Concussion (Child)

A concussion is a type of brain injury. It can be caused by a direct hit or blow to the head, neck, face, or body. The force of the blow makes the head and brain shake quickly back and forth. This can cause headache, nausea, vomiting, or dizziness. A child’s behavior, walk, or speech can change. Your child may also lose consciousness for a time. Your child may have a blank stare. He or she may seem confused or have trouble remembering things. For example, your child may ask the same questions over and over. Your child might stumble when walking, easily laugh or cry, or he or she may have trouble sleeping. If the symptoms are severe, your child should be evaluated in the emergency room. This could mean a more severe brain injury is possible.

It can take from a few hours up to a few days to get better. The length of time depends on how hard the blow to the head was. In some cases, symptoms last a few months or longer. This is called post-concussion syndrome.

Symptoms should get better as the hours and days go by. Symptoms that get worse could be a sign of a more serious brain injury. this might be a bruise or bleeding in the brain. Watch for the warning signs listed below. Your child’s healthcare provider will tell you about any other care needed.

Home care

If your child's injury is mild and there are no serious signs or symptoms, you can watch him or her at home.  If the injury is more serious, take your child to his or her healthcare provider or the emergency department. Follow these guidelines when caring for your child at home:

  • You will likely not have to wake your child from sleep after a minor head injury. But, if your child's healthcare provider does recommend this, your child should be able to know where they are when awakened. Ask your child's healthcare provider if you need to wake your child during the night. If so, ask how often. If not, then let your child rest as needed.

  • Carefully watch your child for any of the symptoms listed below. If you notice any of them, call 911 right away or seek medical care right away.

  • Ask your child's healthcare provider when it will be safe to let your child return to normal play if he or she has no symptoms.

  • Don't let your child return right away to sports or any activity that could result in another head injury. Wait until all symptoms are gone and your child's healthcare provider says it's OK. A second head injury before fully getting over the first one can lead to serious brain injury. Ask your child’s healthcare provider if you have questions about when your child can return to playing sports.

  • Don't give your child aspirin or ibuprofen after a head injury. You may give your child acetaminophen to control pain, unless another pain medicine was prescribed. If your child has long-term (chronic) liver or kidney disease, or ever had a stomach ulcer or gastrointestinal bleeding, talk with your healthcare provider before using these medicines.

  • If your child 's face or scalp is swollen, apply an ice pack. Do this for 20 minutes every 2 to 3 hours until the swelling starts to go down. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Never put ice or an ice pack directly on the skin.

  • School and other activities that require concentration can be more difficult after a concussion. They may also delay recovery. Ask your child's healthcare provider if it is safe to return to school or do other things that require a lot of focus.

  • Getting back to normal life activities within 7 days of the concussion may lead to a better recovery. This includes getting back to physical activity. But talk with your provider about what is best for your child.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

Special note to parents

Healthcare providers are trained to see injuries such as this in young children as a sign of possible abuse. You may be asked questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done to protect your child. Please try to be patient.

When to seek medical advice

Call your child's healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • Neck pain or stiffness

  • Headache that won't go away

  • Dizziness that  won’t go away

Call 911

Call 911 or get medical care immediately if any of these occur:

  • Swelling or bruising on head that gets worse

  • Bulging soft spot on top of baby's head

  • Pain doesn't get better or gets worse. Babies may show pain as crying or fussing that can't be soothed.

  • Eyes that look black from very large pupils

  • One pupil is larger or smaller than the other

  • Blank stare

  • Clear or bloody fluid coming from ear or nose

  • Worsening headache

  • Clumsiness or shaking

  • Confusion

  • Abnormal behavior

  • Worsening dizziness

  • Sleepiness or trouble waking from sleep

  • Trouble speaking

  • Trouble walking or using arms or legs

  • Seizures

  • Repeated vomiting (It's common to vomit once after a head injury. But, if this happens more than that, get medical care right away.)

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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