Head Injury

Written by Alberta Health Services and Project HEAL; Photo: Fotolia.com

A concussion is a mild brain injury resulting from a jarring of the brain following a head injury. Head injuries can result from: a direct blow to the head, a hit to the upper body, or a rapid accelerating/decelerating force on the body. These forces cause the brain to move inside the skull. Concussion symptoms can occur even without a loss of consciousness (fainting/blackout) and can last minutes or hours to days and months. Concussions are a brain injury that will not be seen on x-rays, CT scans, or MRIs. They can affect the way a child may think, behave, and remember things.

Key points

• Concussions are a minor traumatic brain injury following an impact on the head or upper body.
  
  
• Children with concussions can have lots of different symptoms - the most common symptoms are headaches, dizziness, nausea, and difficulty concentrating.
  
  
• Allowing your child’s brain to rest and recuperate is the best treatment for concussions. It is recommended that your child slowly return to school and sports after a short time of quiet rest.
  
  
• Most children recover from their concussion in two weeks. If your child has symptoms for more than a month, they should be referred to a specialist.
  
  
• For detailed information on concussion symptoms and how to help your child return to school and activities, visit parachutecanada.org and click on ‘Injury Topics.’ 

Symptoms

The signs (seen by others) and the symptoms (felt by the person) of a concussion can be hard to notice.

Symptoms may start hours or rarely, days later. A concussion can cause one or more of the following:

• Headache
  
  
• Dizziness
  
  
• Vertigo (spinning) or imbalance
  
  
• Lack of awareness
  
  
• Loss of consciousness
  
  
• Nausea and vomiting

Late symptoms of concussion:

• Staring
  
  
• Slow to answer questions
  
  
• Disorientation
  
  
• Confusion
  
  
• Memory loss (amnesia)
  
  
• Slurred speech
  
  
• Behavioral or mood changes
  
  
• Light or noise sensitivity
  
  
• Fatigue or sleep disturbance
  
  
• Ear-ringing
  
  
• ‘Seeing stars’ or vision changes
  
  
• Blurred vision
  
  
• Poor balance or coordination

Very young children may show the following signs:

• Decreased interest in feeding/nursing
  
  
• Loss of learned skills (i.e. toilet training)
  
  
• High-pitched cry or more difficult to settle 

Treatment

A concussion is a serious event, but most children can recover fully if their brain is given time to rest and recuperate. Returning to regular activities like school and sport is a step-by-step process that requires patience and caution.

A ‘return to learn’ followed by a ‘return to play’ system is recommended for children with concussions. This means they should start with going back to school and doing ‘mental work’ before they go back to physical activities.

It is recommended your child take complete rest for one to two days following their injury. They should avoid any activities including going to school, watching television, taking a walk, or reading a book.

After the first few days of rest, your child should begin to ‘return to learn.’ This means a slow return to school and homework. Your child’s teacher(s) should know about the concussion. Your child may need some extra help with assignments or a quieter workspace to complete their tests.

Once your child can attend school without any concussion symptoms, they can start a gradual return to sports and activities. 

How long do concussions last?

The length of time a child will experience concussion symptoms can be quite variable. Most children will recover within one to two weeks, especially if they follow brain rest and activity rest guidelines that are recommended.

Some children will experience symptoms such as chronic headaches, poor concentration, and memory issues for more than two weeks. If the concussion symptoms last longer than a month, your child should be seen by their family doctor and consider a referral to a specialist in concussion management. 

How can you prevent concussions from happening?

The best way to prevent concussions is to prevent high speed/high impact injuries to the head and neck. While helmets are great at avoiding damage to the skull, they do not prevent concussions. Children who have had multiple concussions are at a higher risk for long-term issues with headaches and learning problems.

Where can you get more information?

Parachute Canada, parachutecanada.org, is an excellent guideline for parents and caregivers. Parachute Canada is a national organization dedicated to injury prevention and has multiple tools for families.

HEAL is a resource aimed at providing families across Alberta easily accessible, reliable information about common minor illness and injuries in children. Alberta Health Services and Project HEAL strive to ensure that all material is correct but will not be held liable for errors or incomplete information contained in this article. Reprinted with permission by HEAL. For more information, visit ahs.ca/heal.