What You Need to Know About Kids and Concussions
It’s morning. You are using all ten of your hands to make school lunches, lay out clothing, ensure everyone has eaten breakfast and have brushed their teeth... and then the phone rings. You turn your back for just a moment to answer this interruption. But, you didn’t realize your toddler is now Usain Bolt and can travel 10 meters in 3 seconds flat. You hear that dreaded cry... and find him lying at the bottom of the stairs.
He bumped his head, but seems to be “OK.” Obviously, he is shaken – you both are. He is crying. Nothing “looks” broken. You grab your cell phone and quickly consult Dr. Google... after all, you don’t want to go all the way to the ER if you don’t have to. You have a million questions:
When is a bump on the head more than just a bump? What is a concussion anyway? What are the symptoms of a concussion? How do you recognize if your child has a concussion if they are not yet verbal? When do you need to see your doctor? When is a trip to the ER necessary?
You are probably right if it seems like your child is always falling. According to the Canadian Pediatric Society, falls are the most common cause of hospitalizations in children of all ages. But determining whether a fall warrants a hospital trip can be tricky. Here’s what you need to know:
What is a concussion?
There has been a lot of discussion on the topic of concussions over the past five years or so (even before Hollywood embraced concussion prevention). A concussion is a type of Traumatic Brain Injury. A concussion can result from a direct hit to the head or a hit to the body, neck or face that causes the brain to hit the inner wall of the skull. This can disrupt the normal functions of the brain. Usually, these disruptions are temporary.
The underlying process of injury in concussion is not entirely understood. Although less common, concussions can cause a more serious form of brain injury where bleeding occurs inside or around the brain. Such bleeding can be fatal and can cause symptoms immediately, or several days following the accident. Therefore, anyone experiencing a bump on the head needs to be monitored for symptoms of head injury for several days.
Symptoms of concussion
It can be difficult to recognize symptoms of concussion in infants and toddlers since they are not able to tell you what they feel. It is, therefore, necessary to look for nonverbal cues.
The American Academy of Pediatrics recommends that you contact your family doctor if your child receives anything more than a light bump on the head.
If your child has any of these symptoms they should be checked immediately by a medical doctor.
- Loss of consciousness
- Appearing dazed
- Excessive sleepiness or tires easily
- Changes in sleeping patterns
- Irritability and crankiness
- Loss of balance and unsteady walking
- Change in eating habits or refusing to eat
- Not interested in playing with their favorite toys
- Pupils that are unequal in size or larger than normal
- Sensitivity to light or noise
- Loss of newly learned skills
- Crying that cannot be consoled
- Longer than normal periods of quietness or inactivity
- Bumps at the soft spots on the front and back of an infant’s skull
Additional symptoms a verbal child may communicate to you:
- Blurred or double vision
- Headache, dizziness or vertigo
- Ringing in the ears
- Feeling sluggish or groggy
- Difficulty concentrating
- Difficulty remembering (especially how the injury occurred or events immediately before)
- Trouble tasting or smelling
The following are symptoms of a more serious brain injury and require immediate attention. Go immediately to the ER if your child is experiencing any of the following:
- New symptoms start, after you have consulted with your doctor
- Symptoms worsen
- There is blood or fluid comes out of the nose or ears
- Appears confused or dazed
- Cannot see or speak clearly
- Vomits repeatedly.
- A headache that gets worse
- Has a seizure
- Has severe neck pain
- Drowsiness that worsens
- You are unable to wake your child from sleep
- Has weakness in the arms or legs
- Cannot recognize people or places
- Loses consciousness
- Has a large bump or bruise on the scalp, especially in infants younger than 12 months of age.
Continue monitoring your child. The symptoms of a concussion can be subtle and may not be immediately apparent. If symptoms do appear, they may last for a few days or even longer.
What to expect after a concussion
The primary treatment for concussion is to rest until the symptoms are gone. This can take several days to several weeks. According to the Canadian Pediatric Society, it is no longer advised to wake a concussed child every hour. Following a concussion, a child requires rest to heal. Continue monitoring your child regularly. You want to ensure they are: breathing normally (not any faster or slower), and not moaning or vomiting in their sleep (these are symptoms of a more serious brain injury, requiring immediate medical attention).
Rest includes rest for the body and the brain. Activities that require the brain to process information such as video games, tablets, television and reading should be avoided. School-aged children may need to stay home. Normal activities can be resumed gradually as symptoms decrease.
Having a concussion puts children at higher risk of having another one, and of developing Post-Concussive Syndrome. Post-Concussive Syndrome is when a concussed person experiences ongoing symptoms weeks or even years after the concussion took place. According to research conducted by Carol A. DeMatteo, an Associate Clinical Professor at McMaster University School of Rehabilitative, more than 70% of children studied were still experiencing symptoms of concussion six months after they were injured.
If symptoms persist longer than a few days, consult with your medical doctor. Consulting with a manual therapist can also help the brain and body heal. Chiropractic, osteopathy, registered massage therapy and cranial therapy – just to name a few options – can be very helpful in ensuring the body is working and healing efficiently, as well as treating and relieving symptoms of Post-Concussive Syndrome.
When a concussion has not resulted after a hit to the head, it would be beneficial to seek help from health professionals such as a chiropractor, osteopath and / or registered massage therapist, to ensure there has not been damage to other parts of the body, particularly the neck and rest of the spine.
How can concussions be prevented?
Many concussions can be or could have been prevented. It is impossible to watch your child every moment of the day, especially once they are school-aged (believe me, I wish I could bubble wrap my kids!), but there are things you can do to lower the chances.
When your baby starts rolling, do not leave them unattended as they can easily roll off the change table, couch or bed. Use safety gates on stairs once your child becomes mobile. Child-proof any coffee tables or fireplace mantels with sharp edges. Ensure young athletes use protective gear, as they are particularly at risk of injury.
According to Statistics Canada, two out of three concussions in adolescents are the result of a sport-related injury. Helmets are recommended (often legally required depending on your area) for many activities. Use a helmet while biking (required by law in Ontario for cyclists under 18 years of age), on a scooter, skateboarding, tobogganing, skating (required by Skate Canada), and downhill skiing (recommended by the Canadian Ski Council).
It only takes a moment to ensure your child is safe. Just as it can only take a moment for their life, and yours, to be changed forever. To quote the great Benjamin Franklin, “an ounce of prevention is worth a pound of cure.”
Image credit: Lubomir Simek / CC BY 2.0 via Flickr