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Concussion Symptoms in Kids
Kelly Ochoa, MD
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While unloading your groceries you drop the bananas on the floor. Ugh! You pick them up, no bruising, no dents, no cuts. You set them back on the counter. When you’re done unloading all of your groceries, you go to eat one of the bananas. You find the outside now is a bit bruised. You then peel it and notice that most of it looks ok, but one part is browned and mushy. It tastes fine, but you know it is just not 100% good banana. Well in a concussion, your brain is the fallen banana. (And you thought I was going to have you slip on the banana peel to start this article on concussions, didn’t you? That would be cruel.)
What Are the Symptoms of a Concussion?
A Bouncing Brain Causes Dizziness and Pain
Falling with the head striking the ground often causes injury to your outside “peel” – like a bruise or cut, and swelling. A hard enough fall can an injure your brain itself. A concussion results from the brain moving back and forth quickly, causing it to “bounce” against the skull. This then causes swelling, stretching, and bruising to your brain cells. This damage can cause a person to lose consciousness and completely forget the incident all together when they wake up. They may vomit, become confused, disoriented and dazed, and even have behavioral changes. A concussion will undoubtedly cause headache as well.
How Do You Treat a Concussion?
Your Brain Needs Rest = No Homework, No Test!
When you sprain your ankle playing soccer, you have to sit out and allow it to heal before going back to play; Analogously, in a concussion, your brain was injured, and it is imperative that it rests before being used again. So how do you “rest” your brain? I evaluate a LOT of children with concussions in the ER (notoriously from a football injury), and this is the one positive I can tell the child after delivering the disappointing news that they are out of football for the rest of the season – they get a doctor’s note for NO HOMEWORK! They basically have a prescription to be lazy. No school, no reading, no TV, no electronics. They should do mild non-contact aerobic activity where there is NO chance of a repeat head injury. They are to do basically nothing that takes a lot of brain power or focus. This is “resting” their injured brain.
Normal Activity – Only When Symptom Free
A stepwise approach back to normal activity then proceeds. When the child is completely symptom free for a full 24 hours, then little by little they can resume normal activity as long as they stay symptom free. Their progress should be followed closely by a doctor, who then can advise when it is appropriate to resume sports and school again. It is incredibly important that the child does not sustain another head injury before their brain completely recovers from the first. Their brain at this stage is very vulnerable and easily damaged further with even light collisions. A second concussion on top of the initial one can result in something called “second impact syndrome,” which is devastating and can cause permanent brain damage or death.
How Long Do Concussion Symptoms Last?
Symptoms May Be Short or Long – Conservative Treatment Is Never Wrong
Thankfully the majority of children suffering a concussion completely recover within 1 month and can go back to normal activity. However, 1 out of 10 will continue to have prolonged symptoms for months, and occasionally years after a concussion. If the child has a history of migraines, is female, or the initial event was severe, they are more likely than others to have prolonged symptoms. If they don’t follow a conservative, monitored step-wise approach back to sports and school, they are also more likely to suffer from concussion symptoms longer.
Spring is here with inviting weather! Get your children outside on those bikes and rollerblades, but PLEASE make sure to protect their most important organ with a helmet. If a head injury does occur, consult with their doctor on how to care for their injury. After sustaining a concussion, a step-wise approach back to normal life as well as prevention of a recurrent head injury are necessary to prevent prolonged symptoms and serious long term consequences.