Paediatrics@home

Concussion

Your child has been diagnosed with a concussion.

We know this can be a stressful time with lots of information from healthcare providers. It can be difficult to absorb everything.

We hope the following pages will be helpful in providing you with the education and resources you need to support your child from home.

What is a Concussion?

A concussion is a type of brain injury that can affect how the brain functions. It happens after a hit to the head or anywhere else on the body that makes the brain move quickly back and forth inside the skull.

Click continue to learn more!

Other Resources: Concussions Ontario - What is a concussion?

Symptoms of a Concussion

The symptoms of a concussion can range from mild to severe and can last for hours, days, weeks or even months.

Symptoms of a concussion fit into four main categories:

A. Thinking and remembering

  • not thinking clearly
  • feeling slowed down
  • not being able to concentrate
  • not being able to remember new information

B. Physical

  • nausea and/or vomiting
  • headache
  • fuzzy or blurry vision
  • dizziness
  • sensitivity to light or sound
  • ringing in ears
  • balance problems
  • feeling tired or having no energy

C. Emotional and mood

  • easily upset or angered
  • sad or not interested in your usual activities
  • nervous or anxious

D. Sleep

  • sleeping more or less than usual
  • having a hard time falling or staying asleep

Resource: Concussions Ontario - What is a concussion?

How is a concussion diagnosed?

A doctor or nurse practitioner will diagnose a concussion based on the history you provide and your child's physical exam. Concussions do not show up on imaging tests like CT scans or MRIs, so these tests are not helpful in making a diagnosis.

Occasionally, your doctor may order a CT scan to rule out other problems like bleeding inside the head or a skull fracture, but there are also ways to rule these out without using CT scans. There are downsides to doing CT scans and MRIs, including radiation, and incorrectly diagnosing what is seen, so your doctor will consider doing imaging tests only when necessary.

What to do at home

Click below for information on ways to help at home.

Track your symptoms

Symptoms can appear right away or start a few days later. Track symptoms by writing them down including the symptom, when it started, how severe and frequent it is, and any changes. Bring this to your follow-up visit with your healthcare provider.

Pain management

To help alleviate pain, you can give your child acetaminophen (Tylenol) and/or ibuprofen (Advil), so long as your child does not have allergies or other reasons not to take these medications.

Unless your doctor advises you otherwise, give the dose recommended on the medication package. Safe Acetaminophen Dosing for Infants and Children Mount Sinai - Ibuprofen Dosing for Infants and Children

Return to School

The first stage of recovery requires rest of the body and brain. For the first 1 to 2 days, your child should rest as much as possible.

After this time your child can start some light cognitive and physical activity so long as these do not worsen symptoms.

The following resource provides a strategy for returning to school after a concussion. It is important to complete these steps before returning to more intense physical activity or sport. It should take about a week or so to advance through these steps. If it is taking longer or your child is feeling worse, please contact your doctor or get medical help sooner. Parachute - Return to School Guidelines

Return to Sport

Once your child has fully completed the first stage of recovery and is back to school, please see your primary care provider for medical clearance before returning to sport.

If your child is medically cleared, then you can start advancing physical activity slowly with the goal or returning to full sports play, usually within a week or two.

The following resource provides a strategy for returning to sport after a concussion. Each stage provides advice on the type of activity and is at least 24 hours. Your child can advance to the next stage when they tolerate the activities in the current stage without new or worsening symptoms. If symptoms worsen, go back to the last stage that your child tolerated. If your child's symptoms continue to worsen see your primary care provider. Parachute - Return to Sport Guidelines

Do I need to wake my child at night?

Unless your doctor specifically advises it, you do not need to wake up your child throughout the night.

When to seek medical attention

Here are some signs that, if present, should lead you to seek immediate medical attention for your child:

  • a headache that gets severely worse
  • weakness, numbness or decreased coordination
  • repeated vomiting or nausea
  • slurred speech
  • extreme drowsiness or unable to wake
  • one pupil that is larger than the other
  • convulsions or seizures
  • difficulty recognizing people or places
  • increasing confusion, restlessness, or agitation
  • fainting or sudden loss of consciousness

Follow Up

Your brain is more sensitive to being injured again after a concussion. While you are recovering, be sure to avoid activities that might injure you again.

Many people recover within a few days, though it is common to take a few weeks to recover. In rare cases, concussions cause more serious and long-lasting problems. Repeated concussions or a severe concussion are higher risk for long-lasting symptoms.

Please follow up with your primary care provider unless instructed otherwise. Of course, if you feel your child needs immediate medical attention, please do not hesitate to call 911 or bring them to your closest emergency department.

We hope this has been useful. Thank you for using Paediatrics@home!