Concussion

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What is a concussion?

A concussion is a brain injury caused by a bump or blow to the head or body that makes the brain move back and forth quickly inside the skull. Your child does not have to lose consciousness, or be “knocked out,” to have a concussion. Even what seems to be a mild bump to the head or body can be serious. 

Signs or symptoms of a concussion may last for days, weeks or longer after the injury. It is important to see a healthcare provider who can assess your child’s symptoms and recommend ways to help your child get better as quickly and safely as possible.

  • What causes concussions in children and teens?

    Concussions can happen to anyone. Common causes of concussions in children and teens include:

    • Injuries from sports, such as football, soccer, basketball, baseball, softball, ice hockey, lacrosse, gymnastics, cheerleading and other activities
    • Motor vehicle accidents
    • Falls
    • Being hit by an object or another person

    If your child has had a concussion before, the chance of having another during their youth is higher. If they take part in sports, tell the coach and athletic trainer if your child has ever had a concussion. Also, speak with a healthcare provider to find out what sports and other activities your child can do safely.

Why is it so important to take time to recover from a concussion? 

Children and teens with a concussion may take longer to recover and resume normal activities than adults do. This is because kids’ brains are still growing and developing. Most kids get better quickly without any lasting damage. But it is important that they have clearance from a healthcare provider who understands concussions before they return to sports or other physical activities. 

If your child returns to play before their brain recovers from the original concussion, any new bump or blow may cause worse symptoms. In rare cases, this results in longer-lasting symptoms, permanent mental and physical disabilities or, very rarely, even death. 

Your child or teen may downplay their symptoms in order to get back to their sport sooner. Remind your child that it is important to tell the truth about their symptoms.

Orthopedics and Sports Medicine at Seattle Children's

Seattle Children’s pediatric orthopedics team partners with researchers around the world to make sure we are using the latest treatment approaches and technologies.

 

What are the symptoms of a concussion?

Concussions pose risks to children and teens if they don’t get the proper medical treatment. Make sure your child knows the signs and symptoms of a concussion and isn’t afraid to tell an adult if they have any of them.

  • Signs to watch for if your child gets a bump or blow to the head or body
    • Appears dazed or stunned
    • Can’t remember events before or after the hit or fall
    • Answers questions slowly
    • Becomes clumsy
    • Has changes in eating habits
    • Is confused about their role or position (if in sports)
    • Forgets sports plays or routines (if in sports)
    • Is unsure of the game, score or other team (if in sports)
    • Shows changes in behavior or personality
    • Is no longer awake and aware (loses consciousness)
    • Has changes in sleep habits
  • Common symptoms of a concussion
    • Headache or “pressure in the head”
    • or throwing up
    • Balance problems or dizziness
    • Double or blurry vision
    • Sensitivity to light or sound
    • Confusion
    • Feeling sluggish, hazy, foggy, groggy or more tired than usual
    • Trouble focusing or memory problems
    • Doesn’t “feel right”
    • Grouchy
  • “Red flag” symptoms that need emergency care

    Take your child to the Emergency Department if you think they have a concussion and they have any of these symptoms:

    • Lost consciousness
    • Speech problems, like slurring
    • 1 pupil larger than the other or double vision
    • Very drowsy, trouble being woken up or trouble staying awake
    • Seizures or convulsions
    • Weakness, numbness or tingling in the arms or legs
    • Trouble coordinating movement, such as problems walking
    • Severe or increasing headache
    • Repeated vomiting
    • Change in mental status, such as seeming confused, restless or disoriented or showing a major change in personality
    • Not able to recognize people or places
    • Neck pain or tenderness
    • Change in skull shape
    • Blood or fluid coming from their ear or nose

What to Do If You Suspect a Concussion

If you think your child might have a concussion and they lost consciousness or have “red flag” symptoms, take them to Seattle Children’s Emergency Department.

If your child did not lose consciousness and they don’t have “red flag” symptoms — or you are not sure what to do — call your child’s doctor or an urgent care clinic or:

It is important to seek treatment even if your child’s injury seems minor and did not make them lose consciousness. Some children and teens may get symptoms later, even if they did not notice symptoms at the time of the injury.

How is a concussion diagnosed?  

Diagnosis is mainly based on your child’s signs and symptoms. We will give your child a complete evaluation so we can recommend ways to help them get better as quickly and safely as possible. The evaluation may include a neurological exam and checks of their memory, brain function and balance. The more information you can give, the better, especially if your child is confused or has memory loss. It’s also helpful for us to have information from other family members, friends, coaches and medical providers or athletic trainers who were on site when your child was injured.

How is a concussion treated?

At Seattle Children’s, our Concussion Program team manages sport-related concussions, and our Rehabilitation Medicine team manages non-sport-related concussions. In both cases, the care team will help you decide the best treatment for your child’s injury. Your child’s healthcare providers may recommend the following options: 

  • Get plenty of rest and sleep.
  • During early recovery, limit screen time, such as computers, televisions, phones, video games and other electronic devices. Ask your child’s concussion team for guidance about gradually adding screens back in.
  • Keep up with regular meals and drinks, even if your child doesn’t feel as hungry as usual. Their brain needs the energy from food to help with healing. Drinking fluids is helpful to prevent symptoms of dehydration, like headache, which can be confused with symptoms of a concussion.
  • Let your child’s school know early on that your child may need accommodations.
    • Changes may include reduced assignments, extra time for schoolwork and homework and taking tests later.
    • Your child may also need other adjustments while at school. Examples include a place to take a break, access to snacks and water and other ways to rest and help their symptoms.
    • Some students may need to stay home from school in the first couple days after the injury. But we encourage kids to go back to school as soon as possible with accommodations in place. Going back to school helps them keep a normal routine and not get too far behind in their work.
  • Avoid taking part in activities that put your child at risk for another concussion until a licensed healthcare provider evaluates your child and approves them to take part in those activities. All children and teens in Washington state who show signs of a concussion must get written approval from a doctor or other licensed healthcare provider trained in the evaluation and treatment of concussions before they can resume full play in a sport.

