Posts for tag: Head Injury
You're at your 10-year-old's soccer game and he's just collided with a member of the opposing team while fighting for a ball in the air. Unfortunately, the two hit heads and both leave the field crying, but clearly conscious. It's a youth game on an elementary-school field, so barring the presence of parent who happens to be a doctor, there's no one around to evaluate either child for a possible concussion. What to do? In many cases, both children will return to the game a few minutes later. Big mistake.
Concussions are serious whenever they occur, but unlike professional sports, when children suffer a possible concussion, there's often no one around to evaluate it properly. Here's what you can do to help identify some of the often-subtle signs of a concussion and make the informed decision to get further evaluation from a health care professional.
First, let's start with the most severe case: If a child experiences any of the following symptoms, particularly immediately after a collision or fall in which they struck their head, they need to go to the ER immediately for evaluation, according to KidsHealth.org:
- Loss of consciousness
- Severe headache / headache that worsens
- Blurred vision
- Difficulty walking
- Confusion / not making sense
- Slurred speech
- Unresponsiveness (unable to be awakened)
Of course, many children may not display any of those symptoms following a head impact, but still be at risk for concussion, so it's important to evaluate the child with some a simple battery of initial tests that, if nothing else, will alert you to the fact that the child should a) be removed from the game; and b) seek medical attention. Here are a few of the ways you can get a sense of what may be going on. These and other variables are all part of the Sport Concussion Assessment Tool, which is used by health care professionals to help assess concussion symptoms:
- What month is it?
- What is the date today?
- What is the day of the week?
- What year is it?
- What time is it right now? (within one hour)
You can also ask the child questions specific to the event in which they are participating, such as:
- At what venue (field, tournament, city, etc.) are we at today?
- Which half is it now?
- Who scored last in this game?
- What team did you play last week / game? Did your team win the last game?
Give Them a List
Say a short list of words (example: apple, bubble, elbow, carpet, saddle) to the child and then have them recite the list back to you in any order. Repeat several times and assess how accurately they are able to recall all five words. You can do the same thing with a short list of numbers; or by having them recite the months of the year in reverse order.
The most important variable when it comes to determining whether your child should continue to play, be removed from play and/or be seen by a medical provider in the absence of clear symptoms (loss of consciousness, severe headache, slurred speech, etc.) may be how the child is acting compared to before the contact occurred. You know your child. If they're acting "out of sorts," err on the side of caution.
Keep in mind that the above should not be relied upon in lieu of proper evaluation by a health care provider, but if you suspect a concussion has occurred, these symptoms / signs and tests are an important first option to help determine the next step you should take. Talk to your doctor for additional information about concussions and how you can help keep your child safe on and off the field.
By Charles Masarsky, DC, FICC
If you've done any research on concussions, you have probably already familiarized yourself with the Zurich Statement1 and the Center for Disease Control and Prevention's fact sheet,2 among other relevant literature. While public awareness of the problem is much greater today than it was 10-15 years ago, there is still much confusion among the general public. Here are some important points to be aware of and discuss with your doctor:
You Don't Have to Hit Your Head to Hurt Your Brain
Many people still think a blow to the head is required to get a concussion. There is now widespread scientific consensus that an injury to another part of the body can transmit enough force to the head to cause concussion. Therefore, all sorts of trauma, including sports injuries, assaults, slip-and-fall incidents and whiplash, can cause concussion.
A Concussion Doesn't Always Result in a Knockout
While a dazed feeling is common, loss of consciousness actually afflicts a minority of concussion victims. This fact still surprises many people.
The Concussion You Have Immediately Isn't Necessarily the Concussion You Have Eventually
The severity of the concussion may not be apparent until hours or days after the trauma. If this is not understood by those in close contact with the concussion victim, deterioration can be easily missed.
You Can't Just Snap a Picture of a Concussion
Ever suffered a blow to the head, but an MRI was done and found no concussion? The misconception that standard imaging will rule out concussion is still prevalent. A careful history and physical exam are essential in evaluating and following the concussion victim.
Concussions Don't Always Go Away by Themselves
Sadly, concussion victims are too often told to "walk it off," even today. While a majority of adults recover from signs and symptoms of concussion within 10 days (3-4 weeks for children and adolescents), a significant minority develop post-concussion chronicity.
An Injury That Hurts Your Brain Hurts Your Spine
The misconception that doctors of chiropractic have no legitimate role to play in managing the concussion victim is unfortunately widespread within the health professional community, as well as the lay public. It surely boggles your imagination that someone could emerge from a concussive injury and not have new subluxations or exacerbation of existing ones.3 Recent clinical findings indicate failure to correct these subluxations can be a factor in chronicity of concussion symptoms.4
- McCrory P, Meeuwisse WH, Aubry M, et al. Consensus statement on concussion in sport. The 4th International Conference on Concussion in Sport Held in Zurich, November 2012. Br J Sports Med, 2013;47:250-258.
- "Facts for Physicians About Mild Traumatic Brain Injury." Centers for Disease Control and Prevention, Department of Health and Human Services.
- Masarsky C. "The Concussion-Subluxation Complex." Dynamic Chiropractic, Nov. 15, 2015.
- Masarsky C. "Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment." Dynamic Chiropractic, Aug. 1, 2014.