Details on what a concussion is, what the symptoms are, and when you should call a doctor.

child with headache
Credit: Alexandra Grablewski

Childhood bumps and bruises are as common as sippy cups and mac 'n'cheese, with stumbles and falls occurring on a near-daily basis as kids learn to first walk, then run, then scale the jungle gym and play sports. According to the Centers for Disease Control and Prevention (CDC), children under the age of 4 are the most frequent victims of head injuries. But while many injuries can be fixed with a bandage and a kiss, a blow to the head is a more serious matter because it can cause a condition known as a concussion. "Any injury that causes the head to shake can [affect] the brain," says Matthew Grady, M.D., a pediatric sports medicine specialist at the Children's Hospital of Philadelphia. Whether your child has taken a spill from his bike, banged his head while wrestling with his brother, or was sacked on a football field, here's what you need to know about concussions and their symptoms.

What Is a Concussion?

A concussion is a mild traumatic brain injury (sometimes referred to as a TBI) that temporarily interferes with the way the brain functions. Because the brain "floats" in fluid in the skull, a knock to the head or jolt to the body can send it crashing into the hard bones of the skull, resulting in this injury.

A concussion can be caused by a simple bump on the head from a fall or a body hit, as might occur in a car accident. Any collision, including those between players on the sports field or an accidental blow to the face or head from a ball during gym class, can cause a concussion. A concussion can also occur as a result of the head or body being violently shaken.

Falls are the number-one cause of head injuries to children under age 9, the CDC reports. Older kids have a greater chance of a sports-related concussion, with football as the leading cause for boys, and soccer and basketball for girls. Bicycling is responsible for the most non-sports-related concussions.

The Symptoms

Some concussion signs will show up right away; others can take 24 to 48 hours to appear. A loss of consciousness may or may not occur with a concussion -- it's actually a lot less likely than most people believe, usually only 10 percent of the time. "Most concussions have at least a few symptoms, not just one," Dr. Grady explains. Be on the lookout for these warning signs after a blow to the head or body. Your child:

  • appears dazed, stunned, or confused
  • can't recall events that happened before or after the bump or fall
  • has difficulty thinking, concentrating; feels sluggish or groggy
  • has a headache
  • feels dizzy or has balance problems
  • has blurred vision
  • has difficulty reading
  • needs to sleep more than usual
  • is nauseated or vomiting. Some kids throw up once out of shock or fear. Continued vomiting, along with other symptoms, is a bigger concern.

For babies who are not yet walking or talking, additional danger signs include bulges at the fontanel (the soft spot on the front and back of the skull), vomiting, lethargy, difficulty feeding, and high-pitched crying.

When to call the doctor

The American Academy of Pediatrics recommends a call to the doctor for anything more than a light bump on the head. Seek immediate emergency care if you notice any of the following:

  • vomiting more than once
  • severe or increased headache
  • stumbling, clumsiness, disorientation
  • slurred speech
  • blood or fluid from the ears or nose
  • changes in breathing pattern
  • dilated pupils or pupils of unequal size
  • a loss of consciousness that lasts more than a minute
  • stiffness in the neck
  • weakness or numbness in the face, arms, or legs
  • convulsions
  • a seizure

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