While a bump to the head is usually no cause for panic, guidelines for managing children and adolescents who suffer concussion recommend taking a cautious approach to recovery.
Participating in sport offers children and adolescents terrific benefits, not only in terms of their health but for their social and all-round development. But accidents will happen and when it comes to concussion, knowing how to deal with the bumps and lumps of sports is important to safeguard young brains from long-term injury.
Concussion is the most common type of brain injury sustained in sports. Among children, concussion accounts for around six per cent of sports-related emergency department visits and, of course, children can also sustain concussion in non-sports related accidents.
So what do you do if you think a child in your care has suffered a concussion?
Guidelines to think about
The International Conference of Concussion in Sports released guidelines on the management of children and adolescents who suffer concussion in sport.
Dr Gerard Goia, speaking for the panel which determined the guidelines, said they "point to the important role parents, coaches and teachers play in assessing and treating young athletes".
The guidelines recommend that any athlete who shows signs of concussion should be medically examined as soon as possible. Because children's and adolescents' brains are still developing, they are at higher risk than adults of long-term damage, particularly from repeat concussion.
Signs and symptoms of concussion can vary considerably and it's important to note that most concussions don't involve a loss of consciousness. The symptoms can include nausea; dizziness or balance problems; double or fuzzy vision; sensitivity to light and noise; feelings of confusion; sluggishness; fogginess; and difficulty remembering and concentrating.
If you think a child might have sustained a concussion, seek medical advice right away.
Once concussion is diagnosed, the international guidelines recommend that children and adolescents:
- Should never return to play the same day, regardless of the level of the competition
- May need a longer period of full rest than adults and a more gradual return to normal activity. They should not return to play before all symptoms of concussion have disappeared
- Should have full ‘cognitive’ as well as physical rest. This means limitation of activities such as academic activity and studying, playing video games and watching TV, and even text messaging.
Why is it so important?
Researchers at UCLA (University of California, Los Angeles) reviewed the available literature on the effect of traumatic brain injury in children and found that the effects of concussion and brain injury can continue for years.
According to lead author Dr Talin Babikian, "The good news is that the studies showed that children with mild traumatic brain injuries and concussions may show some difficulties in cognition initially, but the effects are subtle and typically diminish over time". But she said that there were a subgroup of children who show persistent problems that required evaluation and help.
Returning to play
For most concussions, symptoms will fade over a number of days and children and adolescents can get back to their normal activities relatively quickly. However, as symptoms can sometimes be difficult to detect, if there's any doubt, seek advice from the child's medical practitioner.
References:
McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, Cantu R (2009) Consensus statement on concussion in sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. British Journal of Sports Medicine 43: i76-i84.
Babikian T, Asarnow R (2009) Neurocognitive outcomes and recovery after pediatric TBI: meta-analytic review of the literature. Neuropsychology 23(3):283-296. Brain Injury Association of America. 2009 Sports and concussion BIAA fact sheet. Viewed 29/06/09. Available at http://www.biausa.org/biam.htm
American Academy of Pediatrics. Minor head injury. Viewed 29/06/09 Available at http://www.aap.org/publiced/BR_HeadInjury.htm
