Concussion in young children. How to identify the symptoms of a concussion in a child? At home

Healthy children have difficulty sitting still. They jump, run, climb a slide, ride a bike, and jump off the couch at home. Moreover, children have not yet developed a sense of danger. That’s why my mother’s endless “be careful, you’ll fall!” they fall on deaf ears. Injuries in children are common, including head contusions. This can lead to a concussion. In children it does not always appear immediately. However, this condition is dangerous due to its consequences; emergency medical care is required. Parents should know what symptoms their child is experiencing and how to provide first aid.

1. Acute, in which symptoms of brain dysfunction occur. It lasts up to 10 days, after which the condition returns to normal.
2. Intermediate – lasts up to six months. During this time, with timely treatment, brain functions are fully restored.
3. Remote. It lasts 1-2 years after the injury. By the end of it, either complete recovery occurs, or the person experiences irreversible pathologies.

Usually, when children fall and get bruised, they experience a slight concussion, after which a full recovery of health occurs.

After a concussion, a child may experience complications such as bleeding in the brain and swelling of its tissues, post-traumatic epilepsy. A long-term consequence may be early brain aging, which affects overall health and life expectancy.

This injury is most often observed in children over 7 years of age. The danger is that a fall or injury may occur in the absence of adults. The child does not pay attention to unusual signs or hides what happened to him. In this case, the consequences are more serious, since assistance is not provided on time.

In children under 2 months of age, such injury is observed least frequently. The peculiarities of the development of children are such that during the first year of life their motor centers develop, only then do the parts of the brain responsible for mental reactions and mental development begin to function.

Therefore, they first learn to roll over on their side, crawl, walk, and then understand how to overcome obstacles, recognize loved ones, master speech, and navigate in space. As a result, head contusion is a fairly common injury for young children. Up to one and a half years, it most often occurs due to the carelessness of parents who leave the baby unattended on a changing table or bed. Older children suffer as a result of natural physical activity.

Warning: Doctors warn that even intense motion sickness in children can cause a concussion. The so-called “shaking syndrome” also occurs when jumping from a height or sudden braking while running.

Video: What is a concussion

Symptoms and signs

There are primary and secondary signs of concussion in children. The primary ones include the following:

1. Paleness of the skin. Immediately after a blow or fall, the child's face may turn pale, and then the skin on the arms and legs. Veins appear on them, making the skin appear transparent. A blue or greenish tint appears.
2. Formation of a hematoma (bump) on the head. If there is only a bruise of the soft tissues of the head, then the bump is small and quickly disappears after applying ice. If it does not decrease, but becomes even larger, it is necessary to call an ambulance, since tissues and blood vessels are damaged.
3. Headache. It usually gradually intensifies and occurs in the temple and back of the head areas. After treatment, the pain, although not so excruciating, bothers the child for several more weeks.
4. Vision disorders. After the blow, short-term blindness sometimes occurs.
5. Constriction and twitching of the pupils.
6. Increased breathing. It occurs immediately after injury and usually goes away quickly.
7. Weakness. Dizziness, nausea and vomiting may occur.
8. Increased heart rate (tachycardia), fluctuations in blood pressure, tinnitus, increased sweating. A brief loss of consciousness may occur.

Secondary signs in children do not appear immediately, but after several days and even weeks. Photophobia and intolerance to loud sounds, insomnia appear, and children have nightmares. Reactions to the actions of others decrease, the baby does not perceive words addressed to him, and becomes irritable. Often after an injury, children do not remember what happened to them and what happened next.

Video: Head injuries and their dangers

Symptoms by which a doctor determines the presence of a concussion

For successful treatment, it is important, if there are symptoms of a concussion in children, to call a doctor who will determine whether the child can be left at home or whether urgent hospitalization and examination by a traumatologist or neurologist is required. Symptoms that require mandatory consultation with a doctor are any disturbances in the functioning of the central nervous system, increasing pain in the head, dizziness and vomiting.

The doctor pays attention to such signs as the appearance of facial asymmetry due to tension in the ligaments, retraction of the tip of the tongue, reduction of the eyeballs to the bridge of the nose, twitching, and decreased motor reflexes. The specialist notices symptoms of irritation of the meninges (pain in the head and neck, fever up to 39° and others).

Manifestations of concussion in babies and older children

Symptoms of concussions vary among children of different ages. The older the baby, the more pronounced the signs of pathology are.

Infants. If a baby usually cries loudly when he is in pain, then when a concussion occurs he does not scream, he can only moan. His skin turns pale and vomits. An infant spits up, refuses to breastfeed, sleeps poorly or, conversely, is too sleepy. There is usually no loss of consciousness. Possible protrusion of the fontanelle due to increased intracranial pressure.

