Concussions are defined by the CDC as “a traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move quickly back and forth.” In the United States alone, the CDC estimates around 1.6 to 3.8 million concussions occur per year due to sports and recreation activities. The CDC further reported that 223,000 traumatic brain injuries were treated in the emergency department in 2018 alone. To further complicate matters, a study conducted by Asken et al. found that up to 50% of concussions go unreported each year and many children do not receive appropriate care.
Concussions can impact a child in almost every aspect of their daily lives. Concussions may reduce the child’s ability to think critically, sleep, participate in classes at school or with friends, cause irritability and emotional distress, impact coordination and balance, or cause problems with eating and appetite. It is especially important that concussions are not only limited to individuals who play contact sports. Concussions oftentimes can occur in infants, toddlers, and school age children following a fall, bump on the head, or even an unexpected push in the back from a friend. Concussions can occur at any age and it is important to monitor your child and understand the typical signs and symptoms of a concussion.
Signs and symptoms:
Concussions are tricky because they can present themselves in many different ways with a variety of symptoms and severities. The red flags of concussions that require a visit to the emergency department are:
One pupil larger than the other
Significant drowsiness and inability to wake up
Headache that does not improve or go away
Slurred speech, weakness, numbness, or decreased coordination
Repeated vomiting or nausea, uncontrolled shaking or twitching
Any loss of consciousness
For infants and toddlers some additional red flags following a blow to the head are:
Will not stop crying and cannot be consoled following a head injury
Will not nurse or eat
Change in the way they play or perform in school
Becoming easily upset and dramatic increase in tantrums
Sad mood and lethargic
Lack of interest in usual activities
Loss of newly acquired skills
Poor attention
Any of the above symptoms warrant a visit to your primary care provider or the emergency department depending on the severity. However, the vast majority of concussions are much more mild and do not require a visit to the emergency department. The typical signs and symptoms of a mild concussion impact a child physically, emotionally, and cognitively. The CDC has released a nice graph of symptoms to watch for with a concussed individual:
With this information at your disposal, it is my hope that you as a parent can recognize when your child may have a concussion. If you do suspect that your child has a concussion, do not hesitate to get them the appropriate care that they need. Here at Kids in Motion we can evaluate and treat concussions and get your child functioning back to 100%. In the next installment of the concussion series, we will discuss the management and treatment of concussions from a physical therapy standpoint and how this treatment has significantly progressed from the previous treatments consisting of rest and slowly returning back to activity.
Please feel free to call Kids In Motion at (701) 415-0000 or email the clinic at info@mandankids.com for a concussion screening for your child.
Resources:
https://www.cdc.gov/headsup/pdfs/providers/facts_about_concussion_tbi-a.pdf
https://www.cdc.gov/traumaticbraininjury/research-programs/index.html
Breton M. Asken, Michael A. McCrea, James R. Clugston, Aliyah R. Snyder, Zachary M. Houck, Russell M. Bauer; “Playing Through It”: Delayed Reporting and Removal From Athletic Activity After Concussion Predicts Prolonged Recovery. J Athl Train 1 April 2016
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