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Concussions – injuries to the brain generally caused by a blow or jolt to the head – have been getting a lot of attention lately. The guidelines and recommendations, particularly as they relate to children and teens, seem to change almost annually.

Dr. Robert Wack, Medical Director of the FMH Pediatric Hospitalist Program, sees two clear trends emerging from the research community and national organizations like the American Academy of Pediatrics (AAP) and the American Academy of Neurology.

“First, the amount of head trauma considered a significant risk for concussion is becoming less and less with each guideline revision,” Dr. Wack says. “In other words, even minor head injuries have been found to cause measurable neurologic impairment associated with concussion.”

Gone are the days when coaches (at any level) took a quick glance at a player who’d just taken an accidental elbow to the head, figured if he or she didn’t lose consciousness it couldn’t be too serious, and put the player back in the game. Today, the rule of thumb is “when in doubt, sit them out.”

“The amount of time to recover from any concussion is growing longer and longer, due to the more detailed measurement of subtle neurologic problems and how long they persist after the initial injury,” Dr. Wack says. “Current guidelines are two weeks without contact sports, and that may become even longer in the near future.”

These two trends, plus the pending litigation about head injury risks at the professional level, mean big changes are coming for both the recreational and the scholastic athlete. While there’s no way to know precisely what those changes will be, Dr. Wack says we can expect them to follow these trends.

“Be sure to ask your doctor about the latest findings if your child has the misfortune of a head injury,” Dr. Wack recommends.

Concussion Symptoms

According to the AAP, symptoms of a concussion can be subtle or obvious, beginning immediately after the injury or showing up hours or days later.

Symptoms of a concussion include the following:

• Headache
• Nausea or vomiting
• Dizziness or balance problems
• Double or blurry vision
• Sensitivity to light
• Sensitivity to noise
• Feeling dazed or stunned
• Feeling mentally “foggy”
• Trouble concentrating
• Trouble remembering
• Confused or forgetful about recent events
• Slow to answer questions
• Changes in mood—irritable, sad, emotional, nervous
• Drowsiness
• Sleeping more or less than usual
• Trouble falling asleep

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