The SCORE team wants parents, coaches, and teachers to be informed about concussions. Please use this section to learn how to identify, treat, and when to send kids back into the game or school. You can also view all of these answers in video form.
The term mild traumatic brain injury (TBI) is used interchangeably with the term concussion. A mild TBI or concussion is a disruption in the function of the brain as a result of a forceful blow to the head, either direct or indirect. This disturbance of brain function is typically not detected with a normal CT scan or MRI. A concussion results in a set of physical, cognitive emotional and/or sleep-related symptoms and often does not involve a loss of consciousness. Duration of symptoms is highly variable and may last from several minutes to days, weeks, months, or even longer in some cases.
A complete evaluation is important to determine the effects of the concussion and to develop an appropriate treatment plan. This will also be an important tool in deciding when the child is ready to return to normal activities including school, social activities and sports.
How common are concussions?
Concussions are probably more common than we know because they often go unrecognized. It is estimated that each year more than three million children sustain a traumatic brain injury, 80 to 90 percent of which are mild. Some of the more common causes of a mild TBI/concussion include:
- Vehicle accidents
- Pedestrian-motor vehicle accidents
- Bicycle accidents
- Sports and recreation activities
Although we used to think that about 300,000 people in the United States sustained sports and recreation-related mild TBI/concussions every year, new estimates now indicate that up to 3.8 million people sustain a concussion each year. Most of these mild TBIs are not treated in a hospital or emergency department. Concussions can occur in any sport but have higher frequencies in the collision/contact sports such as:
- Ice hockey
- Horseback riding
Signs and symptoms of a concussion
The biggest problem in treating concussions is the lack of recognition and identification. This problem has been labeled the “silent epidemic.” People are often not familiar with the signs and symptoms of a concussion. Contrary to popular belief, the child does not have to lose consciousness to sustain a concussion. In fact, nine out of ten children do not lose consciousness.
To help recognize a concussion you should watch for the following two things in the child or adolescent:
- A forceful blow to the head or body that results in rapid movement of the head
- Any change in their behavior, thinking, or physical functioning (See the signs and symptoms of concussion listed in the table below)
Signs observed by others
- Appears dazed or stunned
- Is confused about what they are doing
- Forgets plays or current activities
- Is unsure of recent events (game, score, or opponent)
- Moves clumsily
- Answers questions slowly
- Loses consciousness
- Shows behavior or personality changes- irritability, more emotional
- Can’t recall events before or after the hit or blow
Signs reported by the child/adolescent
- Appears dazed or stunned headache
- Balance problems or dizziness
- Double or fuzzy vision
- Sensitivity to light or noise
- Feeling sluggish or slowed down
- Feeling foggy or groggy
- Concentration or memory problems
If your child displays any signs and symptoms of a possible concussion or mild traumatic brain injury, it is important to contact a physician or a clinician as soon as possible. Research shows that if an injured athlete returns to the game and to schoolwork before they are fully recovered, it can have serious long term effects. A medical professional, like those in the Children’s National Safe Concussion Outcome Recovery and Education (SCORE) program, can help you and your child athlete determine when and if it’s time to get back into the game and get back to school.
The professionals at the SCORE program, including Gerard Gioia, Ph.D., and Christopher Vaughan, Psy.D., are available to help by providing appropriate evaluation, treatment, and concussion management. There are also many resources for parents, coaches, and athletic trainers at the SCORE program. To schedule an appointment at SCORE, call Katea Selby, the senior coordinator at 202-476-2429.