What Happens After the Dianosis
Getting a Diagnosis
Signs of a concussion are the first thing doctors look for when a child suffers a bump on the head, says Anatoly Belilovsky, M.D., a pediatrician in Brooklyn, New York. "It's the most common type of head injury we see in kids."
Even the most mild form can lead to fatigue and repeated headaches that last for days beyond the injury's occurrence. More serious ones will often cause a child to have sleeping trouble and behavior issues and can affect his ability to concentrate on schoolwork. So after asking whether the injury left the child dazed or knocked out, a physician will perform a basic neurological exam to check vision, hearing, reflexes, and balance.
If the history or exam gives the doctor reason to suspect a more serious injury, she may order a CT scan to check for a far less common type of TBI called a subdural hematoma, when blood builds up between the surface of the brain and its outer covering, called the dura. (A rare subset of TBI is an epidural hematoma, in which blood pools between the skull and the dura. This is what actress Natasha Richardson died from in 2009 after she hit her head while skiing. Richardson initially felt fine, so by the time a scan could be performed to reveal her hematoma, it was too late to save her life.) If the CT scan shows any internal bleeding in the head, doctors may operate to reduce the pressure. Although hematomas can be deadly, they are easy for a trained neurosurgeon to treat if caught -- which is why you should get your child checked out right away.
Life After an Accident
Children who have suffered a concussion should initially avoid any activity that works their brain -- even computer and video games, says DeMatteo. So they may need to stay home from school. They should also steer clear of tumbling, sports, even amusement-park rides. After a few days, they should return for a follow-up visit to see whether side effects persist. (In recent research conducted by DeMatteo, more than 70 percent of the children studied were still experiencing symptoms six months post-injury.) Your pediatrician may ask teachers and coaches to weigh in too. "We really want to know whether your child seems to be back to the way he was before the injury," she explains. "That's the marker we need in order to give a clean bill of health and let kids resume their regular activities."
The number of sports-related concussions is growing. A new study in Pediatrics shows that E.R. visits more than doubled for children ages 8 to 13 over ten years -- 3,800 kids in 1997 to 7,800 in 2007. To highlight the seriousness of concussions, the CDC launched Heads Up, a major public-awareness campaign, with information specifically for coaches. Its aim is to help them spot the signs of a concussion and know how to respond when one is suspected, including removing the child from play. (Even the world of pro football is recognizing the dangers -- in December 2009 the National Football League announced a new policy requiring that players not be allowed to play on the same day after showing signs of a concussion.)