Concussions

What is a concussion?

A concussion is a brain injury caused by a blow to the head or body that causes the brain to shake inside the skull. A concussion is a type of mild traumatic brain injury (mTBI). It can affect how the brain works and lead to physical, cognitive (thinking), emotional and sleep-related symptoms.

Concussions signs and symptoms vary from person to person. You can have a concussion without losing consciousness or showing visible signs of a head injury.

The time frame for concussion recovery also varies from person to person. Children’s Health offers individualized treatment plans to help with recovery.

What are the signs and symptoms of a concussion?

The signs and symptoms of a concussion/mTBI may appear right away, or they may develop gradually over several hours or days. Very young children may not be able to express how they’re feeling. That’s why it’s important to watch for any changes in behavior, sleep or mood.

Medical experts describe concussion signs and symptoms in four categories:

Physical signs and symptoms of a concussion

• Loss of consciousness

• Headache

• Dizziness

• Fuzzy or blurred vision

• Sensitivity to light

• Nausea and vomiting

• Ringing in the ears or sensitivity to sound

• Trouble with balance or coordination

• Sluggishness (feeling slowed down)

Cognitive (thinking and remembering) effects of a concussion

• Difficulty concentrating

• Trouble with memory, such as not remembering the injury

• Confusion or “brain fog”

• Slowed thinking

Sleep changes after a concussion

• Sleep that lasts longer or shorter than usual

• Fatigue (tiredness)

• Trouble falling asleep or staying asleep

Emotional and mood changes after a concussion

• Anxiety and nervousness

• Sadness and depression

• Mood swings or irritability

When to seek emergency care after a head injury

Go to the nearest emergency room if any of these signs or symptoms occur:

• Any loss of consciousness, even if brief

• Seizures (twitching or jerking movements in the body)

• Inability to recognize people or places

• Repeated vomiting

• Slurred speech

• Difficulty waking up or staying awake

• Blood or clear fluid coming out of the nose or ears

• One pupil (black center of the eye) that’s larger than the other

• Weakness or tingling in the arms or legs

Children's Health also provides a 24-hour concussion advice line at 844-414-6824.

How is a concussion diagnosed?

It’s not possible to see a concussion with imaging, and there’s not one specific test that can diagnose a concussion. Our expert teams offer comprehensive evaluations, including asking you about your symptoms. We also do a physical exam and use concussion testing, a series of painless tests to understand how your brain is working. We use this information to confirm a concussion diagnosis and treat the injury, ensuing a full return to your usual activities.

What causes a concussion?

A concussion happens when the brain is injured. A person can get a concussion from a hit to the head, face, neck or body. You don’t have to get hit directly in the head to get a concussion. If the head forcefully snaps forward and back, it may cause rapid acceleration of the brain inside the skull that can lead to a concussion.

Some causes of a concussion include:

• Motor vehicle accidents

• Falls, such as falling from playground equipment, falling on stairs or slipping on a hard surface

• Recreation accidents involving bicycles, scooters, skateboards, ATVs or other wheeled activities

• Sports injuries, such as blows to the head, face or chest during play

• Assaults, including being hit or shaken by another person

How is a concussion treated?

Concussion treatment begins once we diagnose a concussion. Treatment recommendations typically include:

• Relative rest: We recommend resting from physical and cognitive activities for 24 to 48 hours. You can then begin to gradually return to these activities. We also recommend focusing on adequate hydration and nutrition and stress management.

• Routine sleep schedule: It’s important to maintain your typical sleep schedule, because too much or too little sleep may interfere with recovery.

• Pain management: If needed before your first visit with a concussion specialist, over-the-counter pain medications, such as acetaminophen (Tylenol^®), can help manage headaches and other pain due to a concussion. Avoid taking ibuprofen (Advil^®/Motrin^®) until your first visit, when your specialist will provide more detailed recommendations.

• Emotional support: Family members and caregivers play a vital role in supporting a person’s emotional well-being. This support helps maintain reassurance and patience, and it promotes a positive healing environment.

• Return to activities: Our tailored return-to-learn and return-to-play protocols help support healing and provide guidance on how and when to increase cognitive and physical activities. We provide tailored letters for school and sports to support an early return to activity, which research shows as the best way to support healing. We typically update your plan at each office visit.

Concussion treatment at Children’s Health

Our pediatric concussion teams in Dallas, Plano, Frisco, Prosper and Fairview offer comprehensive, specialized care for people with concussions, including those with delayed or incomplete recovery.

Our concussion care providers include:

• Neurologists (doctors who specialize in the care of conditions and injuries affecting the brain, spinal cord and nerves)

• Neuropsychologists (providers with specialized training in how brain conditions and injuries affect behavior and cognitive skills)

• Primary care sports medicine physicians (doctors who specialize in the care of sports injuries and return to physical activity)

• Advanced practice providers (nurse practitioners and physician assistants specially trained in pediatric neurology and concussion management)

• Occupational therapists who provide specialized vision therapy and cognitive exercises to aid in recovery

• Physical therapists who provide vestibular (balance) and ocular (vision) physical therapy

• Speech-language pathologists who provide support for cognitive functioning, memory and speech-language skills

• Support providers including nurses and athletic trainers

We provide ongoing follow-up care to monitor progress, ensure that the concussion heals completely and watch for any new or worsening symptoms.

Making sure a concussion is fully healed is important to avoid life-threatening brain injury. Second impact syndrome is extremely rare, but it can occur if a person experiences a second concussion before the first one has fully healed. Second impact syndrome, also called repetitive head injury syndrome, can lead to rapid brain swelling and even death within a matter of minutes. You should never resume sports without a full clearance from a doctor.

Learn more about our Concussion Program in Dallas and Plano and our Sports Concussion Program in Plano, Frisco, Prosper and Fairview.