Concussions The Children's Medical Center of Dayton (page 1 of 2) Page 1 of 2

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A concussion is a head injury that happens most often to children. Young children's head sizes are disproportionately large compared to the rest of their body. As children reach adolescence, they experience rapid height and weight growth. Both of these factors make children more prone to accidents than adults.

A concussion or closed head injury may be caused by a sudden fall, jolt or blow to the head. According to the National Dissemination Center for Children with Disabilities, concussions happen to one million children each year. More than 30,000 of these children incur long-term disabilities as a result of this brain injury.

New research regarding concussions

Although concussions previously were thought to be trivial brain injuries, recent scientific studies have demonstrated that even the most minor concussion can produce serious negative effects on an athlete's concentration, memory, reaction time and emotions, says Laurence Kleiner, MD, a pediatric neurosurgeon at The Children's Medical Center of Dayton.

Concussions are often the result of:

• Motor vehicle accidents
• Cycling
• Skates, skateboarding, scooters
• Sports: football, soccer, boxing or any contact sport
• Falling
• Violence

A concussion may or may not involve a loss of consciousness and/or amnesia. The child usually is awake, disoriented or confused and may have a headache, nausea and vomiting. The symptoms of a concussion may last days, weeks or longer.

When a concussion happens to a child

An adult should stay with the child for the first 24 hours, monitoring changes in vision, headaches, nausea, vomiting, drowsiness, loss of memory or dizziness.

Brain tests (scans) can work to determine the severity of a concussion, but many times they do not show signs of concussions, so it is important to observe the child's behavior after an injury.

Do not give medications to the child without consulting a physician first (avoid aspirin as it may cause bleeding).

Watch for:

• Confusion or if the child is easily distracted and cannot do normal activities
• Stares blankly
• Delayed answering of questions
• Slurred speech
• Stumbling or clumsiness, uncoordinated or cannot walk a straight line
• Cries very easily or becomes angry easily or exhibits extreme emotions
• Problem with memory, repeats self, repeatedly asks questions, unable to recall words or objects
• Loss of consciousness

Other symptoms of a concussion:

• Confusion
• Loss of memory about accident
• Headache
• Nausea
• Difficulty with memory
• Slowed thinking
• Tiredness
• Change in sleep
• Unbalanced
• Dizziness
• Ringing in ears
• Increased sensitivity to light or sounds
• Mood changes — sad, irritable, non-motivated
• Blurred vision
• Ringing in ears

Call the doctor or EMT immediately if any of following symptoms appear:

• A headache that will not go away and is severe
• Not waking up; very sleepy
• Seizure
• Repeated vomiting
• Personality change
• Loss of coordination
• Weakness in arms or legs
• Ringing in ears
• Blurred vision
• Sensitivity to loud noises or bright lights

Younger children may have difficulty communicating how they are feeling. Watch for:

• Listlessness, being overly tired
• Irritability
• Change in sleep or eating patterns
• Change in play
• Change in their school performance (a sudden decline in grades or disruption in school)
• Not interested in toys
• Unsteady walking
• Losing newly learned skills — eg, potty training, reading

Contact your child's physician if you notice any of these symptoms.

Sports and concussions

Children who are involved in sports frequently are victims of concussions. Many of these children continue to play and experience repeat concussions.

"Concussions are a widely recognized sports injury, but they are more common — and subtle — than people might think," says Dr. Kleiner.

Concussions happen frequently among athletes, especially those engaged in contact sports such as football, hockey, rugby, soccer and lacrosse. The incidence of concussion ranges from 10 percent to 50 percent of participants per year. The risk of a repeat concussion is as high as 50 percent per season.

In addition to playing organized sports, active children also are at risk for concussions during recreational activities that include skateboarding, biking and skating.

Post-concussive syndrome has been well validated as a debilitating condition that can affect children, adolescents and young adults who have been repeatedly traumatized during the course of playing sports. Because many people only recognize loss of consciousness as a symptom of concussions, many concussions go dangerously unrecognized.

Dr. Kleiner suggests the following grade scale to determine the best way to deal with a child's concussion:

• Grade 1 — Symptoms are noticeable for less than 15 minutes. Generally, return to play is not recommended until the next day.
• Grade 2 — Symptoms are noticeable for longer than 15 minutes. Generally, clearance by a health care professional is recommended before return to play.
• Grade 3 — Any loss of consciousness. Child needs immediate medical attention.

If a child might have a concussion, it is important for him or her to sit out from play for at least 15 minutes. During this time, the coach can evaluate the child's concussion grade.

Repeat concussions

When a child has suffered from more than one concussion at any point in time, it is known as a repeat concussion. The effects on the brain are more serious than the effects of the first concussion. Other effects of repeat concussions are: symptoms last longer, chronic headaches, slower response rates and decreasing test scores.

From The Children's Medical Center of Dayton.

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