Signs of Concussion in a Child

Sports are the cornerstones of many communities. As the air crisps and cools, fall soccer season brings friends and family together in support of their home teams. Children get together to train and compete in the spirit of teamwork. Refs don their whistles and parents slice oranges.

But while it gives fans and athletes alike plenty to celebrate, soccer—like football, ice hockey, basketball, and many other sports—poses a risk to children who play it: concussions.

Ross D. Zafonte, DO, a Mass General Brigham sports medicine specialist, is an expert in concussion care. In this article, Dr. Zafonte shares insights into the signs and symptoms of concussions in children, as well as how to treat them.

He is the president of the Spaulding Rehabilitation Network, chief of the Department of Physical Medicine and Rehabilitation (PM&R) at Massachusetts General Hospital, and chair of the Department of PM&R at Brigham and Women’s Hospital. Dr. Zafonte is renowned for his work on traumatic brain injuries, which includes “Brain Injury Medicine,” a textbook considered to be the standard in brain injury care. 

What are concussions?

“Concussions are related to an external force that causes a transient neurologic deficit,” explains Dr. Zafonte. They are a common, mild form of brain injury that can happen in a variety of scenarios, including during a fall, in an accident, or while playing sports. They can happen when a person is hit in the head, or when another kind of injury causes their head to shake back and forth very quickly.

Watch this video featuring Dr. Zafonte for the answers to other common questions about concussions.  

What are the signs of concussion in a child?

• Loss of memory
• Loss of consciousness
• Headache
• Dizziness
• Light headedness
• Visual problems
• Problems with balance
• Problem with affect (the way your child expresses their emotions)
• Sense of being foggy

In very young children, such as toddlers and infants, you also may notice that your child cannot stop crying and cannot be soothed, and/or they will not eat or chestfeed.

Concussion symptoms may not appear right away after your child hits their head—in some cases, it can take up to 48 hours for symptoms to show. So if you believe your child may have a concussion, keep an eye on their behavior for a couple of days following the event. 

Can a concussion cause a fever in a child?

Yes—concussions and other head injuries can cause fever. Typically, fever is a short-term symptom of concussion if it occurs at all. 

How long can a concussion last in a child?

“The story for concussions is generally a good one,” says Dr. Zafonte. “With proper recognition and proper treatment, most people will recover quickly. Even those who get treatment somewhat later on can improve significantly.”

Most children will start feeling better within a week after their injury. For some children, concussion symptoms can last a month or more. If you don’t see an improvement in your child’s symptoms, contact their health care provider. 

What to do if you suspect your child has a concussion

“The critical element in concussion is reporting it early, and getting early, focused treatment,” says Dr. Zafonte. Recent studies on young athletes have shown that recovery within the first week leads to faster recovery times. So, if you believe your child has a concussion, it’s important to seek medical care as soon as possible so serious injury can be ruled out or addressed. 

In the meantime, remove your child from the situation where they were hurt and into a safe environment. “When in doubt, sit it out,” Dr. Zafonte says. “Playing with a headache after a concussive event can be dangerous in many ways and can prolong long-term recovery.”

How to treat a concussion in a child

When dealing with a concussion, it’s important to rest. “We’ve learned prolonged rest doesn’t help concussions, but a brief period of rest might,” says Dr. Zafonte.

Many parents wonder, “Should you let a child with concussion sleep?” or “Should I wake my child up after a concussion?” It’s a common myth that you should keep your child awake if they injure their head. Rest is crucial for helping your child heal. And no need to wake them up unless their doctor tells you to.

Other important ways to treat concussion include:

• Drinking plenty of water. If your child finds it hard to drink water regularly, try drinking fruit water by infusing orange, lemon, cucumber, or pineapple.
• Prioritizing sleep. You can set your child up for a good night’s sleep by developing a bedtime routine and avoiding caffeine (and other stimulants) close to bedtime.
• Eat healthy foods. Give your child foods with healthy fats, such as nuts and avocado; lean proteins, like tofu, eggs, beans, fish, or chicken; whole grains; and plenty of fruits and vegetables.
  
  

It may be hard, but in the immediate time after the concussion occurs, it may be helpful to reduce and regulate screen time. “There is some recent information that continuous texting, phone use, or graphics may be harmful to people—certainly within the first 48 hours.” During this time, encourage your child to find safe, fun ways to pass the time. These may include drawing, playing a quiet game, doing a craft, or enjoying a bath.

No one wants to see their child hurt. And while you can’t prevent every injury that might come your child’s way, there’s much you can do to help them heal. With good rest, hydration, and by avoiding screens, your child can be on their way back to their favorite sport.