7 Things You Need to Know About Concussions in Adolescents and Children
By Neil Sparks, DO, sports medicine specialist and family physician at Wake Forest Baptist Health Family Medicine-Reynolda
With fall athletics starting up, many parents worry about protecting their children from sports-related concussions. Parents of football players tend to be most troubled by the idea, but a number of sports, including soccer and cheerleading, put children at risk. Even a car accident or a fall on the playground can cause a concussion. To help parents better understand these brain injuries, I’ve included seven frequently asked questions about concussions:
1. What is a concussion? A concussion is the temporary loss of normal brain function following a head injury. A bump, blow, strike or abnormal head motion can lead to a concussion.
2. How are concussions diagnosed? There is no test for concussions. X-rays, CAT scans and standard MRIs don’t allow us to view the damage. So in place of such tests, a doctor will make a diagnosis based on the symptoms a child is experiencing. These include mild confusion, headache, dizziness, difficulty concentrating and “not feeling right.”
3. What do I do if I suspect my child has a concussion? If your child has a head injury—even a small bump—and has any signs or symptoms of a concussion, he or she must stop playing immediately and rest until examined by a qualified health care professional. Not every child with a concussion needs to be seen in the emergency department; however, if mild symptoms worsen or there are severe signs—such as extreme mood changes, significant drowsiness, significant confusion, any loss of consciousness or a seizure—have your child evaluated immediately by a health care professional who is experienced in dealing with concussions, such as physician who specializes in primary care sports medicine.
4. What care is needed after a concussion is diagnosed? After a concussion is diagnosed, help your child get better by enforcing a cognitive and physical rest policy. This means no screen time (movies, TV, computers, smart phones), reading, studying, video games or physical activity until symptoms have resolved. Even though it’s commonly assumed that a child with a concussion shouldn’t sleep, rest is needed for full recovery. Once symptoms have resolved for 24 hours, your physician will recommend gradually reintroducing activities daily as long as symptoms don’t return. This method is called a graduated return to play.
In general, this process has five to six stages occurring over a week, with an athlete advancing to the each stage only if he or she is symptom free for 24 hours and cleared for full participation by a physician. An example may be found here.
Remember, be an advocate for your child. He or she may need time away from school and athletic activities to heal. The more rest early, the better.
5. Why is it important to follow these steps? Brain development is active in children and adolescents, and head injuries may adversely affect brain development. Also, from studies performed on NFL athletes, we suspect repeated concussions may adversely impact an individual’s long-term cognitive function. Some believe that back-to-back concussions can not only affect brain development but can lead to death.
6. How can concussions be prevented? Proper equipment may help. So far, however, there is no helmet, mouth guard or other device proven to completely prevent concussions. With that said, equipment can definitely prevent other injuries and should be mandatory for all athletes. In football, proper “heads up” tackling technique and the elimination of aggressive hitting and tackling drills may help. In sports such as soccer, some experts advise delaying heading the ball until children are older. 
So far, there is a lot left to learn. Early recognition and intervention is still key.
7. Where do I learn more? Online, the CDC and Matthew Gfeller Foundation are good resources. For an immediate concern, you can make an appointment with me (same-day access is available for new patients with sports injuries), by calling (336) 716-WAKE (9253).
*Sponsored by Wake Forest Baptist Health
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