Preschoolers. Possible loss of consciousness. The baby complains of a severe headache, feels sick and vomits. His pulse is either very fast or slow, and there are pressure fluctuations. The child turns pale and sweats. He becomes whiny, has trouble falling asleep, moans in his sleep, and wakes up crying.

Junior schoolchildren and teenagers. As a rule, they themselves can tell about the symptoms of a concussion: nausea, dizziness, weakness, pain in the head. Sometimes after an injury they experience amnesia lasting up to 10 minutes, coordination of movements is impaired, post-traumatic blindness and deafness are observed.

First aid

If children develop symptoms of a concussion, the first thing to do is call an ambulance. The victim is placed on his side so that he does not choke when vomiting. You cannot place a soft pillow. If hospitalization is required, he is carried on a hard stretcher.

At home, before the doctor arrives, it is necessary to create conditions so that the child suffers as little as possible from headaches (turn off bright, irritating lights, muffle sounds). Ice is applied to the injury site. If there is a wound, it is treated with hydrogen peroxide and bandaged.

You should not use any medicines or traditional methods of treatment without the doctor’s knowledge, as this may confuse the picture. At the hospital, the doctor will find out whether the child has vascular damage or hemorrhage, or whether the bones are damaged. The fragments can enter the brain, causing inflammation.

First of all, parents must pull themselves together to calm the child. If the baby is conscious, you need to talk to him. This will allow you to notice how he reacts and prevent the baby from falling asleep until the doctor arrives, who will determine the severity of the condition based on his reactions.

It is necessary to check your pulse rate. You should quickly collect the things needed in the hospital, since head injuries most often require hospitalization.

Diagnostics

Upon admission to the hospital, the child is examined using the following methods:

• general blood test for leukocytes and coagulation;
• X-ray of the head to detect damage to the cranial bones;
• Ultrasound to determine the presence of edema, hematomas in brain tissue;
• encephalography - x-ray examination of the activity of the centers of the brain, its blood supply, the displacement of its parts;
• CT and MRI of the brain are methods that allow you to obtain a three-dimensional computer image of the brain and notice all changes in the structure.

A spinal puncture is also taken to determine the presence of blood in various parts of the brain and detect inflammation of its membranes.

Treatment

If the doctor determines that the child’s condition is satisfactory, he is left for treatment at home, recommending rest and the use of painkillers.

In the hospital, the child is under constant supervision of doctors, who take all measures to quickly eliminate the symptoms of a concussion and prevent complications from occurring. In the absence of severe injury, the child is left in the hospital for 3-4 days.

During treatment, diuretics (for example, diacarb) are used in combination with potassium preparations that support heart function (panangin, asparkam). This avoids swelling of the meninges.

Sedatives (phenazepam, valerian tincture) are used to improve the child’s mood and relieve tension. Antihistamines (suprastin) are also prescribed. Antiemetics (cerucal) are used.

To restore the functioning of the brain, B vitamins are prescribed, as well as nootropic drugs that improve nutrition and blood circulation in the brain. Analgesics are prescribed to relieve headaches.

After the patient is discharged from the hospital, doctors warn about the need to avoid watching TV, using the computer, and reading books. It is recommended to give up sports and other physical activities for 2-3 weeks and get more rest.

Video: Consequences of head injuries

Up to 10 years of age, any strong impact can cause injury. Impacts, falls, jumps and even sudden braking run the risk of resulting in “shaken baby syndrome” and concussion.

In young children, mild symptoms are less noticeable, but serious trauma is more likely to lead to behavioral problems, emotional and physical consequences in later years.

As you grow older, by the age of 10, the signs of illness become more and more similar to a concussion in an adult.

How to determine that there is a problem?

The first symptoms of a concussion in a 3-year-old child appear immediately or after a couple of hours (sometimes days). Loss of coordination, nausea and vomiting, headache, dizziness, altered pulse - a characteristic condition.

Important! Children don't always lose consciousness. The injury is indicated by 2-3 signs of malaise.

Signs of a concussion in a child under 3 years of age

Children are active, curious, not afraid of heights, they have fragile bones and a developing skull. Although fluid in the brain tissue can cushion the blow, it is often the head that is injured. It is heavier than other parts of the body, and the child does not have time to put his hands up when falling. Preschoolers account for 20% of pediatric concussion calls.

