Every parent knows that bumps and bruises are a part of childhood. However, the impact of concussion, once considered a mild injury, has been making headlines recently as ongoing research uncovers the potential risks of multiple concussions. We asked local medical experts to weigh in on this important topic.
What does concussion look like?
“A concussion is a diffused injury to brain tissue; it’s like a bad bruise,” explains Dr. Jeannine Hogg, pediatric hospitalist with Spence and Becky Wilson Baptist Children’s Hospital. Caused by a blow or jolt to the head, neck, or body that jostles the brain rapidly back and forth, concussion is a traumatic brain injury that requires correct diagnosis and treatment to better ensure proper healing.
The severity of a concussion used to be based on a loss of consciousness. But now doctors know differently. “We assume it’s a concussion if the child loses consciousness, but anytime there’s a direct blow to the head, face, or neck, you can have a concussion,” says Hogg.
Whether your child is hit playing sports or falls from a swing at recess, Hogg advises having him evaluated any time there’s been a direct blow to the head. Symptoms such as dazed or confused behavior, slurred speech, frequent vomiting, or an ongoing headache, may appear immediately or within four to eight hours of the event.
Rest is key
Despite the common misconception that concussions ‘go away’ rather quickly, Hogg says healing can take up to several weeks, depending on the severity of the injury. During this time, concussed kids may sleep more than usual, have difficulty with schoolwork, be more aggressive, become more easily frustrated, and experience headaches.
To help your child heal, experts advise limiting activities such as schoolwork and screen time and avoiding more vigorous activities such as sports and exercise.
Teach kids to sit it out – here’s why
Possibly the most difficult aspect of treating concussions is convincing your athlete to slow down for a period of time. Even worse is telling them they can’t play or practice a favorite sport. Yet Hogg warns parents and kids alike, “If your child returns to play, he can be reinjured and there can be [the risk of] permanent or long-term damage.”
While long-term damage is being studied in adults, what that looks like
in children is still unclear, notes Dr. Paul Klimo, a neurosurgeon at Le Bonheur Children’s Hospital, “We have a good understanding of the symptoms of a concussion, but we are trying to determine what the long-term impact of such injuries are. This is even more challenging in children, because the child’s brain is developing, so does it make it more susceptible to injury? We just don’t know.”
Beth Hussey has seen the results of multiple concussions up close. Her daughter Gracie experienced her first diagnosed concussion at age 7 while playing competitive soccer. Other concussions were detected through the years and treated. Hussey also believes some may have been missed or mistaken as symptoms of dehydration, since both injuries share similar symptoms.
However, like many kids, Gracie was also reluctant to report her symptoms to her mom or coach for fear of sitting on the bench. “I think [kids] don’t really take time to reflect and respect the symptoms like they should because they want to stay out there playing or don’t want to miss practice,” says Hussey.
Gracie has experienced some cumulative effects, such as memory problems. Because of this, she left contact sports at age 13 in order to give herself time to properly heal. Now, Gracie and her mother share her story to help other athletes and parents understand the importance of recognizing concussions and knowing when to sit it out.
Nick Signaigo, who played football for Alabama State (’00-’01) and Mississippi State (’03-’04), understands the athlete’s apprehension. “Back in high school, I would hit and knock myself out and go right back in.” One reason he thinks kids don’t want to report hard hits is that it gives backup players a chance to play. “The high school kids are thinking about dreams and aspirations of playing in college. So if you give your job up, you’re not going to be able to get in and prove yourself to the scouts,” says Signaigo.
This ball player’s message to families? “You can’t play scared. You’ve got to play full out, 110 percent. But then, if something does happen, you’ve got to know when to take yourself out of the game. You’ve got to be smart.”
When to seek further treatment
In most cases, concussions heal properly, leaving no residual effects when recognized early and treated with rest. However, Dr. Sarah Richie, neuropsychologist and owner of Memphis Neuropsychology in Memphis, says multiple concussions can have a cumulative effect, with more prolonged issues potentially affecting memory, attention, concentration, and organizational skills. Parents may notice their child is steadily having trouble in areas not previously experienced, such as performing tasks more slowly or having more errors in schoolwork.
“When parents see that, although the child may looked recovered and not have any of the confusion, disorientation, cloudy vision, or headaches, there could be some things that are higher order cognitive functions that are not back to normal and are affecting them in their daily world,” says Richie. If parents notice these changes, they should seek further advice. If a concussion is suspected, follow up with your physician. But know that having a concussion doesn’t mean every child will experience long-term effects. “It’s a case-by-case basis. It’s important to treat each child as an individual and see what they are up against,” says Richie.
Mike Mitchell, one coach for Holy Rosary’s fifth- and sixth-grade football program, advises parents to ask questions of your team coach to ensure your child is playing in a safe environment.
Does the coach:
Put the player’s health ahead of winning?
Teach safety practices?
Encourage players to report their injuries?
Play just to win?
Signs of a concussion include:
Dazed or confused behavior
Unable to answer simple questions
Ongoing dizziness or headache (for more than a few minutes)
Lack of balance/coordination
Behavior that is not ‘normal’