About Concussions and CHOP Approach to Care
What is a concussion?
A concussion is a mild traumatic brain injury (mTBI) caused by a blow or jolt to the head or body that causes the brain to shake. The shaking can cause the brain to not work normally and can result in serious side effects. Each year, thousands of children and youth are diagnosed with concussion — only half are sports related.
Concussions can occur even when a child does not lose consciousness. In fact, only 10 percent of children with concussions report being “knocked out.” Some of the symptoms of a concussion can appear immediately after the injury, while others may not show up for several days. Symptoms may last days, weeks or months. Sometimes symptoms may be subtle and not obvious.
How is a concussion diagnosed?
Your child’s doctor will ask a lot of questions to understand how the injury happened and what symptoms your child is experiencing. Your child may be asked to take a computerized test to better understand how his brain is functioning; however, there is not a single test that can diagnose a concussion. You cannot see a concussion on brain imaging, like a CT scan or an MRI, because brain imaging looks at the structure of the brain, and a concussion affects the function of the brain — not its structure. Doctors will use all of the information they have gathered to diagnose and manage your child’s concussion.
What are the symptoms of a concussion?
The symptoms of a concussion are related to how well the brain cells are functioning and working together. The most common symptoms are:
| Physical | Sleep | Thinking/ Remembering |
Mood Disruption |
|---|---|---|---|
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Often, symptoms will worsen over a matter of days, and it is common for new symptoms to appear in the days following the injury. Symptoms may also worsen when the brain is stressed, for example, when a child is doing schoolwork or participating in a physical activity.
Call 911 if your child has any of the following symptoms:
- Seizures (twitching or jerking movement of parts of the body; may look stiff)
- Weakness or tingling in the arms or legs
- Cannot recognize people or places
- Confused, restless or agitated
- Impaired consciousness
- Difficult to arouse or unable to awaken
- Repeated vomiting
- Slurred speech
- Bloody or clear fluid from the nose or ears
Pre-existing conditions and concussion symptoms
For children with pre-existing conditions, such as migraine headaches, learning disabilities, attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and emotional and mental health conditions, concussion symptoms may be more severe or prolonged. It is important to know that a concussion may also worsen these underlying conditions and make them more difficult to control.
CHOP's approach to treating concussions
Your child should see her primary care doctor if you think she has a concussion. The primary care doctor can discuss symptoms and help you create a plan. CHOP Primary Care physicians are located in more than 30 communities across Southeastern Pennsylvania and New Jersey. After seeing your primary care doctor, if you have further questions, please call CHOP's Trauma Center at 215-590-5932 or Center for Sports Medicine and Performance at 215-590-1527.
Initial treatment for a concussion is rest, both mental and physical. Rest allows the brain to heal. If your child has a concussion, she should not participate in activities that will exert her brain or body. Such activities may include:
- Activities that could cause another head injury (such as sports, gym class, riding a bike, etc.)
- Other physical activities that cause an increase in your child’s heart rate and make her symptoms worse (such as any activity that causes her to break a sweat, lifting heavy items, etc.)
- Activities that require a lot of concentration (for example, attending school, doing homework, playing video games, texting, etc.)
It is important to allow for sufficient brain rest so that the brain is able to heal. Allow your child to sleep as much as she needs. Your child should stay home from school until her symptoms are resolved. Reintroduce mental activity slowly as your child feels better.
With guidance from your doctor, your child can slowly return to mental and physical activity as she begins to feel better.
It is important to watch your child closely, pay attention to her specific symptoms, and contact your physician with any concerns.
Emotional recovery from concussion
Full recovery goes beyond physical healing. Experts at CHOP have designed an evidenced-based website to help families with emotional recovery. Learn more about your child’s emotional recovery after an injury, and how you can help.
If you suspect a concussion:
Contact your child’s primary care doctor for evaluation.
Find a CHOP Primary Care physician near you»
If you have more questions:
Call one of our following centers:
Pediatric Trauma Center
215-590-5932
Sports Medicine and Performance Center
215-590-1527