REALITY: This may be true for an infant or toddler who can't tell you what's going on, but keeping an older child or teenager awake usually isn't necessary. If you suspect a concussion, have your child checked out by a physician who will advise you of the next steps -- and expect it to include plenty of rest. "Sleep is extremely beneficial to the healing process, especially soon after the injury, and interrupting this rest can make the recovery more difficult," explains Mark Halstead, M.D., an assistant professor of pediatric sports medicine at Washington University in Saint Louis.
REALITY: Wearing a helmet is always a good idea when biking or participating in sports, but according to the American Academy of Pediatrics (AAP), no specific brand of helmet (or mouth guard) results in fewer concussions, despite manufacturer claims. Because the brain "floats" in fluid in the head, a helmet can't prevent it from crashing around inside the skull, which is what causes a concussion. Headgear is still important, however: It's actually designed to protect against a catastrophic injury such as a skull fracture or bleeding in the brain.
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REALITY: Only a small percentage of concussions involve a loss of consciousness. In some cases, a child who's knocked out may suffer less injury than one who remains awake. Every concussion is different, so it's important to watch for other symptoms, such as confusion, dizziness, and headache. Learn more about concussion symptoms below.
REALITY: The type of hit that your child sustains, whether it's hard or soft, doesn't always directly correlate to the severity of the concussion or the duration of the recovery. "I've seen children who have fallen out of a two-story window and within a few days have fully recovered, while others who have simply been hit with a dodge ball in gym class can take a year to get better," Dr. Halstead says.
REALITY: Watching your child throw up is distressing, of course, but a single vomiting incident itself isn't a guarantee of a concussion. Some kids will vomit simply because they're shocked or scared. Continued vomiting, though, along with other symptoms such as confusion, dizziness, and severe headache, could indicate a more significant injury that requires immediate attention in an emergency department, Dr. Halstead says.
REALITY: Overall, the rates tend to be about the same, but the symptoms vary between the sexes. Boys seem to report feeling confused and forgetful and having a bad headache; girls describe milder symptoms, like drowsiness or sensitivity to noise. When comparing kids who participate in the same sports (for example, boys who play basketball versus girls who play basketball), girls have slightly higher concussion rates. The reason for this is unclear, but two theories are: Girls may be more likely to report their symptoms, and they may have weaker neck muscles than boys, which might predispose them to more concussions.
REALITY: Headache, confusion, and amnesia are the most commonly reported symptoms, but there are many others, and no two concussions are alike. Symptoms can be myriad and seemingly unrelated, including sluggishness, irritability, and trouble sleeping or reading. If your child has sustained a blow to the head, take careful note of any unusual behavior and symptoms he's experiencing and then contact his doctor.
REALITY: Neither of these tests can detect most concussions -- they can pick up only structural damage to the brain and bleeding. (The physician examining your child may suspect this if her symptoms are severe; if so, CT scans are usually the diagnostic tool of choice in an ER.) The best way to find out whether a child has a concussion is for a physician to examine a patient and ask her questions about the injury and symptoms she may be experiencing. Some physicians may also use a computerized test that can assess a child's memory and reaction time to assist in the diagnosis, Dr. Halstead says.
REALITY: A knock to the head is usually the way a concussion occurs, but any severe jolt to the body can cause this injury. For example, bad whiplash in a car accident or being shaken violently can also rattle the brain in the skull, resulting in a concussion.
REALITY: Actually, biking is the leading cause of concussions in kids of all ages, but football is at the top of the list for organized sports for children 12 to 15 years of age. Wrestling and cheerleading have the second and third highest concussion rates, respectively, according to Safe Kids Worldwide.
REALITY: Going back to normal school activities too quickly may actually hinder a child's recovery. A brain with a concussion isn't functioning properly, so adding more input in the form of math or reading or even the bright lights and noise of a classroom may multiply the stress. "Children with concussions may have trouble in the classroom, especially with their ability to recall what they've learned," Dr. Halstead says.
Typically, kids with a concussion will recover in about three weeks, but all concussions are unique and symptoms will vary, so each child's return to the classroom will require an individualized approach under the supervision of a physician, Dr. Halstead notes. Kids with severe symptoms may need to stay home from school longer; mild to moderate symptoms may mean a child can head back to school with a few minor adjustments in his schedule (no gym, reduced reading).