He's here with some guidelines to answer some of the most common questions and medical misconceptions to get the best care for your kids.
This week we discussed concussions.
What is a concussion?
- A concussion is a traumatic brain injury from a forceful blow to the head or body
- Very common, especially among athletes, with over 3,000,000 occurring annually
What causes the symptoms?
- Symptoms are caused by mechanical strain on brain cells (neurons) and structures, which causes depolarization of nerve cells, buildup of lactic acid, and decreased blood flow.
- Symptoms usually develop right away, but can take minutes to hours to begin.
- Symptoms may include: Loss of consciousness (getting "knocked out"), headache, confusion, memory loss, problems with speech or concentration, dizziness, vomiting.
- High risk symptoms include loss of consciousness for more than 5 minutes, persistently altered mental status, seizure, focal neurological symptoms, or skull fracture.
- Moderate and lower risk symptoms include headache, vomiting, dizziness, and brief loss of consciousness.
Do you need to get a CT (cat) scan?
- High risk patients need emergent neuroimaging (head CT or MRI).
- Head CT exposes the brain to a lot of radiation and should be avoided in lower risk patients.
- Head CT is used to look for bleeding/pressure in the brain and not to diagnose a concussion. Concussion is a clinical diagnosis.
When should parents worry?
- Moderate / low risk patients should be observed for 4-6 hours after the injury.
- Children with any neurologic symptoms or concern for concussion should be seen by a doctor.
What is the treatment?
- The treatment for a concussion is rest: restriction of physical activity and brain rest for at least 1-2 days. Avoiding additional head injuries is also very important.
- The degree and duration of rest depends on the severity of the concussion.
- Tylenol/Advil can be given for headache, but only for the first 2-3 days.
When can they play sports again?
- May not return to play until at least 5 days after all symptoms have resolved and must see a physician for clearance before resuming contact sports.
- Children with persistent symptoms for longer than 3 weeks or multiple concussions should be seen by a neurologist.