Signs and Symptoms of Concussion
Concussion symptoms can occur immediately following a head injury or can develop hours or even days later. Signs that may indicate concussion in a child who has suffered head trauma include the following:
- Awkward (uncoordinated) movements
- Behavior or personality changes (e.g., irritability)
- Dazed or stunned appearance
- Inability to respond (unresponsiveness) or answer simple questions (e.g., Do you know where you are?)
- Loss of consciousness
- Paleness (pallor)
- Post-traumatic amnesia (short-term memory loss; inability to remember events prior to or immediately following the injury)
Symptoms of concussion following head trauma include the following:
- Blurred vision
- Difficulty concentrating
- Feeling faint, sluggish, lethargic, or confused
- Ringing in the ears (tinnitus)
- Slurred speech
In most cases, it is not necessary to keep a child awake following a concussion. However, your child's physician may recommend that you awaken your child periodically (e.g., once during the night) to make sure that he or she can be awakened normally. If your child does not awaken easily or develops additional symptoms, contact a qualified health care provider immediately.
Symptoms of concussion can be difficult to recognize in very young children who are not yet able to talk. Signs include irritability, listlessness, and changes in eating or sleeping patterns following head trauma. Because the central nervous system (i.e., brain and spinal cord) is still developing in very young children, they are at increased risk for complications following a head injury.
Complications that develop following a concussion, such as internal swelling in the brain (cerebral edema) or internal bleeding in the brain (intracranial or intracerebral hemorrhage), or formation of a blood clot, indicate a more serious head injury.
Post-concussion syndrome can sometimes occur following a mild (grade 1), moderate (grade 2), or severe (grade 3) concussion. In post-concussion syndrome, symptoms, such as headache, dizziness, blurred vision, and difficulty concentrating, persist longer than normal—usually for weeks to months. Post-concussion syndrome develops in about 10% of children who suffer a concussion. In about 15% of cases, concussion symptoms last more than 1 year.
Second impact syndrome, also called repetitive head injury syndrome, is a serious complication in which a child suffers a second head injury before concussion symptoms have completely resolved. This condition causes severe swelling and bleeding in the brain and may result in death.
Children who sustain multiple concussions are at increased risk for neurological damage. It is extremely important to follow the advice of a qualified health care provider for allowing a child to return to participation in sports and other recreational activities following a concussion.