Does my child have a concussion even if they didn’t lose consciousness?

The majority of concussions are not associated with a loss of consciousness. However, a concussion is associated with a period of “altered” consciousness: athletes can appear to be confused or “out of it,” unable to answer simple questions, unable to remember the incident of the fall, hitting their head, etc.

Isn’t it just a headache? Didn’t (s)he just get her/his bell rung?

A headache can be a symptom of a concussion until determined otherwise by a medical provider trained in evaluating concussions. If the headache started after any sudden event, such as a blow to the head or a hard fall, then yes, a simple headache is a sign of a concussion. In fact, it is often the only sign of a concussion. When it comes to your child, it’s better to be safe than sorry. Remember, you can come to NOWcare or our concussion clinic for same day appointments. Learn more about concussion symptoms here.

Can’t they go back in the game?

If an athlete has sustained a concussion, going back in the game can greatly increase their risk for Second Impact Syndrome, a very rare condition in which a second concussion occurs before a first concussion has properly healed. This causes rapid and severe brain swelling and often catastrophic results that can greatly increase the risk of death, even if the second injury was far less intense.

Most cases of Second Impact Syndrome have occurred in young athletes, particularly those who participate in sports such as boxing, baseball, football, hockey, soccer, and skiing. If an athlete has suffered a concussion, it’s best if they don’t return to their sport until the symptoms of the initial head injury are gone. Our protocol requires athletes to stay out of competition/participation until the symptoms from the original concussion are completely gone.

Should I take my child to the emergency room or urgent care tonight?

Not necessarily, but make sure to keep a close eye on them for the first 24 to 48 hours. Although most sport-related concussions are mild, the potential always exists for complications, some of which can be life-threatening (such as bleeding on the brain or Second Impact Syndrome). These complications may occur immediately (minutes to hours) or over several days after the injury. If your child experiences any of the following signs of deteriorating mental status, take her to the hospital immediately:

• Has a headache that gets worse
• Is very drowsy or can’t be awakened
• Can’t recognize people or places
• Is vomiting
• Behaves unusually, seems confused, or is very irritable
• Experiences seizures (arms and legs jerk uncontrollably)
• Has weak or numb arms or legs
• Is unsteady on his or her feet
• Has slurred speech

Is it okay to give my child medication like Tylenol or Aleve?

You can give your child Tylenol (acetaminophen), but avoid ibuprofen, Advil, or Aleve for the first 24 hours due to concern for risk of bleeding.

Does a concussion mean my child has to stay in a dark room and do nothing?

Rest is essential to healing after a concussion. However, studies have shown that bed rest more than three days after getting a concussion actually prolongs the recovery process. As soon as your child is feeling better, allow them light activity that doesn’t provoke symptoms, and split activity up into short intervals.

If my child has a concussion, do I need to keep him/her awake?

You don’t have to keep your child awake. They need their rest. Be sure to check their pupils (are they unequal or dilated?) and orientation (where are you?) every two hours for the first 24 hours after head trauma when the risk of bleeding inside the skull is greatest.

Can my child drive if he/she has a concussion?

Requirements for driving are similar to those for playing sports: In simple terms, no athlete should return to competitive sports until he or she is symptom free — both at rest and with exercise — and follow-up neurocognitive testing is once again normal. Symptoms to watch for include sleep problems, fatigue, problems with concentration or memory, depression, or anxiety. If any of these symptoms persist then driving would not be advisable. Much of this will depend on the severity of the concussion. Ask the athletic trainer or physician on your case for approval before attempting to drive.

When can my child return to his/her sport?

Many factors go into this determination. Older students typically should be out from competition for at least seven days, but may be able to do some non-contact training before the seven days have passed, depending on their recovery. Younger students under 13 years of age should anticipate being held from competition for at least 10 days, as younger brains take longer to heal.

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