I'm concerned about childhood head injuries caused by contact sports. What are the possible effects of concussion in children?

Answer From Sherilyn W. Driscoll, M.D.

Most sports-related head injuries, such as concussions — which temporarily interfere with the way the brain works — are mild and allow for complete recovery.

Head injuries take time to heal. After a concussion, children should rest from both physical and mental (cognitive) activities for a day or two. They should return to activities gradually as their symptoms allow.

Some children who return to school after a concussion may require classroom adjustments, including a lighter course load or a shortened school day. If activities such as reading or jogging cause symptoms, such as headache, children should take a break. Then, they may resume the activity for shorter periods, gradually working up to pre-concussion levels as symptoms improve. A gradual return to learning and physical activity is key.

If there's any suspicion of a concussion, it's best not to return to play until symptoms improve. In other words, "If in doubt, sit it out."

Common concussion symptoms can include:

  • Difficulty with thinking skills, such as memory and attention
  • Dizziness
  • Fatigue
  • Headaches
  • Irritability

Children might develop complications or delay healing if they are reinjured before a concussion has healed. Another blow to the head while the initial concussion is healing can result in longer lasting or more-severe symptoms.

Researchers continue to study other potential long-term effects of concussions. Having a concussion puts children at higher risk of having another. The effects of repeat concussions over years can multiply.

Post-concussion syndrome is a complex disorder of concussion symptoms that last longer than the usual concussion recovery period. It's unclear why some people develop post-concussion syndrome and others don't, though some risk factors have been identified. Some research suggests that having repeat concussions might increase the risk of post-concussion syndrome.

In rare cases, what is initially 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 can be life-threatening.

If your child develops any of the following signs or symptoms after a head injury, seek medical attention immediately.

  • Behavior changes such as agitation, confusion or restlessness
  • Convulsions or seizures
  • Inability to recognize people or places
  • Loss of consciousness
  • One pupil that is larger than the other
  • Slurred speech
  • Unusual behavior
  • Extreme drowsiness or inability to be woken from sleep
  • Vomiting
  • Crying that won't stop and inability to be consoled

To protect your child from head injuries, insist on appropriate and properly fitted protective equipment — such as a helmet — during sports and other activities. However, even the best protective equipment can't prevent all concussions.

Children can have a concussion without losing consciousness. Also, a blow to the body that jars the head can result in concussion. Make sure your child's coach knows if your child has had a concussion. Your child shouldn't return to play until he or she has been cleared by a medical professional. Formal return-to-sport plans are recommended.

Signs and 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
  • Difficulty paying attention
  • Memory problems
  • Confusion
  • Slowness in understanding and responding to others
  • Sleeping problems
  • Mood changes and irritability
  • Changes in behavior
  • Changes in personality

If you think your child has a concussion, seek medical attention. Your child's doctor will determine how serious the concussion is and when it's safe for your child to return to sports, school or other activities.


Sherilyn W. Driscoll, M.D.

May 20, 2021