Concussions emergency medicine general information head injuries

Concussions: What You Need to Know

Parents, coaches, caregivers, teachers, and medical professionals all want to prevent head injuries in children and adolescents, however they happen despite our best efforts. Young children's natural interests, undeveloped coordination and high energy levels can often lead to head injuries, and sometimes, concussions. This page covers the factors contributing to brain injuries in children and youth, explains standard treatment methods, describes the symptoms of concussions, and emphasizes the importance of promptly seeking professional care. A growing body of research shows the importance of safety and brain health for young individuals. Let’s see if we can shed some light on this topic.

 

Common Reasons for Head Injuries

Young individuals are naturally inclined to engage in physical activities, sports, and exploration, making head injuries relatively common. Here are some of the most common reasons for head injuries in youth:

  • Falls during Play - Falls result from climbing trees, playing on playground equipment, or participating in recreational activities.
  • Sports-Related Collisions - Participating in sports, including football, soccer, basketball, and cycling, leads to collisions, tackles, and falls.
  • Bicycle Accidents - Riding bicycles is an everyday childhood activity that can lead to head injuries.
  • Accidents at Home or School - While playing indoors or at school, children can encounter situations where they accidentally bump their heads or fall.
  • Motor Vehicle Accidents – Unfortunately, car accidents are a common cause of head injury in all age groups.

It's important to note that these incidents can result in various degrees of head injury, ranging from mild to severe, with varying symptoms.

 

Signs and Common Symptoms of a Concussion

A concussion is called by doctors a mild traumatic brain injury (TBI) that is often difficult to detect because its symptoms can be subtle, and can take time to appear after the incident. The  signs and symptoms of a concussion vary from person to person, but can include:

Confusion - The individual may appear disoriented, have difficulty concentrating, or forget what happened.

Memory Problems - Memory issues may occur, particularly with recalling events leading up to or following the injury.

Dizziness - Dizziness or a feeling of being unsteady on one's feet.

Feeling "In a Fog" - Some individuals describe feeling like they are in a fog, unable to think clearly.

Headache - Headaches are probably the single most common symptom. The headaches are often described as pressure or aching in the head.

Nausea and Vomiting - Some individuals experience nausea or vomiting after a head injury.

Sensitivity to Light and Noise - Increased sensitivity to light and noise can occur.

Fatigue - An unusual level of fatigue or sleepiness may be present.

Irritability - Mood changes such as irritability, sadness, or heightened mood swings may be noticeable.

Some people experience all of these symptoms, many people only experience a handful. Often symptoms will change over time, sometimes not appearing until several hours or even multiple days after the injury. This underscores the importance of closely monitoring individuals who have experienced a head injury.

 

Typical Treatment

Immediate medical evaluation is essential if a concussion is suspected. Concussion treatment typically involves the following components:

Physical and Cognitive Rest – Rest for both mind and body is the mainstay of treatment for concussions. This means resisting the urge to participate in physical exertion, using electronic devices for entertainment or job purposes, or participating in cognitively demanding activities such as academic assignments or exams.

Adequate Sleep - Ensuring the individual gets enough sleep is crucial for recovery.

Hydration - Staying hydrated is essential for overall well-being and recovery.

Pain Management - Over-the-counter pain relievers help to manage headaches or other discomforts.

Avoidance of Alcohol and Certain Medications - Alcohol and or illicit drugs that can affect the brain should be avoided during recovery (this should be obvious for children and youth!)

Gradual Return to Activities - When signs of the concussion have subsided, people gradually resume their regular routines. A medical professional's constant supervision and direction is essential throughout this phase. Youth shouldn’t return to sports until cleared by their primary care doctor.

Adhering to your doctor's orders is important when dealing with a concussion. Resist the urge to return to sports until cleared by your doctor. The return to sports and other physical activities should be gradual and closely monitored. Concussions can be especially damaging to the brain if a young individual sustains a second concussion while recovering from an initial concussion.

 

When to Seek Emergent Care: The Red Flag Symptoms

Some injuries to the head can actually cause bleeding inside the skull, around the brain. These are the most serious types of head injuries and are even more serious than a concussion alone. Bleeding around the brain can cause permanent brain damage or even death. Some of the “red flags” ER doctors watch for that can suggest bleeding around the brain are:

Loss of Consciousness - If a child loses consciousness, even briefly, you should seek medical care immediately.

Seizures - If a youth experiences a seizure following a head injury, it's an emergency that requires immediate medical attention.

Worsening Symptoms - If symptoms like severe headaches, vomiting, increasing confusion, or weakness worsen over time, it's essential to seek medical care.

Decreased mental status or level of consciousness – If a child or youth does not quickly return to their normal state of mind, this is concerning for a serious brain injury. This could include inability to fully wake from sleep, agitation, fussiness, confusion, excessive sleepiness, repetitive questioning, or slow response to verbal communication. If you see these things, seek medical attention in the nearest emergency department.  

Clear Fluid Drainage from the Nose or Ears - This could indicate a fracture in the skull, and medical attention is essential.

 Parents and caregivers should err on the side of caution regarding head injuries. If in doubt about the severity of an injury, seeking medical advice or evaluation is recommended.

 

Preventing Youth Head Injuries

Prevention is critical in safeguarding youth against head injuries. Here are some proactive measures to reduce the risk of head injuries:

Safety Gear - Ensure that children wear appropriate safety gear when participating in sports or activities with a head injury risk. Helmets, in particular, are important for activities like cycling, skateboarding, and contact sports.

Safe Practices - Teach children safe practices, such as looking both ways before crossing the street, using handrails on stairs, and not engaging in risky behaviors.

Childproofing - Childproof the home environment by securing sharp objects, keeping floors free of clutter, and using safety gates and locks where necessary.

Supervision - Provide appropriate supervision, especially for younger children, during play and activities.

Education - Educate children about the importance of safety and the potential risks associated with certain activities.

Enforce Seatbelt Use - Enforce seatbelt use for all ages of children and teens, especially when they begin to drive.

 

We can limit the frequency of concussions and other head injuries by sharing information, establishing educational programs, and adopting proactive tactics. Knowing how to recognize the symptoms of a serious head injury or concussion, what treatments are available, and when to seek medical attention could save someone’s life! If you’ve made it this far in this article, I want to congratulate you on educating yourself on head injuries in youth and children! Do you have any questions? Concerns? Suggestions? I’d love to hear from you. Comment below!

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