Concussions in Teens

What should parents know about concussions in teenagers?

As a parent, keeping your child safe and healthy is always a top priority. This is especially true for parents of athletes who have a high risk of getting a concussion. The symptoms of a concussion are not always immediately apparent, and teens may not fully understand the seriousness of an injury.

“Parents should take extra care in recognizing the signs of concussions and work with coaches to ensure young athletes’ bodies have time to heal after experiencing a concussion,” said Jennifer Gray, DO, St. Charles Hospital Physical Medicine & Rehabilitation Medical Director. “Giving the brain enough time to heal from an injury is important before returning to the court or playing on the field.”

The ThinkSMART!™ program at St. Charles Hospital (Port Jefferson, NY) can help parents understand concussion symptoms and prepare their child to gradually return to activities as their condition improves.

What is a concussion?

A concussion is an injury to the brain caused by a bump, blow or jolt to the head, which causes the brain to move back and forth rapidly. The brain may twist or bounce inside the skull when the sudden movement occurs.

The movement causes chemical changes in the brain, damaging brain cells. These chemical changes can affect behavior and learning. Symptoms of a concussion are often the most severe immediately after the injury.

Are concussions serious?

“Concussions are usually not life-threatening, and most people recover completely,” said Dr. Gray. “But they are dangerous all the same.”

A concussion is a type of brain injury that causes temporary changes within brain cells. These changes make it difficult for the brain to function normally, leading to physical, cognitive and emotional symptoms. Returning to activities before the concussion has resolved can lead to long-term and sometimes tragic consequences.

How common are concussions?

Concussions are the most common kind of traumatic brain injury (TBI), and they are especially common among athletes.

The Centers for Disease Control and Prevention (CDC) estimates that 3.8 million concussions result from sports each year. A CDC study found that 2.5 million teens experienced a concussion as a result of playing sports. And one million teens had two concussions in a single year. However, as much as half of concussions go unreported or undiagnosed, so that number is likely higher.

Concussions can occur after any blow to the head. However, they are more likely to happen during contact sports like football, soccer or lacrosse. In these sports, athletes are likely to experience not only a single blow to the head but a series of blows that build up and cause a concussion.

Why do teenagers have a high risk of concussion?

Dr. Gray explained that adolescent brains have less protective coating (myelin) than adult brains. Less myelin makes them more susceptible to mild traumatic brain injuries. Teenagers also engage in more high-risk activities than other age groups, including sports, that make a head injury more likely. 

What are the symptoms of a concussion?

Many athletes, coaches and parents do not recognize the signs of a concussion. Sometimes, concussion symptoms do not appear for several days, and they may change during recovery. They also vary from person to person. Some people may have a headache and nausea early on but have difficulty sleeping a week or two later.  

Dr. Gray emphasized that parents should monitor their children who play sports for signs of a concussion that may have gone unnoticed. Mild symptoms can be easy to overlook or attribute to something else.

Mild concussion symptoms may include:

• Anxiety
• Difficulty concentrating or thinking clearly
• Dizziness
• Headache
• Insomnia or sleeping too much
• Irritability, sadness or feeling more emotional than usual
• Issues with memory
• Light sensitivity
• Nausea
• Vision problems

More serious concussion symptoms require immediate medical attention. These symptoms include:

• Headache that gets progressively worse and will not go away
• Loss of consciousness, severe lethargy, cannot wake up
• One pupil is larger than the other
• Repeated vomiting
• Significant confusion or agitation
• Slurred speech
• Uncontrollable crying
• Weakness, numbness, convulsions, seizure

What should I do if I think my teen has a concussion?

Call your pediatrician or visit the emergency department if you notice concussion symptoms.

“A child who has had a concussion that went undiagnosed and untreated may be more at risk of sustaining another injury in the future,” said Dr. Gray.

She noted that if a concussion occurs while your teen is playing a sport, they should leave the field or court immediately and not return to play until they have fully recovered and a physician has cleared them. 

How are concussions diagnosed?

Diagnostic testing is not available for concussions. Physicians with specialty training in concussion management can diagnose the condition based on your child’s:

• Balance
• Behavior
• Memory
• Motor speed
• Symptoms

A physician may recommend an MRI or CT scan if they suspect a severe injury or if the child presents with unusual symptoms.

How does my teen recover from a concussion?

Concussion symptoms should go away within a few weeks when properly managed. But after a concussion, brain chemicals need time to regain their normal functioning levels. Your child’s body needs rest while this occurs.

In the first days following the injury, limit physical activities that could put your child at risk of another head injury.

• Make sure they get plenty of rest and take naps as needed.
• Limit thinking/memory activities that may make symptoms worse.
• Limit playing video games that can make concussion symptoms worse because they present many elements at once. Cognitive overload from trying to process what is happening on the screen can be overwhelming for a concussed brain.
• Limit social media. Videos on social media can impact concussion recovery. They may cause blurry vision, and the blue light from screens can interfere with sleep cycles.

Gradually return your child to normal activities after the first two or three days. Resting for too long can make the recovery process take longer. As symptoms improve, allow your child to return to nonstrenuous activities slowly. Return to school gradually as the symptoms improve. They should also continue to get the recommended amount of sleep.

A health care professional with experience treating concussions should guide your child’s gradual return to sports.  

Can concussions be prevented?

“Although sports concussions cannot be completely prevented, athletes, coaches and parents can take steps to limit head injuries,” said Dr. Gray.

Recommendations include:

• Using safety and protective equipment that fits properly and is in good working condition to reduce the risk of injury. For football players, coaches should teach and enforce proper tackling methods to reduce the risk. Young athletes should also avoid unnecessary helmet-to-helmet contact.  
• Creating a safe environment for teens to report concussion symptoms to their coaches and parents. Many athletes do not report concussion symptoms to avoid losing playing time or because they do not understand the seriousness of a concussion.
• Talking to your teen to help them understand the risks of concussions and how to ensure their safety and overall health.