It’s Friday evening, and you’re on your way to pick up your 15-year-old daughter from soccer practice. She immediately begins updating you on her day. Ten minutes into the conversation, she mentions her ears are ringing; however, it only lasts a couple of seconds, so you both figured it was nothing.
The next morning your daughter sleeps longer than usual.
She wakes up around 1 pm, seems cranky, and is complaining of a headache. An hour later she runs to the bathroom to vomit. At this point you begin to think, something can’t be right. You decide to take her to the Night Lite Pediatrics clinic around the corner since your pediatrician’s office is closed.
The doctor asks a series of questions, and your daughter mentions she had a header collision with another player the day before at practice.
The Doctor immediately diagnosed her with having a concussion and recommends for the next week that she refrain from any physical activities until her symptoms are gone.
We are now at the peak of the summer season, and many of your little ones and young adults are out and about. It is vital that during this time of year you are aware of the symptoms of a concussion and where you can go if you find yourself in a situation like the scenario mentioned above.
Whether your child has taken a spill from his bike, banged his/her head while wrestling with a sibling, or was sacked on a football field, here are seven myths about concussions and the answers to those myths that every parent should know.
Myth 1: The Symptoms of a concussion occur rapidly and resolve quickly.
ANSWER: NO, not always. A concussion typically results in the rapid onset of short-lived impairment of neurologic function that resolves spontaneously. However, in some cases, signs and symptoms may evolve over a number of minutes to hours and resolution of the clinical and cognitive (behavioral) features may be prolonged. Here are some of the symptoms that may result from a concussion:
- Throwing up
- Blurred Vision
- Difficulty concentrating
- Feeling Tired
- Feeling anxious or irritable
- Ears Ringing or Sensitivity to light
- Feeling Confused or Dazed
- Sleeping more or less than usual
Myth 2: The severity of concussion is based on a grading system.
ANSWER: NO. In the past, severity of concussion was graded either numerically (grade 1, 2 or 3), or as mild, moderate, or severe, primarily based upon the presence and duration of loss of consciousness. However, according to a Concussion in Sports Group consensus statement and the American Academy of Neurology Revised they no longer use this grading scale due to evidence that indicates that a brief loss of consciousness in association with a concussion does not predict clinical course or long-term cognitive impairment. Similarly, the absence of loss of consciousness in a young athlete who has sustained a concussion should not be used to justify a more rapid return to play.
Myth 3: Concussions occur primarily in boys and on the football field.
ANSWER: NO. Incidence of sport-related concussion is higher for high school and college female athletes than male athletes when sports governed by similar rules for both sexes are compared. While, in some studies, girls’ soccer shows a higher incidence of sport-related concussion than boys’ soccer, the same cannot be consistently said of basketball.
Myth 4: Every child with a concussion needs Neuro-imaging (CT or MRI) or referral to a specialist.
ANSWER: NO, NOT NECESSARILY. Neuroimaging should be avoided in patients with no loss of consciousness, a normal mental status, no signs of basilar skull fracture, no vomiting, no other concerning factors, and a headache that is improving or responds to oral analgesics.
Patients with the following findings warrant referral to a physician with specific expertise in managing pediatric concussion (e.g., sports medicine specialist, physiatrist or neurologist):
- Persistent symptoms of concussion (e.g., persistent symptoms 10 days or longer after injury)
- Children and adolescents with multiple concussions occurring with progressively less force and/or associated with more intense symptoms or greater cognitive dysfunction
- Uncertain diagnosis of a concussion that raises the possibility of other acute, subacute, or chronic presentations that resemble concussions
Myth 5: Concussions are isolated injuries.
ANSWER: NOT NECESSARILY. Concussions may be associated with other conditions such as a Intracranial injury with or without bleeds, neck (cervical spine) injuries, heat-related illness, low blood sugar (hypoglycemia) and dehydration. At Night Lite Pediatrics Urgent care (NLP) we can assess the need for and perform X-Ray studies and blood tests and provide initial management of the concussion and any associated conditions.
Myth 6: My young adult is a strong competitive athlete, so he/she can go back to competitive sports.
ANSWER: NO. Although rare, a serious head injury and death may be associated with continued competition too soon after a mild head injury. A child or young adult who has sustained a concussion should not return to any physical activity until cleared by a healthcare provider. The child should be completely symptom-free and participate in school fully. Once cleared, he/she should gradually progress back to any physical activity. Ideally, a certified athletic trainer should supervise the child during this time frame. This gradual progression is critical because the return of any signs or symptoms of a concussion during mild physical activity signals that the brain has not healed and the child is not ready to return to their normal activities.
Myth 7: Physical and mental symptoms improve at the same rate.
ANSWER: NO. Cognitive recovery may lag behind physical recovery, clinicians frequently use neuropsychological testing to help determine when the patient has fully recovered from a concussion.
- Notify your child’s teachers that he or she has sustained a concussion and provide them with any written recommendations you were given during your visit to your healthcare professional. There are “Educator’s Guide to Concussions in the Classroom” which highlight academic accommodations for students healing from a concussion.
Adjustments may include:
- Limited course load
- Shortened classes or school day
- Increased rest time
- Aids for learning (e.g., class notes or supplemental tutoring)
- Postponing high-stakes testing (e.g., the Scholastic Aptitude Test [SAT] or Advanced Placement tests)
Cognitive (brain) and physical rest are the primary interventions for a concussion. The timing for return to school and back to competition vary from patient to patient depending upon their individual clinical course. Some students who do not show any symptoms can return to school immediately.
Most concussions occur when the PCP’s or specialist’s office is closed, which makes Night Lite Pediatrics Urgent Care (open from 4 PM to 11 PM on weekdays and 12 noon to 11 PM on weekends) a cost and time efficient place to access initial evaluation and treatment for your child or young adult.