Concussion

How to detect and manage
Amye Raffaele, RN, BSN,

A concussion is caused by a bump, blow or jolt to the head or body causing the brain to move rapidly back and forth.   It is the most common type of traumatic brain injury.  Concussions cause a variety of physical, cognitive, and emotional symptoms that generally resolve over 7-10 days.

Concussions can happen anywhere, not just on a football field.  It is true that contact sports put your child at a greater risk, but a concussion can occur from falling off of a bike, or from a failed cartwheel attempt.  Males age 12-24 are of the highest group of people to suffer from a concussion.

Recognizing the signs and symptoms of concussions is an important part in diagnosing.  The following are the common signs and symptoms:

  • Headache
  • Dazed/Confused
  • Nausea or vomiting
  • Balance problems
  • Double or blurry vision
  • Sensitivity to light and/or noise
  • Feeling sluggish, hazy, foggy, or groggy
  • Concentration or memory problems
  • Can’t remember events prior to or after the injury

The diagnosis is made through history taking, and a physical that concentrates on a detailed neurologic exam.  MRIs and CT scans are typically not necessary unless there was prolonged loss of consciousness, visible head injury, or worsening symptoms.

Treatment is specific to symptoms.  Motrin or Tylenol may be used as pain management for headaches.  No restrictions need to made to the diet.  Plenty of sleep at night and rest during the day is necessary.  Avoidance of activities that are physically demanding or require a lot of concentration should be avoided until the child is symptom free. 

A gradual return to play schedule should be followed for all sports related activities as follows:

  • Complete rest until symptom free including cognitive rest (reading, texting, watching TV, and video games)
  • Gradual reintroduction of activity as long as the child remains symptom free

    • Light aerobic activity
    • Sport specific activity
    • Noncontact training drills
    • Full contact training drills
    • Game play (medical clearance should be granted prior to game play)

It is important to monitor symptoms closely during the return to play schedule.  A child should only progress to the next level if they are not experiencing symptoms at the current level.  Each level should be achieved 24 hours apart.  If at any point symptoms return, complete rest should occur for the next 24 hours then he/she may start again at the previous level. 

If at any point during the healing process your child experiences the following symptoms you should seek immediate medical attention:

  • Repeated vomiting
  • Worsening of headache
  • Increased confusion
  • Seizures
  • Balance changes
  • Vision changes

Concussions are not something that should be taken lightly or ignored. If you suspect that your child has a concussion you should seek medical attention immediately.  Your child’s medical provider should also follow his/her progress as symptoms diminish and they return to normal activities.  Medical clearance should be granted before the child resumes full activity.

This article appears in the Concussion issue of Pittsburgh Parent.

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