What Is Concussion And How To Treat A Concussion

What Is Concussion And How To Treat A Concussion

Ski and snowboard season is upon us, and with it we are starting to see plenty of head injuries in the emergency room. We do see these types of injuries all year, of course, with contact sports being played all year and kids running into things and falling throughout the year, but with hockey and slippery weather coming, the numbers are on the rise.

There are two main types of head injuries: external and internal. External injuries are to the scalp, while internal injuries may involve the skull, blood vessels in the skull, or brain. Luckily, most injuries in kids result in external injury to the scalp alone. Internal injuries are more worrisome as they may result in bleeding or bruising of the brain, with subsequent impairment.

Scalp Injuries

The scalp has many blood vessels, so even minor lacerations can cause significant bleeding. With even minimal trauma after a blow to the head, the scalp veins can leak fluid or blood under the scalp, leading to a ‘goose egg’.

See your doctor and/or call 911 if your child:

• loses consciousness for more than 5 minutes,
• is not returning to normal level of consciousness within 5 minutes of the injury,
• won’t stop crying (significant irritability),
• has severe head or neck pain,
• vomits repeatedly,
• has seizures or is unable to move the arms or legs properly.

Management of Scalp Trauma

If your child is not an infant, has not lost consciousness, and is alert and behaving normally after the injury:

• Apply ice to the injured area for 15-20 min every 2-3 hours. Wrap ice in a washcloth to avoid skin injury.
• Observe your child carefully over the next 24 hours. If you notice signs of internal injury (see below), contact your physician.
• DO allow your child to sleep. There is NO NEED to wake your child up during sleep. You can assess your child to ensure all is well without waking your child.
• If you are not comfortable with how your child is behaving or how he or she looks, have your child seen. TRUST YOUR INSTINCTS.

Internal injuries

A severe blow to the head can cause the brain to knock against the skull, causing injury or tearing blood vessels. Most injuries are mild and do not require neuro-surgical intervention, but some can be very serious and life threatening.

When to call 911 immediately:

• Obvious serious skull or brain injury
• Unconsciousness for more than 5 minutes
• Abnormal breathing
• Abnormal vision or speech
• Abnormal limb movement or seizures
• Bleeding or clear fluid leakage from the nose, mouth, or ears
• Asymmetry of the pupil size
• Neck pain or decreased movement

What to do if you suspect your child has had a severe head injury:

• DO NOT ATTEMPT TO MOVE YOUR CHILD
• Call 911
• If conscious, keep your child calm and still
• Apply pressure to any bleeding areas unless you suspect a skull fracture (you don’t want to cause further damage)
• DO NOT remove any object stuck in the wound

What is concussion?

Define Concussion

A concussion occurs when there is a temporary loss of normal brain function due to a head injury. Most concussions are mild and do not result in long-term damage. Repeat or severe concussions can lead to brain damage.

Mild concussion symptoms – What does a concussion look like?

• Temporary loss of consciousness or feeling dazed or lightheaded
• Vomiting
• Headaches
• Dizziness
• Memory loss
• Blurred vision
• Slurred speech
• Decreased concentration
• Mood disturbance

This first day should be out of school. If there are no further symptoms as above, the child can VERY gradually return to normal activities.

How to treat a concussion

Concussion severity needs to be assessed by a physician to ensure there is no severe injury. After a mild concussion, I recommend ‘brain rest.’  For 24 hours, your child should have as little stimulation as possible. This means no TV, reading, video games, or studying. This first day should be out of school. If there are no further symptoms as above, the child can VERY gradually return to normal activities. Minimal reading and school work can be attempted. If any symptoms of concussion return, brain rest is implemented again. Athletes should take time off as well, then re-enter athletics slowly. Walk before running, running before practicing, practicing before playing a game.

Head injury prevention

• Ensure your child wears appropriate protective gear when participating in athletics and exercise. Helmets when biking, in-line skating, skiing/snowboarding and skateboarding are imperative.
• Ensure your child (and you!) wear a safety belt in the car, EVERY TIME you drive
• Follow ‘brain rest’ after a head injury – a second concussion after a first can delay recovery and lead to significantly more impairment.