What should parents look for regarding post-concussive syndrome in children?
With babies, it can be difficult to recognize that a brain injury has occurred. The most obvious symptom is loss of consciousness but other signs include crying inconsolably and not being able to be comforted, vomiting, or excessive sleepiness. Refusing to eat, prolonged irritability, or unusual or prolonged periods of quietness or inactivity may also be signs of a concussion or more serious brain injury. Bulging of the “soft spot” of the head can also be a sign. If your child has any of these symptoms he or she should be checked immediately by a doctor.
After the injury, parents may notice a temporary loss of the most recently attained developmental skills (for example, if injured at age 6 months, the baby may stop babbling or may no longer be able to sit independently). But the baby should regain these skills and acquire new skills. Parents may also notice that the child is more irritable, cries more, has become a fussier eater, and has a change in sleep patterns. If a child cries more in a particular position, it may mean that vertigo or dizziness has developed from the injury and that position should be avoided for a few weeks. In most cases, the infant will return to normal over the space of several weeks.
With pre-schoolers and young children, it is sometimes hard to recognize a brain injury because limited short-term memory and brief attention spans are normal at these ages. With older children and adolescents, confusion and word-finding problems may be apparent.
Aside from memory and attention span issues or changes, recognizing a concussion in children and adolescents may include the following signs and symptoms:
- Brief (less than 20 minutes) loss of consciousness
- Confusion or being dazed or stunned, or seeing stars
- Emotional lability (cry or laugh unexpectedly)
- Anxiety or depression
- Sleep disturbance
- Fatigue and the vertigo
These symptoms are best treated initially by rest — both physical and mental. Recovery is faster when the child or adolescent rests often and consistently post-injury. For the first few days after an injury, almost complete rest is important. After the symptoms have disappeared, see what happens when the child walks on even ground at a relatively brisk pace. If no symptoms recur then the child can increase his physical activity as long as he remains symptom free. Parents and teachers should carefully monitor the child’s first few days, weeks, and months after the injury and return to school. If symptoms return or problems in school develop, the child should be taken to a physician and possibly a neuropsychologist.
If any of the symptoms get significantly worse rather than better, if new symptoms appear after a few days, if the child starts vomiting, or is difficult to arouse then he should be taken immediately for an assessment by an emergency physician.