What are the signs of a concussion in a child?
What is a concussion?
A concussion happens when there is enough force to cause the brain to shift inside the skull. This abnormal shift causes the neurons inside the brain to misfire. These neurons create energy for the brain, when they misfire it leads to a reduction in the creation of energy and an increased need for energy to heal the brain. This “energy crisis” that the brain goes into following a concussion affects the basic functioning of the brain such as memory, concentration, and sleep.
What are signs my child has a concussion?
Concussion symptoms in children can range from a mild headache that lasts for a few days to more intense nausea and vomiting. Typical symptoms include:
Headache or “pressure” in head.
Nausea or vomiting
Balance problems, dizziness, or double/blurry vision.
Bothered by light or noise.
Feeling sluggish, hazy, foggy, or groggy.
Confusion, trouble concentrating or memory problems.
As a provider, I start any concussion assessment with questions on how the suspected concussion happened. Any hits involving the head, regardless of how hard, I would consider a likely concussion. The next questions I ask are what the child felt like immediately after the hit, and then how they felt over the next few hours or days. Typically concussion symptoms take about three days to reach their max.
As a parent or coach, removing the child from play and thoroughly evaluating a player following any hit that involves the head is critical to reduce the risk of further injury to the child. The following symptoms may be noticed immediately following a suspected concussion:
Just not “feeling right,” or “feeling down”.
Can’t recall events prior to or after a hit or fall.
Appears dazed or stunned.
Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.
Answers questions slowly.
Shows mood, behavior, or personality changes.
Once a child is removed from play, and any of the above symptoms are noticed. A child should not return to play until being evaluated by a healthcare provider. Their symptoms may evolve and change over the next few hours and days. With any head injury, there is always a risk for something more serious going on than a concussion.
You want to closely monitor your child for any of the following red flag symptoms, and if noted they should immediately be seen at the emergency room:
A severely increasing headache that gets worse and does not go away.
Inability to move neck
Double vision
Slurred speech, weakness, numbness, or decreased coordination.
Repeated vomiting or nausea, convulsions or seizures (shaking or twitching).
Unusual behavior, increased confusion, restlessness, or agitation.
Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously.
If there are not any red flags noticed, there is not need to send your child to the emergency room or request imaging. If a hit was seen, and they still have some of the symptoms noticed above the best next step is to make an appointment with a medical provider skilled in concussion care to properly evaluate and instruct you on return-to-play protocols.
Why are concussion symptoms sometimes delayed?
Concussion symptoms can sometimes take many hours or even a few days to hit their max intensity. It is not abnormal for someone to get a concussion on a Saturday game, and have the worst of their symptoms show up on Monday. So why is this?
The energy crisis (reduction in the ability to make energy and the increased need for energy) that happens during a concussion, takes about three days to reach its peak.
Why do concussion symptoms seem to come and go?
When a child is recovering from a concussion, you may notice they are returning to their normal selves one day, and then the very next day they can barely get out of bed. Remember, with a concussion the brain is in an energy crisis. All the functions of your brain are fighting for resources and only the very vital ones are getting them. They eventually do start to feel better because their brain has recovered some of its energy, however, it is usually not enough to sustain their normal pre-concussion daily activities right away.
Recovering from a concussion is all about balance. Consider it a marathon and not a sprint. Try and encourage your child to return to their normal habits including sleeping at night, school work, video games, reading etc. If they become symptomatic, allow them to take breaks. This will allow the brain to work within its limits to provide the best environment for healing.
If you continue to have questions or would like to speak to myself, a physical therapist and concussion specialist, hit the button below to send me a message.
Happy Healing,
Dr. Kira, PT, DPT
Concussion Specialist
Related Articles:
Consensus Statement on Concussion
The content on this site is for informational or educational purposes only, and does not substitute professional medical advice or consultations with healthcare professionals.