At 3-4 years old

• Consciousness “fades away” for a few seconds and the child cannot explain how he received the injury.
• He staggers and his movements are uncoordinated.
• Sensitivity and response to stimuli is reduced due to a lack of oxygen in brain cells.
• There are complaints of headache, tinnitus, dizziness.
• The skin becomes pale or whitish.
• Loss of blood circulation causes nausea or repeated vomiting.
• The baby is covered in cold sweat.
• Breathing quickens, tears and saliva flow.
• Pulse is rare.
• Complaints of pain in the navel, pressure in the left hypochondrium.
• The child loses his appetite, sleeps poorly, and is capricious.

Symptoms in children aged 5 to 6 years

Manifestation of the disease in girls and boys of school age

By the age of 7-8 years, the formation of the skull is completed, the bones become stronger, head growth slows down, and the brain is less susceptible to external influences. The first signs of injury in children 7-8 years old often appear after a couple of hours. The physical and emotional consequences of a concussion lead to the fact that the student has difficulty concentrating, academic performance drops, and apathy, irritability and aggressiveness appear. If a child refuses favorite activities and sleeps a lot, this indicates hidden problems.

For first-graders 6-7 years old

• Fainting, short-term memory loss (up to 15 minutes).
• “Post-traumatic blindness” and hearing impairment are possible.
• Loss of orientation.
• Tachycardia.
• Nausea or vomiting.
• Red circles before the eyes.
• Weakness and trembling of the limbs.
• Cold sweat.
• Pallor.
• Insomnia.

For students in grades 2-4

Symptoms of a concussion in children under 10 years of age are as follows:

• Fainting can last from a few seconds to 10-15 minutes.
• The small arteries of the face alternately narrow and widen, and the pallor of the skin gives way to redness.
• Vision is impaired: gaze paralysis, chaotic movements of the eyeballs, short-term strabismus, changes in the width of the pupils, double vision.
• The schoolboy complains of a strong headache, sometimes he cannot hold back his tears.
• A gag reflex and nausea appear.
• Breathing is uneven.
• There is bleeding from the nose or ears.
• Coordination and memory are impaired (unable to tell what happened before the injury).
• The pulse quickens (more than 90 beats) or falls (less than 60).

Important! Visual impairment (post-traumatic blindness) at all ages lasts from a few minutes to a couple of hours after the impact. It passes without visible consequences.

Manifestations depending on severity

Signs in babies under 5

Injuries to the developing skull have a greater impact on future health, but younger children almost never lose consciousness - this is more common among older schoolchildren.

Symptoms in children 6-10 years old

It can often be delayed - Symptoms appear hours or days after the impact.

1. For mild concussion- no loss of consciousness. Mild malaise (nausea, headache, dizziness). It passes, like in young children, in 15-20 minutes without visible consequences.
2. For moderate trauma— a schoolchild complains of deteriorating vision, “spots” before the eyes and tinnitus, and vomiting. After an injury, it is difficult for him to maintain balance, he “turns off” for 1-2 minutes or loses concentration. To determine the problem, just ask him simple questions.
3. Heavy- loss of consciousness, disturbances in thinking and speech, severe headache, frequent vomiting, perspiration. The injury disrupts the sequential chain of events in his memory, and he cannot say how he received the concussion. In rare cases, the child loses other memories.

Schoolchildren often do not admit that they have been injured. The appearance of several symptoms is a reason to immediately consult a specialist.

First aid

Regardless of the severity of the injury you need to quickly deliver the victim to the trauma center yourself or call an ambulance. It is necessary to ensure a flow of fresh air and peace. The child is placed on his side so that he does not choke on vomit. If you are very thirsty, wet your lips with water, but drinking is not recommended. Pulse changes are monitored through the carotid artery. Cold is applied to the lump. If there is a wound, then a clean gauze or cloth is applied to its surface.

The child is not allowed to sleep: when awake, the dynamics of the condition are better visible.

If the child is unconscious, he is placed on his right side, his right bent arm is placed under his head, and his legs are bent at the knees. This position will also prevent you from choking on vomit.

Treatment

For moderate and severe cases, hospital treatment is prescribed. In mild cases, the child is treated on an outpatient basis.

In the hospital

In the hospital, hardware examinations are carried out that will reveal the extent of damage. The victim is provided with complete rest, bed rest and medication. The choice of medications is aimed at:

• reduce cerebral edema with diuretics;
• speed up brain recovery processes;
• relieve cramps;
• normalize intracranial pressure.

Painkillers and sedatives are prescribed at the discretion of the doctor. Treatment in a hospital ranges from 3-4 days to several weeks, depending on the severity of the condition.

