Concussions | Symptoms & Causes
What causes concussions?
Children can get concussions from any hard hit to the head, neck, face, or body that cause a rapid acceleration of the brain. This typically happens when they are struck in the head. It can also occur if an athlete is hit on the facemask or chest, causing the head to snap forward or backward.
Some of the most common causes of concussion in children include:
- falls
- sports injuries
- motor vehicle accidents
- being hit by an object or another person
Is it possible to reduce a child’s risk of concussion?
The most important way parents and athletes can prevent serious injury from a concussion is to allow time for proper recovery. If your child has had a concussion, it is important to follow their doctor’s recommendation for when it is safe to return to vigorous exercise or other high-impact situations. In addition, neck-strengthening exercises can help keep an athlete’s head from snapping backward or forward during impact and reduce the chance of sports concussions.
Do helmets prevent sports concussions?
Helmets are not designed to prevent concussions. They are made to prevent catastrophic brain injury, which they're very effective at. Every athlete who plays football should have a new, properly fitted, undamaged helmet. But parents and athletes should understand that this will not decrease the risk of concussion.
Mouth guards have been proposed as a way to decrease the risk of concussion, but they don't help either. Mouthguards are an important way to prevent facial trauma during some sports, but they will not reduce the risk of concussion.
What are the symptoms of a concussion?
Most children and young athletes don't recognize their symptoms as a concussion. Parents can look for signs, like their child being slow to respond verbally, being off-balance and looking spaced-out or glassy-eyed. The bottom line is if you suspect your child has a concussion, take them to see a doctor. It's critical that patients are evaluated after sustaining a concussion.
Possible signs and symptoms of concussion include:
- being slow to respond
- headache
- changes in sleep habits, such as sleeping more or less than usual
- changes in play habits
- dizziness
- fatigue
- trouble concentrating, remembering, or paying attention
- changes in eating habits
- persistent crying or crankiness
If your child has any of the following symptoms after a fall or hit, seek emergency care right away:
- trouble with balance or walking
- excessive vomiting
- slurred speech
- extreme tiredness or trouble being awakened
- seizures or convulsions
- loss of consciousness (passing out) for longer than 1 minute
- one pupil (black center of the eye) is larger than the other
- problems with balance or coordination
How do I know if my child needs to see a specialist?
Some children with a concussion need more specialized treatment. If your child is not getting better or is feeling worse after a few days, you should ask for a referral to a specialist.
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.
Concussions | Diagnosis & Treatments
How is a concussion diagnosed?
There’s no way to see a concussion so, doctors look for signs of injury to brain function. The doctor will examine your child and take a full medical history. They may also check your child’s balance, coordination, and ability to think and process certain types of information. Your child may also need other tests depending on their symptoms.
What is baseline testing?
A baseline test can measure your child’s normal brain function and balance before any injury. This baseline measure can then be used as a comparison to help diagnose a concussion after an injury. For example, the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) test creates a record of a child’s physical and mental abilities. In the case of a concussion, this helps doctors track the child’s progress and back to their previous abilities.
We recommend that all student athletes, especially those who play high-impact sports like ice hockey, football, rugby, and soccer, get baseline testing before the start of the season.
How are concussions treated?
The most important treatment for a concussion is physical and mental rest. This gives the body a break from moving and thinking, so the brain can heal. Depending on your child’s symptoms, they may need to stay home from school for a few days.
Physical and mental rest includes:
- getting plenty of sleep
- taking a break from the computer, phone, and reading
- keeping stress levels low
- modified or no homework
- no contact or collision sports, limited physical activity, and/or no gym class
- for older teens, no driving or operating any type of machinery
- Doing too much before the brain has fully healed can slow recovery. Your child’s doctor will tell you when it’s safe for your child to resume normal school, home, and sports routines.
Returning to sports after concussion
It's very important that a child with a sports concussion not return to sports until they have regained normal brain function. A second concussion is more likely and can have a more serious long-term impact.
Returning to sports after a concussion is a gradual process that involves a series of steps. Your child’s doctor will explain the specific steps for your child’s recovery, but they usually include:
- A period of total rest from 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 symptoms.
- Clearance to start light aerobic activity, such as walking or riding an exercise bike.
- Clearance to resume warm-up activities related to the child's sport (for example, jogging on a training track or swimming laps).
- Clearance to take part in non-contact training drills.
- Clearance to resume resistance training, gradually upping the level of difficulty with each session.
- Clearance to return to full-contact training/practice. This can only begin after your child’s doctor has deemed it safe.
- Clearance to take part in games or meets.
If concussion symptoms start again, your child should see the doctor right away. They may need to go back to the previous step (or several previous steps) until the symptoms go away and the doctor gives the OK to move forward. Don’t let your child's coach, trainer, or fellow athletes pressure them to returning to play too soon.
Medication
Although no medication can “cure” a concussion, your child's doctor may prescribe medication to manage symptoms such as headaches or trouble sleeping. If you have questions about any medication or are concerned about side effects, call or see your doctor right away.
Follow-up care after concussion
How often your child will need to see the doctor for follow-up care depends on your child’s specific injury and symptoms. Some children need only annual check-ups, while others may require ongoing assessments and testing. Ask your doctor for a detailed follow-up plan.
What to expect after a concussion (patient education brochure)
