Concussion in children - discharge

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Alternative Names

Mild brain injury in children - discharge; Brain injury in children - discharge; Mild traumatic brain injury in children - discharge; Closed head injury in children - discharge; TBI in children - discharge

When Your Child Was in the Hospital

Your child was treated for a concussion. This is a mild brain injury that can result when the head hits an object or a moving object strikes the head. It can affect how your child's brain works for a while. It may also have made your child lose consciousness for a short time. Your child may have a bad headache.

What to Expect at Home

Healing from a concussion takes days to weeks or even months. Your child's condition will slowly improve.

When Your Child First Goes Home

Your child may use acetaminophen (Tylenol) for a headache. DO NOT give aspirin, ibuprofen (Motrin, Advil, Naproxen), or other non-steroidal anti-inflammatory drugs.

Feed your child foods that are easy to digest. Light activity around the home is okay. Your child needs rest but does not need to stay in bed. It is very important that your child does not do anything that results in another, or similar, head injury.

Have your child avoid activities that need concentration, such as reading, homework, and complex tasks.

When you go home from the emergency room, it is OK for your child to sleep:

  • For the first 12 hours, you may want to wake up your child briefly every 2 or 3 hours.
  • Ask a simple question, such as your child's name, and look for any other changes in the way your child looks or acts.
  • Make sure the pupils of your child's eyes are the same size and get smaller when you shine a light in them.
  • Ask your health care provider how long you need to do this for.

Returning to School

As long as your child has symptoms, your child should avoid sports, hard play at recess, being overly active, and physical education class. Ask the doctor when your child can return to their normal activities.

Make sure your child's teacher, physical education teacher, coaches, and school nurse are aware of the recent injury.

Talk to teachers about helping your child catch up on school work. Also ask about timing of tests or major projects. Teachers should also understand that your child may be more tired, withdrawn, easily upset, or confused. Your child may also have a hard time with tasks that require remembering or concentrating. Your child may have mild headaches and be less tolerant of noise. If your child has symptoms in school, have your child stay home until feeling better.

Talk with teachers about:

  • Not having your child make up all of their missed work right away
  • Reducing the amount of homework or class work your child does for a while
  • Allowing rest times during the day
  • Allowing your child to turn assignments in late
  • Giving your child extra time to study and complete tests
  • Being patient with your child's behaviors as they recover

Based on how bad the head injury was, your child may need to wait 1 to 3 months before doing the following activities. Ask your child's provider about:

  • Playing contact sports, such as football, hockey, and soccer
  • Riding a bicycle, motorcycle, or off-road vehicle
  • Driving a car (if they are old enough and licensed)
  • Skiing, snowboarding, skating, skateboarding, gymnastics, or martial arts
  • Participating in any activity where there is a risk of hitting the head or of a jolt to the head

Some organizations recommend that your child stay away from sports activities that could produce a similar head injury, for the rest of the season.

When to Call the Doctor

If symptoms do not go away or are not improving a lot after 2 or 3 weeks, follow-up with your child's doctor.

Call the doctor if your child has:

  • A stiff neck
  • Fluid or blood leaking from the nose or ears
  • Any change in awareness, a hard time waking up, or has become more sleepy
  • A headache that is getting worse, lasts a long time, or is not relieved by acetaminophen (Tylenol)
  • Fever
  • Vomiting more than 3 times
  • Problems walking or talking
  • Changes in speech (slurred, difficult to understand, does not make sense)
  • Problems thinking straight
  • Seizures (jerking arms or legs without control)
  • Changes in behavior or unusual behavior
  • Double vision
  • Changes in nursing or eating patterns

References

Committee on Sports-Related Concussions in Youth; Board on Children, Youth, and Families; Institute of Medicine; National Research Council; Graham R, Rivara FP, Ford MA, Spicer CM, eds. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: National Academies Press; 2014.

Liebig CW, Congeni JA. Sports-related traumatic brain Injury (concussion). In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 688.

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