Treatment for Concussion
Treatment for concussion usually involves rest and observation. Once the child has been examined by a qualified health care provider and more serious head injury has been ruled out, he or she should be watched closely for signs of complications, including the following:
- Altered level of consciousness, difficulty waking the child
- Changes in cognitive function (thinking) or mental state (e.g., confusion, irritability)
- Gait disturbances
- Persistent vomiting
- Severe headache
- Unequal pupils
In mild cases, ice or a bag of frozen vegetables wrapped in a cloth may be applied to the head to reduce pain and swelling. For the first 24 hours, ice may be applied for about 20 minutes every few hours. Some physicians also recommend over-the-counter pain relievers, such as acetaminophen (e.g., Tylenol®) or ibuprofen (e.g., Advil®, Motrin®). Serious concussions may require observation in a hospital for a few hours or overnight.
Following concussion injury, parents and caregivers should follow the advice of a qualified health care provider regarding the child's return to participation in sports and other recreational activities. A number of assessment tools have been developed to establish return-to-play guidelines. These tools include symptom checklists, computerized testing, the Balance Error Scoring System (BESS), and the Standardized Assessment of Concussion (SAC).
Children and adolescents who suffer grade 1 or grade 2 concussions often are allowed to return once they have been symptom-free for at least 1 week. Grade 3 concussions and second head injuries require a longer recovery period (at least 24 weeks). A child who sustains a third head injury should not return to play until the following season.
Once concussion symptoms have resolved, the child may participate in light physical activity, then progress to sport-specific activity, non-contact drills, contact drills, and finally game play. If symptoms return, the child should not proceed to the next step and his or her physician should be contacted.