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Concussions & Kids

Concussion symptoms, treatment and protection

(page 1 of 2)

It was the homecoming football game Saturday against rival St. Jerome, an important day for 11-year-old Eddie Guarnaccia of Southampton, PA, and tensions were high. 

“I had the ball, put my head down to run and got hit on my head with the other guy’s helmet,” recalls Eddie, who was tackled, fell back and hit the ground. 

Because Eddie wasn’t knocked unconscious, he was able to get himself up. His dad, Ed, the offensive-line coach, conducted a quick sideline evaluation, determined that Eddie seemed OK and put him back in the game. Unbeknownst to his dad, Eddie had suffered a concussion.

Signs of a concussion

Families think that most concussions cause a loss of consciousness, but this happens only 10 percent or less of the time, explains Thomas Drake, MD, children’s rehabilitation specialist at Cooper University Health Care in Camden, NJ. Like Eddie, a child may look and seem OK because there may be no bump or swelling.

Because collisions and hits happen so often in high-contact sports (even ones that may not be obvious, like girls' soccer and snow sports), many players, including Eddie, don’t think twice when they do occur. “You can’t judge the injury by the mechanics of what you saw happen,” says Dr. Drake. Sometimes kids seem to experience a fairly minor blow but have very significant symptoms, while for others it’s the reverse.

“There can be immediate concussion symptoms and delayed ones that initially don’t seem like a big deal,” says Rochelle Haas, MD, pediatric rehabilitation medical specialist at Nemours/Alfred I. duPont Hospital in Wilmington, DE.

Concussions: a "silent epidemic"

“In 2007, the Centers for Disease Control recognized that concussions were likely a silent epidemic — underdiagnosed and misdiagnosed. They were completely missed and mistreated,” says Dr. Drake. This prompted the CDC, the NFL and 26 other sports organizations to launch “Heads Up” to educate coaches, medical providers and parents about this stealth danger. 

“A concussion is a very difficult thing to define, because there is no way for me as a doctor to see, feel, touch or measure it,” states Dr. Drake. Neurological scans are not fail-safe, because not all concussions lead to detectable bleeding or bruises.  

Dr. Drake explains that a concussion is a functional injury that results in problems in four main areas — physical, cognitive, behavior and sleep. Symptoms may be immediate or delayed. Some patients may experience a raft of symptoms; others, just one.  

Next page: Concussion treatment, recovery and return to activity

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