Dr. Dana Johnson: With Possible Concussions, It’s Better to Sit Out

Featured in the Wisconsin State Journal on September 5, 2013.

Dear Dr. Johnson:
How do I know if my child has a concussion?

Dear Reader: Concussions have been in the news a lot lately. There has been more focus on the long-term effects for professional athletes especially NFL football players. Fortunately, there has also been more focus on younger athletes and concussions. A child or adolescent’s brain is more susceptible to injury as it is still developing.

A concussion is any injury to the brain that disrupts normal brain function. They are typically caused by a blow or jolt to the head. While usually the head is impacted, it doesn’t have to be. A jerking motion that causes the head to come to an abrupt stop can also result in a concussion. The blow also doesn’t have to be to the scalp region. Hits to the face and neck can also result in a concussion.

Concussions cannot be diagnosed just by the type of hit or injury. Two children can suffer very similar blows to the head. One may have a concussion and the other not. Most of the time those that have concussions were not knocked out or unconscious.

There is not an imaging test (X-ray, CT scan, MRI, etc.) that can reliably diagnose a concussion. The diagnosis is based upon the signs and symptoms the person is having.

Common symptoms of a concussion are:

• Headache
• Nausea and/or vomiting
• Dizziness, lightheadness, or balance problems
• Changes in vision (often double or blurry)
• Sensitivity to light and/or sound
• Feeling dazed, stunned, foggy or just “off”
• Difficulty concentrating or remembering
• Confusion
• Forgetfulness
• Difficulty with school work
• Changes in mood – more irritable or emotional
• Drowsiness
• Sleeping more or less

If a concussion is suspected, the individual should be removed from play and should visit a doctor to confirm the diagnosis and determine when it’s safe for an individual to return to activity. All concussions are serious. If a second concussion is suffered before fully recovering from the first, permanent brain damage and even death can occur.

The treatment for concussions is physical and mental rest. Some children need to stay at home from school for a period of time with gradual return. Video games, television and other mentally stimulating activities should also be avoided. Once symptoms have resolved and a doctor has cleared the individual, a stepwise return to physical activity is recommended.

If symptoms recur at any point, activity should be stopped as this is an indication that the brain has not fully healed. A computer based test is sometimes used to further evaluation if mental function has returned to baseline. The most common test used in Madison is the ImPACT test. This test is most valuable if the individual took a baseline test prior to ever having a concussion for comparison.

Once an individual has suffered a concussion, they may be more susceptible to another one in the future.

“When in Doubt, Sit Them Out!”

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