Pediatric Concussion


by Mackenzie J. Hemje, MD

Why are pediatric concussions important?

Spring time and summer break often involve a time of increased participation in physical activities such as unsupervised bicycling, skateboarding, pool accidents, rough housing, and various summer sports practices and camps.

Since 2000 there has been a drastic increase in pediatric and adolescent concussions.

Recurrent concussions can lead to both short-term and long-term physical and cognitive ailments including lower IQ, depression, anxiety, and even suicide.

What are signs and symptoms of pediatric concussions?

Following witnessed trauma or suspected trauma, concern should be raised for concussion if person develops:

  • Headaches, dizziness, difficulty concentrating, confusion/disorientation, vision changes, light and noise sensitivity, nausea, drowsiness, amnesia

  • One should be concerned of a more emergent head injury and immediately seen in an emergency department if person develops:

  • Weakness, numbness, seizure, worst headache of life, persistent lethargy and/or prolonged loss of consciousness.

What to do if you suspect a concussion?

Prevention is most important as avoiding high risk activities or using appropriate protective gear can reduce the incidence of concussions. Beginning of season, perform baseline cognitive studies that can be utilized for management if a concussion is suffered in the future.

  • First, remove child or adolescent from activity immediately if any signs or symptoms develop.

  • Person should be evaluated by certified healthcare professional and undergo formal concussion assessment for physical and cognitive symptoms.

How are concussions managed?

  • Basis of treatment is an immediate period of physical and cognitive rest until patient is completely symptom free. 

  • Cognitive rest consists of staying home from school, no electronics or reading, and limited visitation.

  • With appropriate rest and clinician follow-up the majority of  patients are completely symptom free at 2-3 weeks.  Incomplete physical and cognitive rest can prolong symptoms over several months.

  • Reassess baseline cognitive testing

  • Recurrent concussions: consider avoiding contact activities permanently and/or see a specialist

Christine Weeks