What you need to know about head injuries in Children

Head Injury – What Parents Need to Know


We are once again soon to start another sports season, and our children are on the field in a multitude of activities. Children and teens need this activity to thrive, but athletes, parents and coaches need to be aware of the signs and symptoms of brain injury, recognizing concussion and preventing the potentially devastating Second Impact Syndrome. The leading causes for concussion in high school athletes are football for males and soccer for females, but concussion is not limited to these sports. Concussions are seen in biking, basketball, playground activities, motor vehicle accidents, and other activities. A concussion is a brain injury, most occurring without loss of consciousness. They are caused by a blow to the head or by a blow to the body that causes the head to move back and forth rapidly. Even a ‘ding’ on the head can start a complex cascade of dysfunction on the cellular level in the nerves in the brain. A repeat concussion occurring before the brain has fully recovered from the first concussion can result in brain swelling, permanent brain damage, and even death. This is the dreaded Second Impact Syndrome. Signs and symptoms of concussion can be obvious or subtle. Physical manifestations may include headache, nausea, vomiting, balance problems,  dizziness, visual problems, fatigue, sensitivity to light or sound, numbness, tingling, or being dazed or stunned. Cognitive manifestations may include feeling mentally ‘foggy’, feeling slowed down, trouble concentrating, difficulty remembering, forgetfulness with short term memory, confusion about recent events, repeating questions or answering questions slowly. In adolescents the emotional signs can be even more subtle and may include increased irritability, sadness, nervousness or being more emotional overall. There may be changes in sleep patterns with more or less sleep than usual , drowsiness, or trouble falling asleep. If a concussion is suspected, the CDC recommends a 4-step action plan. 1)Remove the athlete from play. When in doubt, keep the athlete out of play. 2)Ensure the athlete is evaluated by a health care professional. 3)Inform the athlete’s parents about the possible concussion. 4)Keep the athlete out of play the day of the injury and until a health care professional says they are symptom free and it is OK to return to play Virginia law effective July 1, 2011 provides schools with guidelines on concussions. It directs that “A student athlete who has been removed from play, evaluated and suspected to have a concussion or brain injury shall not return to play that same day nor until evaluated by an appropriate licensed health care  provider as determined by the Board of Education and in receipt of written clearance to return to play from such licensed health care provider.” Symptoms can last for days, weeks or even longer. It can vary from person to person depending on severity of the concussion, what part of the brain was injured, age, and health status prior to the injury. Health care providers typically will recommend physical and sometimes cognitive rest to let the brain heal. It is essential that athletes not return to high risk activities if any symptoms of concussion persist. When symptoms totally resolve, the athlete may slowly return to daily activities. As the level of activity increases if symptoms recur, the athlete should return to rest. Your child’s school should be aware of these recommendations and provide the needed support.


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Dr. Judith Grossberg