Pediatric Brain Injury: Concussion

Concussion: Overview

What is a concussion?

A concussion is a brain injury that is caused by a sudden blow to the head or to the body. The blow shakes the brain inside the skull, which temporarily prevents the brain from working normally.

Some people have obvious symptoms of a concussion (such as passing out or feeling lightheaded), while others do not. With rest, most people fully recover from concussions within a few hours to a few weeks.

On rare occasions, concussions cause more serious problems. Repeated concussions or a severe concussion may require surgery or lead to long-lasting problems with movement, learning, or speaking. Because of the small chance of permanent brain problems, it is important to contact a doctor if you or someone you know has symptoms of a concussion.

What causes a concussion?

The brain is composed of soft, delicate structures that lie within the rigid skull. Surrounding the brain is a tough, leathery outer covering called the dura (door-a). Within the brain are (cranial) nerves that are responsible for many activities, such as eye opening, facial movements, speech and hearing. These nerves carry and receive messages that allow the person to think and function normally. There are also centers that control level of consciousness and vital activities, such as breathing. The brain is cushioned by blood and spinal fluid. There is very little extra room within the skull cavity.

An injury to the head causes the brain to bounce against the rigid bone of the skull. This force may cause a tearing or twisting of the structures and blood vessels of the brain, which results in a breakdown of the normal flow of messages within the brain. The damage to the brain generally is found deep within the brain tissue. Because of this damage, the normal function of the brain signals are interrupted.

There are many ways to get a concussion. Some common ways include fights, falls, playground injuries, car crashes, and bike accidents. Concussions can also happen while participating in rough or high-speed sports such as football, boxing, hockey, soccer, skiing, or snowboarding.

What are the symptoms?

It is not always easy to know if someone has a concussion. Not everyone who has a concussion passes out. A person who might have a concussion should immediately stop any kind of activity or sport. Becoming active again before the brain returns to normal functioning increases the person's risk of having a more serious brain injury.

Symptoms of a concussion range from mild to severe and can last for hours, days, weeks, or even months. If you notice any symptoms of a concussion, contact your doctor.

Symptoms of a concussion can include:

• Passing out.
• Not being able to remember what happened after the injury.
• Acting confused, asking the same question over and over, slurring words, or not being able to concentrate.
• Feeling lightheaded, seeing "stars," having blurry vision, or experiencing ringing in the ears.
• Not being able to stand or walk; or having coordination and balance problems.
• Feeling nauseated or throwing up.

Sometimes, it can be hard to tell if a small child has a concussion. If your child has had a head injury, call your doctor for advice on what to do.

Occasionally, a person who has a more serious concussion develops new symptoms over time and feels worse than he or she did before the injury. This is called post-concussive syndrome. If you have symptoms of post-concussive syndrome, call your doctor. Symptoms of post-concussive syndrome include:

• Changes in your ability to think, concentrate, or remember.
• Headaches or blurry vision.
• Changes in your sleep patterns, such as not being able to sleep or sleeping all the time.
• Changes in your personality such as becoming angry or anxious for no clear reason.
• Lack of interest in your usual activities.
• Changes in your sex drive.
• Loss of your sense of taste or smell.

Feeling that you are spinning, whirling, falling, or tilting describe vertigo, or a sensation that you or your surroundings are moving when there is no movement. Vertigo may make you lightheaded or nauseated, and you may throw up. You may also have trouble standing or walking and lose your balance.

How is a concussion diagnosed?

If a doctor thinks that you have a concussion, he or she will ask questions about the injury. The doctor may also ask you simple questions such as “What day is it?” to see if your brain is working normally. Then the doctor will check your strength, balance, coordination, reflexes, and sensation. Sometimes, a doctor will order imaging tests such as a CT scan or a MRI to make sure your brain is not bruised or bleeding.

How is it treated?

Initial treatment for a concussion is to watch a person closely for any changes in behavior or for any new symptoms. Some people have to stay in the hospital to be watched while others can go home safely.

If you have any swelling, your doctor may recommend using cold packs to reduce the swelling. He or she may also prescribe a pain medicine or recommend a pain medicine that you can buy without a prescription such as acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil or Motrin).

At home, rest is the best way to recover from a concussion. Get plenty of sleep at night and take it easy during the day. To prevent a second brain injury, avoid alcohol, illegal drugs, and any activities that could lead to another head injury for a few days or even a few weeks. Your doctor may also tell you not to drive or swim for a while.

Some people feel normal again in a few hours while others have symptoms for weeks or months. It is very important to allow yourself time to get better and to slowly return to your regular activities. It is also important to call your doctor if you are not improving as expected or if you think that you are getting worse instead of better.

How can I prevent a concussion?

• You can reduce your chances of getting a concussion if:
• You wear helmets and safety equipment when you are biking, blading, skateboarding, snowboarding or skiing.
• You wear your seat belt in a car, pay attention while driving, and do not drive if you have been drinking or using drugs.
• You make your home as accident-proof as possible. This can be done by adding lighting to dark areas, fixing uneven surfaces, blocking off stairways, or padding edges of sharp objects.

• Concussion
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General Brain Injury Topics

• General Brain Injury Verdicts
• Pediatric Brain Injury
• Types of Brain Injuries

General Brain Injury Videos

General Brain Injury Links

• General Brain Injury - Brain Injury Association of America
Official website for the Brain Injury Association of America - includes symptoms, treatments, contacts, etc.
• General Brain Injury - Medline Plus- Brain Injury
General information on head injuries including types, symptoms, treatment, and other resources.