Concussion
Concussion, also known as mild traumatic brain injury (mTBI), is a very common injury seen in pediatricians’ offices. Many people think of football in relation to mTBI, but it can be caused by many different sports as well as falls, other hits to the head, or hits to the body that transfer some force to the head. It’s most often seen in older children and adolescents.
What does a mTBI do to the brain?
The main thing that happens in a mTBI is that the force of the injury causes various chemicals to be released in the brain. While these are chemicals the brain is used to, they are released in such quantities that it causes the brain to not function correctly for a time. The amount of time depends on multiple factors. There can also sometimes be some minor tearing of brain tissue that can’t be seen on imaging.
Why do you say it can’t be seen on imaging?
Because an mTBI specifically refers to an injury that leads to limited neurological function change, occasionally with initial brief loss of consciousness it essentially means nothing will be seen on a CT or MRI scan of the head. If there is something seen on those, then there are bigger problems to deal with.
Alright, so what are the symptoms of mTBI?
You can put the symptoms in three categories: physical, psychological, and mental. Physically, the child can have headaches, dizziness, and some trouble with vision. Psychologically, they can have low energy, be emotional, be depressed, or anger more quickly. Mentally they can have problems remembering things or not be able to concentrate as well, not do as well in school.
You said temporary symptoms. How long does it last?
There are many times when they last less than a week. In fact, about 70% of kids are fine within a month, 90% are fine within three months, and only 5% of kids are still having symptoms after a year.
That can be a long time. Why so long?
There are some things which have been seen to indicate recovery will take longer. These include previous history of mTBI, worse initial symptoms, older kids, lower socioeconomic status, or family or social stressors. Also, if the child has a previous history of learning disorders, headaches, neurological or psychiatric disorder.
How do I help my child get better?
First, make sure your child knows they have your support. A good source of physical and emotional support helps children have a more positive and healthy life.
Secondly, work with your doctor and your child’s school to get them back into class. Data now shows that after a maximum of two rest days children should start getting back into their regular activities. It’s okay if your child needs shortened school days or assignments for a while, remember that their brain is trying to heal.
Getting back into sports should be a stepwise affair. Most schools have a return to sports form that allows the child to slowly return while keeping in mind the mTBI.
With both school and other activities there are a few good tips. 1.) If something doesn’t make the symptoms worse, then it’s okay to do. That includes social media. 2.) Remember that it can be a slow process.
Why do we worry about mTBI in kids so much?
There are several reasons we are concerned so much about children. First, they are much more likely to fall down, or be in a situation that can lead to a head injury (toddlers, sports, some lack of self preservation, growing body changing how they’re used to moving). Secondly, their muscles and other structures in the neck and upper back that support the head aren’t as strong and able to stop the head from trauma. Thirdly, their neurons don’t have the amount of insulation around them that adults do, and they’re more affected by the chemicals released during an mTBI. And finally, they’re young, they have a lot more time to add more concussions to their collection.
Why is it dangerous to have multiple concussions?
Most people know about the issue with professional football players and mental decline. Luckily, so far, studies haven’t shown significant issues with high school players, but there isn’t a lot of data out there yet on different sports. We do know, however, that with a second concussion the symptoms are more likely to last longer than the first one. If the second one comes while the brain is still trying to heal from the first one, the damage would be even worse.
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