Concussion in Children

What is Concussion?

Concussion is a temporary injury to the brain that affects how the brain functions. It is often caused by a bump or blow to the head. It can also be caused by knocks to other parts of the body that jolt the head such as a sports tackle. Most concussions occur without loss of consciousness (being “knocked out”).

Signs and symptoms of a concussion

Tiredness and weakness
Changes in mood or behaviour
Headaches
Poor concentration
Nausea
Memory loss
Dizziness
Changes to sleep
Confusion
Difficulties processing information
Vision changes
Difficulties at school

Symptoms usually appear immediately after the injury or within the first 24 to 48 hours. Most children recover completely and symptoms get better within a few days or weeks. Some children may develop post-concussion syndrome and take longer to get better.

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What can I do to help?

The first 24 to 48 hours: Time to rest

Minimise the amount of screen time, physical and mental activity
Try and create a calm and quiet environment - children may need a day or two off school.

Follow a Graduated Return To Activity programme

After the rest period children can gradually return to education and physical activity. It is important that the brain has time to recover. Returning to activity too soon can:

Prolong or worsen symptoms
Increase the risk of further concussion
Increase the risk of other injuries
Affect school performance

A further brain injury before a concussion has healed can be serious. It can cause permanent brain injury or death from second impact syndrome.

Further guidance

The UK Government has created a national concussion guideline which includes a graduated return to activity and sport programme.

If in doubt, sit them out

Staged return to activity

Stage 1 - Relative rest for 24–48 hours

Minimise screen time
Gentle exercise*

* rest until following day if activity more than mildly increases symptoms.

Stage 2 - Gradually introduce daily activities

Activities away from school/work ( TV, reading, games etc)*
Light exercise e.g. a walk

* rest until following day if activity more than mildly increases symptoms.

Stage 3 - Increase mental & exercise activities

Increase study/work-related activities with rest periods*
Increase intensity of exercise*

* rest until following day if activity more than mildly increases symptoms.

Stage 4 - Return to study/work and sport training

Part-time return to education/work*
Start training without risk of head impact but not before 7 days*

* rest until following day if activity more than mildly increases symptoms.

Stage 5 - Return to normal work/education and full training

Full work/education
If symptom-free at rest for 14 days consider full training

Stage 6 - Return to sports competition (not before 21 days)

If symptom free at rest for 14 days and during the pre-competition training of Stage 5

What if I have ongoing symptoms or concerns?

The time it takes to return to normal activities and sport will be different for each child. A small number of children may develop post-concussion syndrome and need further support. Seek medical review:

Urgently if any of the worrying features in the head injury advice leaflet occur.
From your GP if symptoms do not improve by 14 days or are getting worse
From your GP if symptoms are ongoing beyond 28 days

Further information

The Children's Trust have some useful guidance about learning to spot when a bump is a conussion.

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