We will help create a plan to slowly let your child get back to their regular physical and mental activities in the safest and most efficient way.

As part of the care plan, we sometimes recommend imaging studies, like a CT (computed tomography) scan (PDF) or MRI (magnetic resonance imaging) scan (PDF) of the brain to find out more. Your child’s care team will decide if your child needs imaging based on their past conditions or current symptoms. If your child’s imaging is normal, your child may still have a concussion. It's important to follow-up with a healthcare provider until your child’s symptoms have gone away and your child is successfully back to school and physical activity.

For some children, we may recommend neuropsychological testing if:

  • Their symptoms are not improving as expected
  • They have had many concussions in the past
  • They are having trouble in school, like difficulty with learning or understanding

This testing may be helpful to find out:

  • What parts of the brain are most affected
  • If your child has other conditions that might be affecting their brain
  • If your child needs any cognitive (mental) rehabilitation
  • If we can help work with your child’s school

Other services, like physical therapy and biofeedback, may help some children with getting better after a concussion.  

Why choose Seattle Children’s for concussion treatment?

Seattle Children’s has the region’s top specialists on concussions and brain injuries in children and teens. We are experienced in evaluating, diagnosing and managing any level of injury to your child’s brain. We will also work with you to make a plan to help your child safely return to play if they take part in sports.

Our Concussion Program cares for children and teens with sport-related concussions. Our Rehabilitation Medicine team assesses and manages concussions from other causes.

  • The concussion experts you need are here
    • As the area’s premier center for evaluating head injuries in young people, we involve experts from many different fields, including Orthopedics and Sports Medicine, Rehabilitation Medicine, Adolescent Medicine, Neuropsychology, Neurosciences, Physical Therapy, Rehabilitation Psychology and Biofeedback.
    • Based on your child’s needs, they may receive care from a team of doctors, surgeons, , , , and other healthcare providers trained in concussion care.
    • Concussions can have complex effects on your child’s brain. Our Neuropsychology team can help your child after their concussion by studying how your child behaves, learns, remembers and thinks. use special testing to help diagnose problems and guide decisions about schoolwork and return to play. Testing may also help us plan care if your child’s symptoms are not improving as expected.
  • Care custom-made for your child
    • We are dedicated to providing the right strategies at the right time to keep your child safe and healthy as their brain recovers.
    • Your child’s team will create a care plan custom-made for your child to help them recover safely so they can go back to their regular activities, including school, sports and other physical activities. Care often includes getting the right amount of rest, limiting screen time at first and getting good nutrition and hydration.
    • We will provide recommendations and support to help your student return to school and manage schoolwork. Concussions may affect your child’s ability to complete tasks they could do before. Changes like reducing their school hours and workload for a while can help children return to school successfully.
  • Support for the best recovery
    • We know it can be stressful to have a child with a concussion and to find the care they need. Everyone at Seattle Children’s works to make your experience here as easy as we can on your whole family.
    • Your child’s team does more than plan and provide care for your child. We also make sure you and your child understand your child’s condition and treatment options.
    • For your convenience, our doctors see patients at locations in Seattle, Bellevue, Everett and Federal Way. We bring high-quality care closer to where you live.
    • Seattle Children’s supports your family with a range of resources. Our Child Life specialists, Family Resource Center and Guest Services are here to help.
  • Research to improve concussion care
    • Seattle Children’s is on the leading edge of concussion science. Many of our current projects focus on the best ways to assess and treat children and teens with concussions and to support families in learning about concussion care.
    • CARE4Kids is a study using , blood tests and eye tests () to learn why some children with concussions have symptoms that last longer than or feel different from other children’s symptoms.
    • MSTEP is a study using telehealth to help kids recover from concussions faster with rehabilitative exercises. MSTEP stands for Mobile Subthreshold Exercise Program for Concussion. 
    • The CHIP study provides virtual support to teens and parents to improve concussion recovery. CHIP stands for Concussion Health Improvement Program. 
    • Learn more about the Seattle Concussion Research Collaborative (SCRC) at Seattle Children’s Research Institute, SCRC research projects and how your child can take part.

Contact Us

Sport-related concussion: If you think your child or teen has a sport-related concussion, make an appointment with our Concussion Program. Call Orthopedics and Sports Medicine at 206-987-2109 (appointments may be available at locations in Bellevue, Everett, Federal Way or Seattle) or call Odessa Brown Children’s Clinic Othello at 206-987-7210.

Non-sport-related concussion: To make an appointment for a non-sport-related concussion, call Rehabilitation Medicine at 206-987-2114.

Providers, see how to refer a patient to Orthopedics and how to refer a patient to Rehabilitation Medicine.

Paying for Care

Learn about paying for care at Seattle Children’s, including insurance coverage, billing and financial assistance.