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Health blog

Hit in the Head Much? Concussion in Children and Adolescents.

A concussion is an injury to the brain caused by trauma that results in the brain sloshing through its protective fluid and hitting the inside of the skull. Concussion can result from motor vehicle or bicycle accidents, sports injuries, falls, etc. It may lead to a loss of consciousness, altered mental status, or behavioral changes. Young athletes are more susceptible to the effects of a concussion than adults are because their brains are still developing.

A new study finds that more than a quarter million visits to emergency rooms during a four year period were due to sports-related concussion among 8 to 19 year olds, representing a 200% increase over the past decade.

The injuries were most common in ice hockey, football, basketball, baseball, and soccer. Football has the highest incidence of concussion, but girls have higher concussion rates than boys in similar sports. The numbers may be much higher as some coaches or parents don’t seek care for what they view as minor injuries. Young athletes may tend to minimize their injury and strive to return immediately to the game.

The American Academy of Pediatrics published guidelines on sports-related concussions (see source below). Among the recommendations are:

•Children or adolescents who sustain a concussion should always be evaluated by a physician and receive medical clearance before returning to play.

•After a concussion, all athletes should be restricted from physical activity until they are asymptomatic at rest and with exertion. Physical and cognitive exertion, such as homework, playing video games, using a computer or watching TV may worsen symptoms.

•Symptoms of a concussion usually resolve in 7 to 10 days, but some athletes may take weeks or months to fully recover.

Good medical management is essential for reducing the risk of long-term complications of concussion, such as learning disabilities, memory problems, and chronic headaches. Preventive measures include wearing protective headgear, adhering to the rules of the sport, and educating parents, athletes, and trainers about the dangers of concussion. Don’t ignore head injuries in young people. And remember, never give children under 18 aspirin without the express instruction of a physician due to the rare but potential life-threatening condition called Reye Syndrome that has been associated with its use in young people.

For more information see my continuing education module for nurses at: The module is free for anyone to read.

(Halstead ME and Walter KD. “Sport-Related Concussion in Children and Adolescents,” Pediatrics, 126(3), 597-614.)

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