Concussions: Facts for Parents

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What is a concussion?

Concussions: Facts for Parents

A concussion is a type of traumatic brain injury, usually caused by a bump to the head. Even a mild bump can cause a concussion. In fact, a concussion can occur when there is no injury to the head or face. It can occur if a blow to the body causes the head to jolt which jiggles the brain inside the skull.

What are signs of a concussion?

You cannot see a concussion. Signs and symptoms of a concussion can show up right after an injury. Sometimes symptoms are not noticed until days or weeks after the injury.

Symptoms reported by the injured person may include: nausea or vomiting, balance problems, headache or pressure to the head, dizziness, double vision or blurry vision, sensitivity to light or seeing stars, sensitivity to noise or ringing in ears, feeling sluggish, hazy, foggy or groggy, concentration or memory problems, confusion, feeling “down” or “not right”.

Signs observed by others may include: appears dazed or stunned or confused, forgets an instruction, moves clumsily, answers questions slowly, slurred speech, fatigue, concentration or memory problem, loses consciousness (even briefly), is moody or has personality changes.

Is it possible to have a concussion when wearing a good helmet?

Yes. There is no “concussion-proof” helmet. Concussion occurs when the brain is shaken inside the skull, damaging the brain cells. Helmets cannot prevent that. Helmets do help prevent skull fractures, subdural hematomas (see below), and cuts to the skin and scalp.

What should I do if my child has signs of a concussion?

  1. Call your child’s doctor. The doctor may want to see your child that day or the following day, depending on how your child is feeling.
  2. Ask the person at school who was present at the time of injury to complete a “Referral for Concussion” form. This form describes why a school staff member suspected a concussion. Bring this form to your doctor. Do not rely on your child’srecollection of the injury because concussions often impair memory.
  3. Give your child’s brain a rest (see below for details).
  4. Give your child’s body a rest (see below for details).
  5. Whenever a concussion occurred outside of school, notify the school health office.

Why is resting the brain recommended after a concussion?
Concussions mean the brain’s cells are stressed and need rest to heal. This means your child may need more sleep at night and naps during the day. Too much concentrating can further stress the brain’s cells. Do not send your child to school the day after a concussion. Most doctors recommend against reading, studying, watching TV, or playing video games. Even fun activities require concentration and should be avoided. Too much thinking, bright lights, loud noises, or crowds can bring on concussion symptoms the day after a concussion; sometimes longer. When returning to school, your child’s teacher should expect a little less than usual and should report any symptoms to the health office. Ask your school health office for a “Return to Learn” guideline, so you know what we are watching for. Keep in touch with the school health office during the first few days after concussion.

Why is resting the body recommended after a concussion?
There are two reasons: (1) the brain cannot rest when the body is getting too much exercise. Brief (up to 10 minutes) of normal-paced walking is all that should be done for at least two days. (2) If a second concussion occurs before the first concussion has had time to heal, longer-term damage to the brain may occur. A second concussion may be more likely to happen in the days immediately after the first concussion because the injured person may have more fatigue or poor coordination. Ask your schoolhealth office for a “Return to Play” guideline.

What can I expect from my child’s school, if my child had a concussion?

If your child has signs or symptoms of a concussion, your school will follow the “Return to Play” and “Return to Learn” guidelines. These guidelines will be followed even if your child’s doctor does not confirm that a concussion occurred. This means that your child will be excused from school the day after the concussion and may only be expected to attend a half-day of school on the second day after a concussion. Your child will not be able to fully participate in physical education and school athletics, excepting as outlined in the district’s “Return to Play” protocol. California laws mandate that student athletes stop all play when the concussion occurs and not return to full competition until they have been cleared by their own doctor. For athletes returning to competition, the State of California specifies that a doctor (MD or DO degree) is to clear the student for competition, not a nurse practitioner or physician’s assistant. If your doctor prescribes more rest than the district’s own policy, the district will always followyour doctor’s orders.

After a head injury, what problems other than concussion, can occur?

In addition to concussion, head injuries can cause a “black eye” or bruising of the head or face. A lump on the scalp can form in the days after a head injury. If a blood vessel under the skull is damaged and starts to bleed, this is called a subdural hematoma. This bleeding may occur slowly, so the injured person may not show problems until hours or many days later.

Symptoms of subdural hematoma may be: drowsiness during the day; vomiting; worsening headache; blood or clear fluid oozing from nose or ear; one-sided weakness of arms, hands or legs; unequal or enlarged pupils; coma. If any of these are noticed, bring your child to the emergency department.

For more information on concussions and head injury, go to web site of the Centers for Disease Control and Prevention:www.cdc.gov/concussion

 

Howard Taras, MD Date
District Physician

HT: March 8, 2016