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Concussions: Symptoms and Myths

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This month I have been kept very busy with a lot of web site moving, updating, and computer repair from a virus. Needless to say, I haven’t had much time to add new information to Your Child’s Journey or even correspond much. But one thing did come to my inbox that I think you will really like to know about.

Continuing with the theme of safety for our children, I found a couple articles on Parents.com that talk about concussions. Since this is a potential problem for every child, I thought this would be a good time to share the information.

“According to the Centers for Disease Control and Prevention (CDC), children under the age of 4 are the most frequent victims of head injuries. But while many injuries can be fixed with a bandage and a kiss, a blow to the head is a more serious matter because it can cause a condition known as a concussion. ‘Any injury that causes the head to shake can [affect] the brain,’ says Matthew Grady, M.D., a pediatric sports medicine specialist at the Children’s Hospital of Philadelphia.

“A concussion is a mild traumatic brain injury (sometimes referred to as a TBI-traumatic brain injury) that temporarily interferes with the way the brain functions. Because the brain “floats” in fluid in the skull, a knock to the head or jolt to the body can send it crashing into the hard bones of the skull, resulting in this injury.

“A concussion can be caused by a simple bump on the head from a fall or a body hit, as might occur in a car accident. Any collision, including those between players on the sports field or an accidental blow to the face or head from a ball during gym class, can cause a concussion. A concussion can also occur as a result of the head or body being violently shaken.

“Falls are the number-one cause of head injuries to children under age 9, the CDC reports. Older kids have a greater chance of a sports-related concussion, with football as the leading cause for boys, and soccer and basketball for girls. Bicycling is responsible for the most non-sports-related concussions.”

Symptoms of Concussion

Symptoms can take as long as 24-48 hours to appear. Contrary to popular belief unconsciousness only occurs about 10% of the time. “Most concussions have at least a few symptoms, not just one,” Dr. Grady explains.”
Watch for these warning signs after a blow to the head or body. The child:

  • appears dazed, stunned, or confused
  • can’t recall events that happened before or after the bump or fall
  • has difficulty thinking, concentrating; feels sluggish or groggy
  • has a headache
  • feels dizzy or has balance problems
  • has blurred vision
  • sensitivity to sound or light
  • has difficulty reading
  • irritability
  • needs to sleep more than usual
  • is nauseated or vomiting. Some kids throw up once out of shock or fear. Continued vomiting, along with other symptoms, is a bigger concern.
  • Vomiting more than once.
  • For babies who are not yet walking or talking, additional danger signs include bulges at the fontanel (the soft spot on the front and back of the skull), vomiting, lethargy, difficulty feeding, and high-pitched crying.

Call a doctor immediately if you note:

  • vomiting more than once
  • a severe or increased headache
  • stumbling, clumsiness, disorientation
  • slurred speech
  • blood or fluid from the ears or nose
  • changes in breathing pattern
  • dilated pupils or pupils of unequal size
  • a loss of consciousness that lasts more than a minute
  • stiffness in the neck
  • weakness or numbness in the face, arms, or legs
  • a seizure or convulsions

Myths and Answers:

  • You shouldn’t let your child sleep after a head injury. This may be good advice for babies and toddlers, until you know whether they have a concussion. But sleeping is extremely beneficial to healing.
  • Helmets prevent concussions. A concussion is caused by the brain crashing around inside the skull, so the outside protection cannot prevent concussions. Helmets are still important to protect against skull fractures or bleeding in the brain.
  • If the child doesn’t black out, it isn’t a concussion. Only about 10% of concussions involve loss of consciousness.
  • The harder the blow, the worse the concussion. There is not a direct correlation. The shaking of the brain from playing Dodge Ball can cause as severe symptoms as a hard fall on the head.
  • Vomiting is a sure sign of concussion. Many kids vomit because they’re shocked or scared. Vomiting more than once or accompanied by several other symptoms are better signs of concussion.
  • Boys get more concussions than girls. The rates are about equal with girls just slightly higher incidence. Girls may report their symptoms more than boys and their neck muscles may be weaker than boys.
  • All concussions have the same clear-cut symptoms. No two concussions are alike. Symptoms can be many and varied. Take note of any unusual behavior and symptoms to report to your doctor.
  • An MRI or CT can rule out a concussion. They can only see structural damage to the brain and bleeding. If symptoms are severe CT scans are the diagnostic tool of choice in an ER. A computerized test to assess a child’s memory and reaction time may assist in the diagnosis.
  • Only a blow to the head can cause a concussion. Any severe jolt to the body can cause a concussion, not just blows to the head.
  • It’s fine to return to school after a concussion. Concussions interfere with proper brain function. Adding bright lights, noise and reading may interfere with healing.

I hope you never need this information, but it is always good to be armed with this knowledge.

Symptoms to Call Your Doctor About

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When you become a parent, you earn a medical merit badge of sorts. Whether you’re sopping up a goopy nose or extracting a dangling-by-a-thread baby tooth, eventually few things faze you. But sometimes it’s tough to tell what warrants a call to your doctor’s office: Which temperature actually classifies as a “high fever”? What kind of tummy ache means your child has more than your average stomach bug? And when something truly frightening happens — say, your child suddenly breaks out in hives — should you call your pediatrician or head straight to the E.R.?

“Parents should always err on the side of caution and seek immediate medical care when they’re worried about something,” says Anita Chandra-Puri, M.D., a pediatrician at Northwestern Memorial Physicians Group, in Chicago, and a spokesperson for the American Academy of Pediatrics. However, to give you more specific guidelines to follow, we talked to top pediatricians about the 12 symptoms that always require medical attention.

[Read more…]

Is ADHD on the Rise or Over-diagnosed?

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There is an increasing frequency of ADHD diagnosis. The New York Times has reported data collected from the Centers for Disease Control and Prevention which suggest that 11% of youth (between 4 and 17 years of age) have been diagnosed with ADHD at some point in their lifetime.

This is troubling – primarily because the data came from phone surveys of parents. This means that parents are receiving this diagnosis at unprecedented rates – not that kids are being properly diagnosed with ADHD at higher rates than before. It is too easy for kids to get labeled ADHD and not go through the comprehensive screening that should take place as administered by a multidisciplinary team of professionals.

It’s becoming clear that ADHD is being used as a label to try to provide a quick handle on behavior that may – or even may not – be somewhat troublesome. ADHD involves much more than not sitting still and not paying attention. All kids exhibit “ADHD” like behaviors now and then. It’s a difficult condition to diagnose because it is based on increased frequencies of a number of behaviors across a number of contexts (home and school) for a sustained period of time which cause impairment for the child. Without a detailed diagnostic process, it can be too easy to misread normative behaviors as symptoms of ADHD.

For a good over-all understanding of ADHD, causes, diagnosis, treatments, and therapies, please check the PsyCom.net information.