Concussion in children is the most common trauma in pediatrics. This is due to increased activity and an underestimated sense of danger in children. Due to the untimely diagnosis and lack of adequate treatment and regimen, complications can develop, sometimes even very serious. That is why parents should be aware of the signs of a concussion so as not to miss the moment and not risk the health and future of their child.
Concept of injury
Concussion is a type of traumatic brain injury (TBI) requiring hospitalization.
The high level of injuries is explained by increased activity, restlessness, curiosity, which are combined with imperfect skills in coordinating movements and an underestimated sense of danger. In addition, in young children, the head still has a lot of weight, and when falling, they do not know how to insure themselves with their hands, so they fall head down, without putting the handles forward.
Features
With a concussion in a child, fortunately, there are no irreversible processes. This type of injury has a good prognosis and rarely leads to complications.
All parents should be aware that signs of concussion in children (especially infants) are very different from signs of this head injury in adults.
For example, in adults, the symptoms are as follows:
- loss of consciousness;
- vomiting and severe nausea;
- partial or total memory loss;
- Strong headache;
- violation of coordination of movement.
In a child, the signs and symptoms of concussion are very blurry.
The child immediately feels good immediately after a bruise, but after a while, he suddenly becomes worse — these are the specific features of the developing child’s body that parents should take into account so as not to miss time and prevent undesirable complications.
Children up to a year
In babies, everything is not very symptomatic, as a rule, there is no loss of consciousness. Most often, signs of concussion in a child up to a year are:
- vomiting, sometimes even repeated;
- regurgitation during feeding;
- pale skin;
- poor appetite;
- increased drowsiness, but poor intermittent sleep;
- frequent crying;
- increased irritability;
- fontanel swelling.
Children under 6 years old
Signs of concussion in a child 1 year old and older are more pronounced, vomiting and nausea are already observed after an injury. A child may lose consciousness after hitting his head.
If the main signs of a concussion in a child up to a year are difficult to determine, also because the children cannot speak, then older children can already describe their condition and complain of a headache.
Sometimes a symptom such as post-traumatic blindness is observed in children. It does not develop immediately after a bruise, but can last for several hours, after which it independently passes without a trace.
So, parents need to pay attention to such signs of concussion in a child 1 year old and older, which can occur after a head injury:
- nausea and numerous bouts of vomiting;
- lack of appetite;
- dizziness and headache;
- pale skin;
- weakness and increased drowsiness;
- slow heart rate;
- fever;
- excessive sweating.
Teens
This age group also often goes to hospitals with a diagnosis of TBI. Signs of concussion in a child of 6 years and older are more similar to those observed in an adult:
- Loss of consciousness with short-term memory loss.
- Severe nausea, vomiting.
- Dizziness.
- Severe, persistent headaches.
- Confusion, jerky memories of what happened.
- Lack of coordination of movement.
First aid
What needs to be done for parents whose child has received a head injury? First of all, at the first signs of a concussion in an infant, it should be placed on a hard surface and provided with peace. Urgently call an emergency ambulance, which will take him to the hospital. Young children always have the most minimal symptoms, but they can have very severe brain damage. The absence of signs of concussion in a child up to 2 years old often after some time (from several hours to days) is replaced by a worsening of the condition, which manifests itself in a change in the baby’s behavior, its excitability increases, there may be vomiting, nausea, then this state changes to apathy, drowsiness.
If the child has lost consciousness, it must be put on the right side, bend his left arm and left leg 90 degrees. Then you need to call a doctor.
What can not be done at the first signs of concussion in children:
- Giving medicine and water will increase vomiting.
- Transport the child to the hospital on his own (you need to call an ambulance).
Should I see a doctor?
For any head injury, you must show the child to the doctor. Self-diagnosis should not be, it is extremely dangerous for the life and health of the baby. In addition, the signs of a mild concussion in a child are very hidden, and only a competent specialist can recognize them.
If the child has clear symptoms of a head injury, you should call a doctor, since most injuries do not occur immediately. Very often, parents say that after the bruise everything was fine, and then the child's well-being began to deteriorate. Therefore, one should correctly assess the condition and receive timely treatment, which only a specialist can provide.
Which doctor should I go to?
Depending on the nature of the injury and on what signs of concussion in the child were observed, there is a need for examination by certain specialists:
- So, if there was not a severe injury and the baby feels well, you need to visit a pediatrician. And he will, if necessary, direct to a neurologist.
- If as a result of an injury a person was injured, then a consultation with a dentist-surgeon or ENT is necessary.
- If the blow came in the ear, temporal bone or nose, you need to consult an otolaryngologist. It is very important not to miss the damage to the eardrum, as this will lead to numerous developmental disorders.
- If the child is hit by the forehead or the back of the head, it is necessary to consult a surgeon and a traumatologist.
Survey
If the child has a concussion, then often the examination in the clinic is quite enough. But there are additional research methods that help the doctor clarify the diagnosis and rule out serious damage.
So, with suspected concussion, the following diagnostic procedures are performed:
- Inspection by a pediatrician and neurologist.
- Blood and urine tests.
- Perform lumbar puncture (if necessary).
- Inspection by an oculist of the fundus (if necessary).
