10 Signs Your Child’s Concussion Is Serious — and What to Do

Trip to ER is best if you see any of these red-flag symptoms

10 Signs Your Child's Concussion Is Serious -- and What to Do

If your child suffers a concussion, whether while playing sports or from a fall or other accident, keep a close watch for symptoms of more severe brain trauma.

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“Parents should be concerned about a series of things we call red-flag issues,” says neurologist Andrew Russman, DO. “These are symptoms that warrant a prompt evaluation because they could signal something more worrisome than just a concussion.”

Watch for these 10 red-flag symptoms

If you see any of the following symptoms after a concussion, go to an Emergency Department immediately for a medical evaluation:

  1. Severe or worsening headache or ringing in the ears
  2. Neck pain
  3. Vomiting
  4. Increasing confusion or dizziness (Some patients exhibit sadness about the injury, unusual or irritable behavior or the inability to recognize people or places.)
  5. Fainting, drowsiness, significant decline in alertness, inability to waken from sleep, any prolonged loss of consciousness
  6. Seizures
  7. Slurred speech
  8. Weakness or numbness in arms or legs
  9. Clear, watery discharge from the nose or ears, or bloody discharge from the ears
  10. Pupils that are unequal in size

Of these, Dr. Russman says, the most common are headache, neck pain, and fogginess or dizziness.

“The basic concern is to know to identify the concussion symptoms and seek medical attention appropriately,” he says. “If there are some of these red flags, an ER evaluation is important.”

How to handle a less serious concussion

Dr. Russman addresses two common misconceptions about concussions.

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First, if a child suffers a concussion, he or she does not necessarily need a CT scan, he says.

“Few patients with concussions will benefit from any type of brain imaging in their early evaluation,” he says. “In fact, ERs have a whole list of criteria for requiring a CT scan, so the patient would have to have at least one of the red-flag symptoms.”

Second, you don’t have to keep the child awake if he or she is not showing any of the red-flag symptoms, he says.

“As long as the child has remained awake and alert, there’s no reason that you have to wake them if they fall asleep at a normal time,” he says.

Again, if the child’s condition worsens or he exhibits any of the red-flag symptoms, take him or her immediately to the ER.

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What usually happens when a child athlete gets a concussion?

Typically, if your child gets a concussion during an organized athletic event, one or more members of a team of trained medical professionals will examine him or her immediately. This usually starts with a team physician or athletic trainer on the sidelines. A physical therapist, pediatrician or neurologist may examine your child later.

After that initial evaluation, the medical professional will help decide whether the child should go to the office for a follow-up evaluation, to the ER for immediate medical attention, or whether he or she is well enough for parental observation at home.

“They should never return to the sport on the same day they have had the injury,” says Dr. Russman. “Next, they need to go through a graded program of physical recovery under the direction of a licensed healthcare professional.”

The goal for athletes

While most patients may not need an ER evaluation, they all need to carefully follow a set of guidelines that will return them to the classroom first, and then return them to their athletic activities, Dr. Russman says.

“The point person on the sidelines, the team physician and the athletic trainers, as well as the other medical professionals involved, will follow up and continue to evaluate and eventually help the child return to learn and return to play,” he says.

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