Ask Dr. Marla: How can I tell if my child has a concussion?

Question:

How can I tell if my child has had a concussion, and if he has, what should I do?

Answer:

This is such an important question as concussions often go unrecognized and undertreated. One of the best sources of information comes from Think First, an excellent resource for parents and healthcare providers. It explains that a concussion is a traumatic brain injury that occurs as a result of a direct or indirect force – a so-called disturbance to the brain. There can be a host of non-specific signs and symptoms. It often does not involve loss of consciousness – which surprises many parents. Many people think that if there is no loss of consciousness, it may not be a severe injury and this is not always true, particularly in the case of repeated concussions.

Concussion should be suspected if any of four main areas are impacted. These four areas include:

• headache
• physical signs such as difficulty with balance and walking
• impaired brain function such as confusion
• any abnormal behaviour such as a change in personality.

For even more detail, I turned to the Consensus Statement on Concussion. which was reported in the British Journal of Sports Medicine in 2013. It says concussion should be suspected if one or more of the following visible clues, signs, symptoms or errors in memory questions are present:

1. Visible clues of suspected concussion, such as when your child is obviously unconscious or slow to get up from a fall or hit. A child who appears dazed, blank or has a vacant look requires evaluation.
2. Signs and symptoms of suspected concussion. This is important as many of these can be subtle, such as feeling slowed down or just not feeling right. Irritability and light and noise sensitivity might be a common complaint as well. More concrete complaints include headaches, dizziness and pressure in the head. Often the phrase “feeling foggy” is used. Clearly more obvious signs such as vomiting require attention.
3. Poor memory function, which can include difficulty concentrating and, on occasion, wrong answers to specific questions such as:

• “What venue are we at today?”
• “Who scored last in this game?”
• “ What team did you play last week/game?”
• “ Did your team win the last game?”

The bottom line for me is to always err on the side of caution. As the guidelines clearly state, any athlete with a suspected concussion should be immediately removed from play, and should not be returned to activity until they are assessed by a doctor. 

Athletes with a suspected concussion should not be left alone and it is recommended that, in all cases of suspected concussion, the player is referred to a medical professional for diagnosis and guidance as well as return-to-play decisions, even if the symptoms resolve.

If you suspect that your child might have had a concussion, outline your areas of concern with your child’s healthcare provider right away. 

For more information about concussion safety, visit ThinkFirst.ca

Got a question? Submit it to Dr. Marla.

Originally published in ParentsCanada magazine, November 2013.