Early after the injury (within the first day) After a concussion, should my child see their pediatrician for an examination?
Yes, you should be sure to inform your pediatrician of your child’s concussion. He or she may want to schedule an appointment to examine your child, send you to the Emergency Room, or they may choose to refer you to a concussion specialist.
Do I need to keep my child awake all night or wake him or her up regularly?
No, sleeping does not make brain injuries worse. In fact, sleep is actually very important for recovery! The brain’s energy after a concussion is reduced significantly and there may be a powerful urge to sleep. The general recommendation is to let your child sleep after their injury, but occasionally check on them (gently push or nudge them) to be sure that they respond to you in some way. You do not need to wake them up fully.
The concern is that if your child is sleeping, you cannot see possible signs of a more severe brain injury, related to a bleed in the brain or swelling. These signs are listed in the Danger Signs and include increasing sluggishness or a worsening headache. If the child is not responsive to gentle prodding, you should seek emergency medical care.
My child has now had multiple concussions. How concerned should I be, and should my child continue to play contact sports?
You should be concerned, but you should also consult a concussion specialist to understand if there is likely to be any possible lasting effects for your child. The effects of multiple concussions vary widely for different individuals. Some may still recover quickly, while others do not. There are no steadfast rules as to how many concussions are too many, but if your child has had multiple concussions, you should seek the advice of an expert.
The long-term effects of concussions will vary greatly, although most individuals recover fully without long-term effects. If you are concerned about lasting problems, seek an evaluation from a concussion specialist.
Several days to weeks after the injury Neuropsychological testing has been recommended. What is it and what is it used for?
Neuropsychological testing is one of the tools used in a concussion evaluation. The testing involves assessing the child’s attention, memory, and speed of thinking. These functions are sensitive to the effects of a concussion. Cognitive performance that is not normal for that child can be one indicator that the brain is not working properly. However, there are many reasons why a child’s neuropsychological test performance can be abnormal and, if possible, it is important that a skilled neuropsychologist be involved in interpreting the results of these test findings.
Can I give my child medicine for their headaches? What about taking their other regular medications?
After a concussion is diagnosed, talk to your physician about the use of medication for headache pain or other symptoms. Relieving headache pain is certainly appropriate but does not replace the need for cognitive and physical rest if symptoms are at all present. Be aware that symptom improvement with medication does not mean that the brain has recovered. Symptoms must improve while not on medication before returning to typical activities, particularly contact sports. Decisions about continuing to use other medications should be done in consultation with your physician.
My doctor (coach, athletic trainer, etc) initially said that my child could return in two weeks. Is this the right amount of time after a concussion?
It is very difficult (if not impossible) to predict the length of recovery of a concussion at the time of the injury. No specific time period should be given without regard to the child’s symptom recovery. The decision to return to a sport is an individualized medical decision, and based on the child’s actual symptom recovery. Once the symptoms are fully gone, the child can begin a supervised gradual return to play program.