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Concussion injuries in Children: A quick Fact check!

28.07.2022 | 6:01 am

All of us have experienced some sort of “bumps” to our head at some point in our lives. Not all head bumps need medical attention; however, some head injuries can be significant enough to warrant specialist intervention. In this blog, I will focus on head injuries causing concussions in children, which is a very common presentation to my clinic. 

What is a Concussion?

A concussion is a temporary brain injury caused by a bump or jolt to the head which can temporarily alter the way a child’s brain functions. 

Concussion aftereffects are usually short lasting and usually last for a few days, but sometimes they can last upto 4-6 weeks. Most children do not require hospital admission but some may need emergency treatment. A small minority of children can have long-lasting difficulties which need a specialist Pediatric Neurology input.

What is the science behind Concussion injuries?

Human brain “floats” inside the skull as it is surrounded by fluid to protect from trivial bumps to the head. However, when there is significant blow to the head, or the brain moves rapidly inside the skull, it leads to local injury to the brain which is undetectable on the CT and MRI scans of the head. 

Children are more prone to Concussion injuries as they are more out and about, nature of the sport they undertake and also perhaps because their brains are less myelinated as opposed to adults. Myelin is a covering of the nerve cells, just like the covering of electricity wires which helps the signals to transmit better in the brain. Smaller children are more likely to have concussion and head injuries in general due their head size being larger as opposed to their bodies.

What are the signs and symptoms of concussion?

Concussion injury to the brain can present itself with various signs and symptoms. It is therefore important to see a Child Neurologist if there are any worrying features as listed below. The symptoms usually appear instantly, bust sometimes they can be delayed for a few hours after the injury. Concussion injury can particularly be hard to diagnose in small babies and children if one is not trained to do so.

The usual or common symptoms of Concussion in children are (list not exhaustive):

  • Headache which is persistent
  • Dizziness
  • Wobbly or Clumsiness
  • Nausea and Vomiting
  • Blurred vision or Visual disturbances
  • Confused Child or Unusual changes in Behaviour

In smaller children and babies, one should suspect concussion after a head bump if they are crying a lot and for no reason, they are not interested in their toys, or their sleeping pattern is disrupted.

How do you treat Concussion?

The mainstay of management for Concussion injury remains REST, which includes resting your body and Brain! I usually recommend 4-6 weeks of no contact sports or physical activity that can jeopardize the management plan, because the last thing the child needs is a repeat injury to the head when they are rushed back into the sporting activity. Simple analgesics may be given for headache relief. The child needs to be adequately hydrated during recovery. One should avoid excessive screen time, as focusing on a screen for too long may exacerbate the symptoms. The children must have adequate sleep which helps in the recovery process.

Your doctor might want to do some form of Brain Imaging, if the symptoms are not abating with time. In my experience most children start to improve within a few days and fine in few weeks’ time. However, prevention remains the mainstay of management of concussion injuries in children.

How can we prevent Concussion Injuries in Children?

There has been a lot of research on Concussion in children and fortunately there is increasing awareness amongst teachers and sports coaches to prevent Concussion in children. It is imperative that children wear well-fitted helmets if they are taking up any sport which increases their chances of a head injury eg Biking, Horse riding etc. Children must wear seat belts when in a vehicle to prevent head jolts which can give rise to concussion. 

If there is any suspicion of Concussion injury, Pediatric Neurologist advice must be sought at the earliest.

Disclaimer: Severe head trauma causing brain injury i.e open skull fractures, bleeding inside the skull/Brain etc is not discussed as it is outside the scope of this blog.