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What You Need to Know about Youth Concussions

Anthony Rodrigues, MD, PhD is a pediatric neurologist with Floating Hospital for Children at Tufts Medical Center. As part of Lowell General Hospital’s pediatric partnership with Tufts Medical Center, Dr. Rodrigues regularly sees patients at the Pediatric Specialty Centers in North Chelmsford and Westford. His specialty is chronic pain and headaches, which often stem from concussions. Here, Dr. Rodrigues provides answers to concerns you may have about a child’s vulnerability to concussions and how to react when you suspect a child has a head injury.

What qualifies as a concussion versus a bad bump on the head?
Any time someone has an injury to the head or body, after which they are a little confused or have a headache, amnesia, a little disorientation or dizziness, those are the signs of a concussion. Sometimes that happens right after the injury, sometimes it develops hours afterward or even the next day.

How are concussions different for young people?
That’s the part many people miss because we watch professional athletes playing two weeks later. Adult brains heal faster, and their symptoms go away faster. With kids, we believe their brains are softer. We know their brains are still growing and are not as rigid, so movements of the brain can have more effect. A lot of kids can take months to recover. Muscle mass is also not as high in kids. The neck muscles aren’t as strong, so now we have a softer brain with weaker neck muscles to protect it.

If a parent suspects a concussion, what should they do next?
Kids should be excluded from physical activity and see their primary care physician right away to get a plan put in place for school. Regular school activity can be the hardest part for a child recovering from a concussion. A plan should be developed for how often kids are taking breaks or missing school, and they should be taking fewer tests and doing less homework. If the symptoms aren’t getting better after a couple of weeks or a month, a neurologist should get involved during this chronic phase.

How do doctors treat a concussion?
There is no treatment for concussions, only treatment of symptoms. A concussion has to recover on its own time. When symptoms get chronic, it’s time for a physician to step in. We want to start treating the headache with medication. With dizziness or other visual symptoms, we want to do physical therapy. We can also do some neurologic-psychiatric testing if needed.

Why is a second concussion during recovery so dangerous?
It’s called second impact syndrome, and we believe those are the ones where some kids have died as a result. They either had an acute concussion or were in the chronic phase, and then they had a second concussion. The brain cannot sustain or accommodate the second impact, and these kids have died from brain swelling. That’s an extreme. The more likely scenario is that the symptoms are prolonged even more following a second concussion. There can be long-term consequences. You may not recognize them in the short term, but when the child is 30, 40, even 50 years old, it can start to have some effect.

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