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Concussion

Conditions

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Concussion is a condition in which the brain is not working normally following a blow to the head. The brain looks normal, but its ability to function is not.

Patients can be seen by Texas Children's experts in Sports Medicine.

Causes & Risk Factors

A concussion can occur following a direct blow to the head, or when the body and head accelerate or decelerate quickly.  Concussions are common in sports, especially in sports that involve contact, such as soccer and basketball, or actual collisions, like football and hockey.  Children seem to be more susceptible to concussions than adults.

Symptoms & Types

Common symptoms of a concussion include:

  • Headache
  • Dizziness
  • Balance problems
  • Confusion
  • Blurry vision
  • Difficulty remembering
  • Difficulty concentrating
  • Fatigue
  • Trouble sleeping
  • Irritability
  • Sensitivity to bright light or loud noises 

Most concussion symptoms last only a short time (minutes to hours), but can last much longer (days to weeks).

Diagnosis & Tests

There is no single test to diagnose a concussion. A health care provider makes the diagnosis of concussion based on a history of a blow to the head, a report of symptoms such as those described above, and the absence of signs or symptoms that would indicate a more serious problem, such as bleeding in the head or bruising of the brain.  CT scans and MRI scans can be useful in making sure a child does not have a more serious problem, like bleeding in the head.  Patients with concussions have normal CT or MRI scans.  Patients also may be asked to perform tests on a computer (such as CogSport or ImPACT) to help assess how well their brain is working.

Treatment & Care

The main treatment for a concussion is rest.  This includes avoiding all exercise and sport activities until the symptoms are completely gone.  Rest also includes “brain rest,” including spending a minimum amount of time on the phone or texting, and may include a reduced homework load for school-age patients (your doctor can write a note asking teachers to reduce the workload while the child recovers).  Brain rest also means no gaming, web-surfing, or use of social media.  Rest for a concussion also includes plenty of sleep.  The healthcare provider will usually recommend or prescribe medicine for the headache, and may also recommend medicine to help with dizziness and nausea, or to help with sleep.

Living & Managing

It is very important that athletes do not perform any exercise or return to their sport until their symptoms are completely gone and they have been cleared by a physician.  Athletes who return to their sport before they are ready may have much more difficulty getting over their symptoms completely, and may run the risk of second impact syndrome.

More Information

References & Sources

McCrory P, Meeuwisse WH, Aubry M et al. Consensus statement on concussion in sport: ther 4th international conference on concussion in sport held in Zurich, November 2012. Br J Sports Med 2013; 47, 250-258.

Halstead ME, Walter KD, and the Council on Sports Medicine & Fitness.  Sport-related concussion in children and adolescents.  Pediatr 2010; 126: 597-615.