to know when any given child will experience long-term effects. Some children have five or six concussions with no measurable long-term change in their abilities. 

How we care for concussions

The clinicians and researchers at Boston Children’s are leaders in the field of concussion prevention and treatment and play an instrumental role in setting treatment guidelines that hospitals and clinics around the country use with their patients.

Our Brain Injury Center provides comprehensive care for children and adolescents with concussions and any other type of head or brain injury. Our Sports Concussion Clinic treats sports-related concussions and works with parents, athletes and coaches to ensure safe return to play. 

We collaborate regularly with our clinical experts in sports medicine, neuropsychology, neurology and neuroradiology. Whether a concussion is the result of an accident, fall or sports injury, our experts are fully equipped to assist your child every step of the way.