Wed10222014

Your Health

Recreation-related concussions on the rise in children

Children are getting more sports- and recreation-related concussions than ever before. According to the Centers for Disease Control and Prevention, the rate of concussions in children has risen 60 percent during the past decade. Each year, more than 173,000 children and adolescents are treated in emergency rooms for concussions and other traumatic brain injuries.

Concussions are traumatic injuries to the brain that occur after a blow to the head or body. The brain, made of soft tissue, shifts inside the skull, causing temporary changes in how the brain works. Most concussions last between seven and 10 days, but they can be serious and last longer.

The best way to prevent children from getting a concussion is to help them choose a sport with a lower risk of head trauma, such as swimming.

Common concussion symptoms include headaches, nausea, dizziness, drowsiness, fatigue and sensitivity to light or sound. Your child may seem mentally foggy and have difficulty concentrating, or seem irritable or sad. He or she may have trouble sleeping.

Any time your child takes a hard blow to the head – for example, after falling off a bike or while playing a sport – see a doctor for evaluation. In addition, if your child has any of the above symptoms after a fall, he or she should immediately stop the sport/activity and not return to it until cleared by a physician trained in evaluating concussions, such as your general pediatrician or family physician.

Recovery

Most people with concussions recover quickly and fully within a week. But it’s important that your child make a gradual return to regular activities, such as school and play. During the recovery time, be sure that your child:

• Gets adequate sleep at night and rest during the day.

• Drinks lots of fluids and eats a balanced diet with carbohydrates and protein to maintain appropriate blood-sugar supply to the healing brain.

• Limits activities that require a lot of thinking or concentration, including video games.

• Limits physical activities, such as sports practice and PE, and avoids any contact sports or activities with increase risk of head injury.

As your child’s concussion symptoms improve and he or she returns to daily activities, watch carefully. If symptoms worsen or return, cut back activities and try again to increase them very gradually. Have your doctor evaluate your child’s symptoms after a few days to make sure that recovery is going well.

Some children can return to school with little difficulty, while others need a more gradual re-entry to schoolwork. When your child can concentrate for 30-40 minutes and other concussion symptoms have lessened, he or she can return to school.

Some students need extra help to perform schoolwork at first. The amount of support needed varies from student to student and can be gradually removed as your child improves. Ask your pediatrician to give you a letter with recommendations for your child, and share it with teachers, the school nurse, counselors and the school administrator.

Most student-athletes are eager to return to their sports, but don’t rush it. Your child should have a full and complete recovery from a concussion before playing or practicing. California law requires that your child be seen by a doctor to be cleared to return to contact sports. Talk to your doctor about how to reintroduce your child to the sport in stages.

Repeated concussions can lead to serious brain damage later in life. If your student-athlete doesn’t improve after a concussion, or has had several concussions, consult with a doctor who specializes in concussion management – and consider changing to another sport.

Kate Babington, M.D., is a pediatrician at the Palo Alto Center of the Palo Alto Medical Foundation.

The Palo Alto Medical Foundation and column editor Arian Dasmalchi provide this monthly column.

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