How parents can tell whether it’s a concussion or just a bump on the head

By Bryan Richardson

The issue of concussions came up locally this past week after K-State quarterback Collin Klein suffered an apparent concussion during the Oklahoma State game on Nov. 3.

The concussion discussion for the most part has surrounded the football community. However, a concussion – blunt trauma to the brain caused by its movement inside the skull – can happen outside of football or any organized sport. More importantly, it can occur away from the medical staff that teams often have.

Dr. Rich Foveaux of Jointfit Chiropractic and Sports Medicine Center said knowing when a concussion has occurred and providing treatment is the key to future health. He said there are indications that someone is more susceptible to having another concussion after suffering an initial one.

“The risk is greater for lingering effects if you don’t allow proper recovery the first time,” he said.

Foveaux said there is also a risk of second-impact syndrome in instances of playing before a concussion is healed. “The danger with that would be if there’s a repeated trauma to the brain,” he said. “It doesn’t have to be a big hit.”

It can lead to prolonged recovery or even severe brain swelling that can cause permanent brain damage or death.

Recovery from a concussion varies depending on the severity of the injury. It can last days, week or months. Parents and caregivers must learn how to treat the symptoms, how to monitor for problems, and when to allow a return to normal activities.

Foveaux said the most common symptoms that indicate a concussion has occurred are dizziness, an inability to recall things that happened and/or a headache. He said a headache can be a red flag that it’s something worse.

According to the Mayo Clinic, the following symptoms are cause to seek emergency care after a head injury:

• A loss of consciousness lasting more than a minute

• Vomiting

• Worsening headache and other symptoms

• Seizures

• Changes in behavior, including irritability or fussiness

• Changes in physical coordination, including stumbling or clumsiness

• Confusion or disorientation

• Slurred speech or other changes in speech

• Vision or eye disturbances, including pupils that are bigger than normal or pupils of unequal sizes

• Changes in breathing pattern

• Lasting or recurrent dizziness

• Blood or fluid discharge from the nose or ears

• Large head bumps or bruises on areas other than the forehead, especially in infants under 12 months of age

Head trauma is very common in young children, according to the Mayo Clinic but it is hard to diagnose with infants and toddlers because they can’t communicate their feelings. This is why is important to pick up on the nonverbal clues of a concussion:

• Listlessness, tiring easily

• Irritability, crankiness

• Change in eating or sleeping patterns

• Lack of interest in favorite toys

• Loss of balance, unsteady walking

As far as treatment, Foveaux said the best way to recover is both physical and mental rest to allow the brain to get back to normal. He said parents should contact a physician after any head injury, although it doesn’t have to be immediately if they don’t observe the aformentioned symptoms.

“Going the next day is OK as long as you’re not seeing worsening symptoms two to four hours after the injury,” he said.

Contrary to an often-stated myth, Foveaux said you can sleep with a concussion without be woken up every few hours as long as symptoms don’t require immediate medical attention. “Uninterrupted sleep is needed,” he said. “That allows for a faster recovery.”

The Mayo Clinic recommended acetaminophen (such as Tylenol) for headaches after a concussion. Other pain relievers, such as ibuprofen and aspirin may increase the risk of bleeding.

As the symptoms disappear, Foveaux said parents can allow a slow buildup in activities while monitoring whether any symptoms return during these stages. He said it starts with a return to mental activity, followed by light jogging and an eventual return to full activity.

Foveaux said other concussion myths are that only bad concussions lead to unconsciousness and that a concussion can be graded.

Foveaux said the thought used to be that an athlete “got his bell rung” and then was fine to return to play, rather than consider the concussion risks. “If the athlete seems fine within 15 minutes, even with symptoms, the misconception was you can put them out there,” he said. “That’s putting the athlete at risk.”

While the risk of concussions is more known today, Foveaux said there are dangers of undetected concussion because people don’t know what to look for.

“There are so many rural schools in Kansas that don’t have medical staff other than EMTs who are not directly on the field of play,” he said. Foveaux said a big school like Manhattan High typically has a physician, lowering the potential for second-impact syndrome.

“Our coaches are aware of symptoms of a concussion as are our trainers, obviously,” said Mike Marsh, Manhattan High’s athletic and activities director. Marsh said the school always thinks of the student’s health first. “We do nothing different than what we’ve always done even though more attention has been given by the media and other means,” Marsh said.

Marsh said MHS’s standard practice is to remove an athlete from competition immediately if a concussion has occurred or is suspected to have occurred. A permission slip by a physician is required before a student can return to activity after a concussion. The state officially adopted this rule with the School Sports Head Injury Prevention Act, which was enacted July 2011.

Recently there has been a movement at higher levels of competition to conduct tests before the season to set the baseline for normal cognitive activity, which allows for better diagnosis and recovery from a concussion.

Marsh said that doesn’t reach to the secondary school level, although parents may wish to have testing done for their children. He said each student and parent is made aware of the concussion risks and guidelines through the concussion form that they have to sign.

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