Neurology and Neurosurgery

A guide to concussions in kids: prevention, signs and treatments

Happy girl playing with a rope type jungle gym.


Concussions in kids are common. Find out how to prevent bumps on the head, signs of concussions and how to treat them.


By Paul Wright, MD, Senior Vice President and System Chair of the Nuvance Health Neuroscience Institute


Riding bikes, skateboarding, roller skating, playing outdoors and youth sports are a big part of an active childhood. These activities are wonderful ways for kids to engage in healthy exercises, teamwork and socialization. They can also sometimes cause collisions and blows to the head. 


You probably wonder what you should do when a kid hits their head. Do they keep playing or rest? Should they go to a pediatrician or urgent care? When should you worry about a concussion?


Here is what you need to know about concussions in kids, including what they are, how to spot the signs and when to seek medical care. 


What is a concussion?


A concussion is a type of traumatic brain injury (TBI) that occurs when the brain bounces around or twists inside the skull. A bump, blow or jolt to the head or body that causes the brain to move quickly back and forth can cause a concussion.


What activities increase concussion risk?


Although you can reduce a kid’s concussion risk, accidents can still happen. Slips, trips and falls at home, car accidents and other everyday activities can cause concussions.

Common causes of sports- and activity-related concussions include:

  • Cycling

  • Football

  • Playground equipment

  • Basketball

  • Soccer

  • Recreational vehicles (ATVs, go-carts, etc.)

  • Baseball and softball

  • Exercise equipment



What are the signs of concussions in kids?


There are several signs of concussion, so it is important to pay attention to your kid’s behavior and symptoms after they experience a bump, blow or jolt to the head or body.


A child might have a concussion if they seem dazed, feel sluggish or tired, and forget where they are or what they are doing. They may also appear clumsy or unbalanced in their movements or respond to questions slowly. 


A child may also experience a headache, nausea, vomiting, vision changes, balance problems, difficulty concentrating or sensitivity to light or noise.


If your child has any of these symptoms, have them immediately stop doing the activity that led to the injury. It is always a good idea for a pediatrician, primary care provider or urgent care provider evaluate a child when they have these symptoms after a blow to the head.


Although concussion symptoms often show up right away, some may not appear for hours or days after the injury occurred. Keep an eye on your child and alert their doctor about any new or changing symptoms.


Curious about concussions in adults? Related article: A bump on the head or a concussion? How to tell the difference.


When to take a child to the emergency department for a concussion.


Some concussion symptoms could indicate a serious problem. Take your child to the emergency department or dial 9-1-1 if they sustained a bump, blow or jolt to the head or body and experience “red flag” symptoms, including:

  • One pupil is larger than the other

  • Drowsiness or an inability to wake up

  • Headache that gets worse, is severe or does not go away

  • Slurred speech

  • Weakness, numbness or decreased coordination

  • Repeated vomiting or prolonged nausea

  • Convulsions or seizures

  • Unusual behavior or mood/personality changes, such as confusion, restlessness or agitation

  • Loss of consciousness — even briefly



Where should a child go for concussion care?


Dial 9-1-1 or take your child to the emergency department if they have any of the “red flag” symptoms outlined above. 


Nuvance Health emergency departments have neurologists and neurosurgeons available 24/7 who are equipped to provide emergency concussion and traumatic brain injury care.


For less severe symptoms, take your child to their pediatrician, primary care or urgent care provider as soon as possible.




How does a doctor diagnose a concussion?


Your child’s healthcare provider will ask about their symptoms, how the injury occurred and if they have had concussions in the past. They will also conduct a complete neurological exam.


Imaging tests — such as a CT or MRI — are not usually necessary to diagnose a concussion. Your child’s healthcare provider will order these tests if they suspect they have sustained a skull fracture or have bleeding in their brain.


Depending on whom your child sees for an initial evaluation, they may refer them to a neurologist for follow-up care. Nuvance Health neurologists are experienced in treating concussions and can recommend an appropriate treatment plan for your child.



How is a concussion treated? 


Concussion symptoms may last a couple of weeks but could last longer depending on the severity of the head injury.


Immediately after the head injury, you may need to apply ice to your child’s head if they have a bump. Apply ice for about 15 to 20 minutes at a time. Generally, kids can have over-the-counter acetaminophen for a headache. But, talk with your child’s healthcare provider about what medications to use. 


Rest is a crucial component of concussion recovery. Doctors used to recommend waking kids up regularly after a concussion. Now we recommend letting kids sleep because it can help the brain heal. If possible, avoid drinks and foods that have caffeine, such as chocolate and soda, so kids can rest better.


In addition to getting a good night’s sleep and taking naps during the day, avoid physical activities to prevent another head injury. Limit activities that require thinking and remembering until their symptoms improve. Also, avoid screen time, loud noises and commotion because the brain needs to relax. Try playing soothing music or reading to your child as they recover.


Make sure your child stays hydrated and eats light, nutritious meals after a head injury in case the concussion causes nausea and vomiting. 


When can my child resume sports and normal activities after a concussion? 

Kids may need to stay home from school or daycare for a few days after a concussion. Symptoms should resolve within a couple of weeks but could last longer.

Kids can usually ease back into their school and sports routines as symptoms improve. During their recovery, talk with your child’s teacher and coaches about their head injury to see how they can safely participate in school and activities until they feel 100% better.

Your child’s healthcare provider can help you determine when they can resume their regular activities. They will base recommendations on your child’s overall health, concussion history, severity of the injury and the rate of recovery. Other factors include your child’s risk of sustaining another concussion, for example, if they participate in a sport with a high risk of head injury. 


The bottom line: If you think your child has a concussion, immediately remove them from the activity that may have caused the head injury. For mild symptoms, a healthcare provider like a pediatrician should evaluate your child as soon as possible. If your child has “red flag” concussion symptoms, visit the emergency department or dial 911.