Doc Talk: Concussions

We talked one-on-one with pediatric emergency doctor, Clint Pollack from Valley Children's Hospital.

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.
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