Concussion Symptoms in Children: What to Know
Jul 29, 2021 Cedars-Sinai Staff
As kids return to school, sports and playdates, parents are tending to more sniffly noses, scraped knees and bruises. But bumps and thumps, especially to the head, can be real cause for concern.
Childhood concussions are common, accounting for about 5 million trips to emergency rooms and doctor's offices every year. But typical as they are, concussions can sometimes be dangerous for kids, especially very young ones.
Parents need to recognize the symptoms—which can appear even days after an initial injury and can cause children to be forgetful or foggy—and know how to manage and care for a child with a concussion to prevent more significant brain damage.
We spoke with Dr. Sam Torbati, an emergency medicine physician at Cedars-Sinai, about what parents need to know about concussions.
The bottom line: Do not hesitate to consult a physician if you are concerned about any head injury a child has suffered—especially if you notice any change in the child's behavior.
"Think of a concussion like a punch to the arm that hurts, but doesn't bruise—it's still an injury requiring rest until it heals."
What should parents do if they think their child has suffered a head injury?
Dr. Sam Torbati: Any suspected head injury to a newborn, or any injury that causes a child of any age prolonged loss of consciousness, requires immediate medical attention.
Other alarming symptoms that require prompt medical attention include confusion, vomiting, lethargy, severe headache or a large bump on the head where the injury happened. Physicians rely on well-developed criteria for determining when a child should undergo a CT scan to detect a more severe head injury, and it's best to be safe.
What is a concussion?
ST: A concussion is a mild, temporary form of traumatic brain injury. Concussions do not cause bleeding or bruising in the brain like more severe traumatic brain injuries that require hospitalization, but they still require care and monitoring.
"Think of a concussion like a punch to the arm that hurts, but doesn't bruise—it's still an injury requiring rest until it heals," Dr. Torbati says.
What could cause a concussion in a child?
ST: A concussion can result after a forceful blow to the head or a jolt to the body that causes the brain to bounce against the skull. A fall or bonk to the head can cause a concussion, but it can also happen after being knocked over really hard during roughhousing or sports.
"Even if you're not hit directly in the head, a sudden jolt from a car accident or being tackled to the ground could cause a concussion," Dr. Torbati says.
What are the symptoms of concussion?
ST: Symptoms of childhood concussion can include headaches, dizziness, lack of energy, nausea, blurry vision, forgetfulness or difficulty paying attention or concentrating. Concussions might cause a kid to look or act slow or foggy, or even develop emotional symptoms, such as anxiety, irritation, depression or trouble sleeping or extreme sleepiness.
It's important to understand that symptoms can develop a few days after an injury, so parents who suspect a head injury should monitor kids closely.
"After any injury that could cause a concussion, pay attention to how your child is behaving," Dr. Torbati says. "Even a few days later, kids can develop confusion or disorientation, and that's your clue that they've suffered a head injury."
How are concussions in kids diagnosed?
ST: A physician makes a diagnosis based on symptoms after a direct blow or jolt to the body.
How long will a concussion last?
ST: Symptoms can last for a few days to a few months.
"We can't tell upfront when we see patients whether their symptoms will last a couple days, a couple weeks or up to three months," Dr. Torbati says. "They can vary incredibly in duration and severity."
How are childhood concussions treated?
ST: In the absence of severe symptoms that require medical attention, treatment for concussion in kids mostly involves rest and monitoring. After a concussion, parents should slow down children's physical and cognitive activities, such as school or sports, for one to three days.
"The biggest fear we have when children have had a concussion is that we don't reduce physical activities and they may get another head injury, which increases the risk of more severe forms of intracranial injury," Dr. Torbati says.
Making a slow return to routine activities aids in recovery, but it should be done cautiously. If symptoms get worse, a return to rest is in order.
"If your child is having dizziness or headaches when they go back to reading or sports, they're not ready and they should wait longer before a gradual return," Dr. Torbati says.
Every concussion is unique to each child—unlike strep throat or other infections, there is no single standardized treatment. Physicians give individualized care to families based on kids' current symptoms, risk factors and their baseline emotional and cognitive health.
Some advice pertains to every case: Allow time for your child to recover, and pay close attention.
"Parents should be patient as children go through the healing process, and understand that recovery can be pretty quick, or it could be prolonged," Dr. Torbati says. "It takes patience and a lot of careful monitoring for some children to fully recover."