Concussion in children: What are the symptoms?

Most sports-related head injuries that cause concussions are mild and happen from a direct blow to the head, face or body. The term "concussion" refers to a mild traumatic brain injury.

For a short time, this type of injury interferes with how the brain works, but it does not change the brain's appearance. It does not cause the brain to swell or bleed. Children with these types of injuries typically have a complete recovery.

Symptoms of a concussion may include:

• Headache or a feeling of pressure in the head.
• Nausea or vomiting.
• Balance problems or dizziness.
• Double or blurry vision.
• Sensitivity to light or noise.
• Feeling fatigued, sluggish, groggy or dazed.
• Trouble paying attention.
• Memory problems.
• Confusion.
• Being slow to understand and respond to others.
• Trouble sleeping.
• Mood changes and irritability.
• Changes in behavior.
• Changes in personality.

If there's any suspicion that a concussion has happened during contact sports, it's best that a child not return to play until symptoms improve. In other words, "If in doubt, sit it out." Children can have concussions without losing consciousness. Also, a blow to the body that jars the head can cause a concussion. Make sure your child's coach knows if your child has had a concussion in the past.

If you think your child has a concussion, seek medical care. A healthcare professional can determine the seriousness of the injury. The health professional also can determine when it's safe for your child to return to sports, school and other activities.

Head injuries take time to heal. After a concussion, children need to rest from both physical and mental activities to avoid the risk of further head trauma. They can return to activities slowly as their symptoms allow and as their health professional says.

It is OK to do light activities, such as a brisk walk, basic chores, and some puzzles or games, if they don't increase symptoms.

As symptoms improve, children can slowly return to the level of activity they had before the concussion. A slow return to learning and physical activity is key. Children need to take a break or do less if activities such as reading or jogging increase headaches or other symptoms.

Your child's healthcare professional helps guide your child's return to school and sports. The health professional also gives you specific instructions for teachers and coaches.

Common concussion symptoms may include:

• Trouble with thinking skills, such as memory and attention.
• Dizziness.
• Fatigue.
• Headaches.
• Irritability.
• Sleeping more or less than usual.

Your child may require classroom or workload adjustments when returning to school after a concussion. These may include a lighter course load, additional time for assignments or a shortened school day.

When returning to physical activity after a concussion, your child needs to start exercising at low levels. Your child can do more strenuous physical activity as symptoms allow. Do not allow your child to fully return to play and risk head contact until cleared by a healthcare professional. If your child participates in sports, your healthcare professional helps you make a plan to return to play based on your child's symptoms.

Children might develop complications or have delayed healing if they have another head injury before a concussion has healed. Another blow to the head while a concussion is healing can result in symptoms worsening or lasting longer.

Researchers continue to study other potential long-term effects of concussions. Experts are still trying to understand the effects of repeat concussions.

Symptoms that last longer than the usual recovery period are called persistent symptoms after concussion. This is also called post-concussion syndrome. It's not clear why some people develop this syndrome and others don't. Some research suggests that underlying health conditions or repeat concussions might increase the risk of persistent post-concussive symptoms.

Rarely, what is at first thought to be a concussion turns out to be a more severe brain injury with bleeding in or around the brain. Such bleeding can increase pressure on the brain and be life-threatening.

If your child develops any of the following symptoms after a head injury, get medical care right away:

• Loss of consciousness.
• Seizures.
• Severe and worsening headache.
• One pupil that is larger than the other.
• Slurred speech.
• Behavior that is not usual, such as agitation or severe confusion.
• Being very drowsy or not being able to be woken from sleep.
• Vomiting.

To protect your child from head injuries, insist on the right protective equipment and a proper fit. This includes wearing a helmet during sports and other activities. But even the best protective equipment does not prevent concussions.

If you think your child has a concussion, see a healthcare professional. They can check how serious it is and let you know when your child can safely return to sports and other activities.

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