- Electroencephalogram.
- X-ray of the skull (to exclude bone fractures).
If a diagnosis of Concussion was made, then treatment is prescribed immediately. Drug therapy is not ruled out. It is very important to follow the regimen determined by the doctor.
Treatment
After receiving an injury, before the child is examined by a doctor, he needs to ensure peace. It must be laid on a solid and preferably flat surface. If there are bleeding wounds, it is necessary to examine, treat and bandage them.
Children with a diagnosis of head injury, including concussion, are subject to mandatory hospitalization.
Purpose of hospitalization of the child:
- In the hospital, he will be under the supervision of specialists in order to detect and prevent possible complications of a head injury as early as possible: cerebral edema, internal hematomas, epileptic seizures. The risk of developing such complications is very small, but their consequences are very serious and can lead to rapid deterioration of health. Therefore, at the first signs of concussion in children, they must be hospitalized, the standard period of inpatient treatment is 10 days. With modern technical equipment of the hospital, the child’s stay in the hospital after all the necessary examinations and with the exception of serious injuries is reduced to 3-4 days.
- The second goal of hospitalization is to provide the patient with complete rest. It consists in limiting the motor activity of the child. Of course, it is very difficult to achieve full bed rest, but nevertheless, the hospital does not allow active games, running, noise, prolonged watching TV programs and prolonged sitting at the computer. After discharge, the regimen should be maintained for approximately another 2 weeks plus a few weeks to limit exercise.
Drug treatment consists in the appointment of diuretics such as "Diakarba" or "Furosemide" in the mandatory combined use with potassium preparations - "Asparkam", "Panangin". This is done in order to prevent cerebral edema. In addition, soothing drugs (valerian infusion, "Phenazepam") and antihistamines ("Diazolin", "Suprastin", "Diphenhydramine") are prescribed. If severe headaches are observed, analgesics are prescribed ("Baralgin", "Sedalgin"), with nausea - "Tserukal". After discharge, vitamin preparations are also prescribed.
In the hospital, the child is constantly monitored, if his health begins to deteriorate, then a second examination is carried out and an additional examination is prescribed.
Hospitalization is necessary so as not to miss a more serious injury than a concussion, and this is possible only in a hospital.
As soon as the child's condition becomes satisfactory, they let him go home. But at home, compliance with the regimen prescribed by the doctor is required, walking and watching TV are limited, the child should spend as little time as possible at the computer. Drug treatment should also be continued. And at the first signs of a worsening state of health (vomiting, nausea, ongoing headaches, drowsiness, cramps, weakness in the legs, frequent spitting up in infants), you need to re-see a doctor for additional examination and re-hospitalization.
About 3 weeks after the injury, all signs of concussion in children disappear, the condition fully returns to normal, the child can again go to kindergarten, school, play sports.
Consequences of injury
As a rule, a concussion in childhood occurs without consequences. But there are exceptions.
The most dangerous and serious complication is re-concussion syndrome, which occurs when a repeated head injury occurs shortly after the primary one. This threatens cerebral edema, which can lead to the death of the child.
If the child does not follow the regime, there is a risk of developing a post-traumatic syndrome, which is expressed in severe headaches, nausea, mental symptoms (short temper, aggressiveness, excessive emotionality, impulsiveness).
After a mild concussion, the risk of epileptic seizures, which can appear within a few years after an injury, is several times increased. The risks of such a complication should be discussed with a neurologist, since each individual child has a completely different predisposition to this reaction of the body.
The consequences of a TBI in a child can be cumulative. As a result of constant numerous head injuries, a violation of the child’s mental development occurs, his behavior changes, depression appears, speech, gait, movements are disturbed.
How to avoid
What should parents do to protect their child from concussion? First of all, observe basic safety rules, they will reduce the likelihood and mitigate the power of injury in children of any age:
- Children up to a year: do not leave the child alone on the changing table, even if he still does not know how to roll over and crawl. Active movements with legs and handles can lead to mechanical slipping and sliding. If after a fall there are signs of concussion in a small child (infant), you should immediately consult a doctor.
- Children under 6 years old. They may be injured in the playground. Children of this age group, as a rule, do not see danger and do not feel fear. If the child is smaller than everyone else on the playground, it is better not to leave him unattended.
- School children and adolescents. They are injured as a result of active games and in risky sports. A 12-year-old child has the same signs of concussion as an adult, and the consequences develop the same, so it is always better to prevent injuries than to deal with complications later. It is necessary to find activities for the child in which he will be taught the correct technique for performing certain sports elements, observing safety precautions and quick reactions. If a child is fond of active sports (rollers, skis, a bicycle), it is necessary to teach him how to wear a helmet and other protective elements of his uniform.
Instead of a conclusion
Doctors say that most of the concussions of the brain in children pass without a trace, and the child’s body recovers completely after the injury. But there are times when a baby suffers from the consequences of a head injury even after years.
Concussion is a rather dangerous trauma, the further condition of the child depends on the speed of providing the necessary medical care and timely treatment. That is why all parents need to be careful and notice the main symptoms and signs of concussion in time, as well as understand the causes of its occurrence. This is especially true for babies who cannot independently say what they have and how they feel.