Children's Hospital Colorado

Concussion and Mild Traumatic Brain Injury in Children

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What is a concussion?

A concussion is a mild injury to the brain caused by a significant blow or jolt to the head or neck that temporarily disrupts how the brain normally works. Children often bump or hit their heads without getting a concussion, so parents should monitor their child for development of symptoms after this type of injury. It is important to know that a child does not need to be "knocked out" or lose consciousness to have experienced a concussion. Studies show that only about 10% of all sport-related concussions involve loss of consciousness.

Is a concussion a traumatic brain injury (TBI)?

A traumatic brain injury (TBI) is an injury to the brain from some type of outside force, such as a fall, collision or blow to the head. TBI ranges in severity from mild to severe. Concussions are classified as types of mild TBIs. Even though a concussion might be called a "mild" injury, parents and caregivers still must take it seriously because it is an injury to the brain.

There are a few ways that medical professionals can determine the severity of a TBI:

  • Duration of loss of consciousness
  • Length of amnesia (partial or total memory loss)
  • Length of mental status changes (confusion, disorientation)
  • Time it takes to follow commands
  • Brain imaging abnormalities such as bleeding, bruising or swelling of the brain

What is a moderate-severe traumatic brain injury?

A moderate-severe TBI is a more significant injury than a concussion and should be addressed differently in the home, school and community. A moderate-severe TBI often causes a loss of consciousness, as well as memory loss for several hours to days or weeks.

Children who experience a moderate-severe TBI often need hospitalization and will likely have abnormal findings on brain imaging. Although children with a mild TBI or concussion typically heal in a few days to weeks, individuals who have a moderate-severe TBI often take longer to recover and are likely to require increased support, supervision and overall care for months or longer.

Who gets concussions?

Concussions are common in collision sports such as hockey, football and lacrosse, but it's important to remember that young athletes can get concussions in any sport. Activities that include high speeds and contact or collision with opponents increase the risk of getting a concussion.

Athletes are not the only ones susceptible to concussions. Any child can get a concussion while doing everyday activities like riding bikes or scooters or playing on the playground.

What should I do if I suspect my child has a concussion?

  1. Take your child aside immediately and assess the situation. If your child is an athlete, take them out of the game or practice immediately. Athletes should not return to play on the same day a concussion is suspected.
  2. Ensure your child is evaluated by an appropriate healthcare provider. Do not try to judge the seriousness of the injury yourself.
  3. If you witness a head injury to another child (not your own), tell their parents or guardians about the possible concussion.
  4. Allow children and athletes to return to play only with permission from an appropriate healthcare professional, such as their primary care provider or a concussion specialist.

What should parents do in the first days after a concussion?

Serious medical problems after a mild head injury are rare, but they can occur. For this reason, a healthcare provider should always be involved in a child or teen's care after a concussion.

In the first one to two days after the injury, you should watch your child closely for worsening or severe symptoms. You can give acetaminophen (Tylenol) for headaches, but no other medications should be given during this time without a healthcare provider's approval.

Seek immediate medical help if your child has any of the following:

  • A headache that gets worse or is severe
  • Confusion, extreme sleepiness or trouble waking up
  • Vomiting repeatedly
  • Trouble walking or talking
  • Any numbness, weakness or tingling in arms or legs
  • A seizure or convulsion (arms or legs stiffen or shake uncontrollably)
  • Any sudden change in thinking or behavior

Get to know our pediatric experts.

Christine Petranovich, PhD

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