At home

If, when signs of a concussion are detected in a child 3-10 years old, hospitalization is not needed, the patient is prescribed a special regimen:

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Symptoms of a concussion in a child are the result of an acquired injury, as a result of a blow or fall. TBI leads among other childhood diseases requiring immediate medical attention. Pathological conditions are distinguished by severity - mild, moderate and severe disease. In most cases, with timely treatment, they do not pose any threat.

Nature has made sure that the human brain, especially children's, is protected from possible damage. The bones of the skull reduce the consequences of impacts: they are quite strong and mobile, so they perfectly absorb the impact of contact with hard objects.

Additional protection is provided by cerebrospinal fluid - a liquid substance located between bone tissue and brain cells, which, upon impact, prevents them from colliding; in an infant, the fontanelle.

Due to anatomical features, most injuries do not have negative consequences, especially in a one-year-old baby, whose weight does not allow creating a powerful push or strong inertia.

A concussion in young children cannot be caused by a mild head injury, which means the blow must be strong enough. As a result, the cerebrospinal fluid does not fulfill its main role as a shock absorber and the brain collides with bone tissue, thereby causing functional disorders.

Main Causes of Minor Injuries

Symptoms of concussion in children can come from a variety of sources. Among the main causes of pathology are:

Concussions in children, as a rule, do not lead to any serious impairments, so such injuries very rarely cause various complications, and the prognosis for recovery is favorable.

Symptoms of skull and brain injuries in children

The smaller the baby, the more difficult it is to identify the disease, since children can react differently to all irritating factors. Therefore, parents should have information on how to identify a concussion in a child and what to do to prevent negative consequences. But it should be borne in mind that only timely complex therapy will cope with the disease.

Symptoms of injuries

Signs and warning signs of a concussion in an infant:

• loss of consciousness for a short time: it is almost impossible to notice it, but you can suspect it if the baby starts crying after 5-10 seconds;
• the child refuses to eat after an injury;
• unnatural behavior, crying is observed;
• during feeding he constantly spits up;
• vomiting, fever;
• drowsiness or lack of sleep during the night;
• twitching of the chin or arms, legs.

Any strange manifestations in the condition of newborns or their behavior, even minor ones, require immediate consultation with a specialist.

Signs of a concussion in adult children:

1. Brief loss of consciousness after the incident.
2. Lack of information about the events preceding the injury.
3. Dizziness, migraine attacks.
4. Vomiting, nausea, worsening the baby's condition.
5. Weakness, cold sweat, pallor of the epidermis.
6. Slowing reactions to events occurring around the patient.
7. Loss of orientation, tachycardia, hypotension.

Often, all the consequences of a concussion disappear after complex therapy. Lack of proper rest and constant violations of the regime can cause serious complications.

Adequate rest is required

When is immediate medical attention needed?

You should urgently call an emergency medical team if the child has:

• head wound, bleeding cannot be stopped for 10-15 minutes;
• the baby fell asleep after the incident;
• severe vomiting, speech impairment;
• loss of coordination;
• pupils of different sizes;
• instability of the eyeballs;
• the newborn's fontanel is very swollen;
• the child involuntarily jerks his limbs;
• blood or fluid is discharged from the ears and nose.

Such signs of a concussion indicate the presence of a serious pathology, for which an appropriate diagnosis should be urgently performed.

Brain and skull injuries: severity

With a careful examination, it is possible to establish the fact of a concussion in a child and the nature of its course. Experts distinguish three degrees of pathology.

Knowledge of their characteristics will tell you how to recognize a concussion in a child on your own without the help of a doctor and what to do in this case.

Mild degree

Minor physiological disturbances: dizziness, headaches, weakness. Additional signs of a minor concussion in an infant or older child: short-term vomiting, nausea, regurgitation. If after an hour the pathological condition improves, then the danger has passed.

How to recognize a concussion

But this does not mean that the child’s concussion passed without a trace. The baby needs to be taken to the hospital, where he will be examined, have an X-ray examination, and make sure there is no internal hemorrhage or microcracks. This will prevent serious consequences - headaches of unknown origin.

Average degree

The first symptoms of a concussion in an infant or child are similar, but are observed for a long time. In a pathological condition, loss of consciousness and sudden clouding of reason may be present. The patient cannot concentrate on a specific subject.

Teenagers complain of blurred vision, extraneous sounds, and lack of balance. Such head injuries are accompanied by severe vomiting. It is possible to determine that a child has a moderate pathology by asking simple questions. Diagnostics of children is carried out only by a traumatologist.

Severe degree

The main signs of a concussion in an infant are fainting lasting about 5 minutes, pale skin, lethargy, lack of motor activity, amnesia, loss of orientation. The patient’s brain functions are impaired, cold sweat constantly appears on the face, and perspiration appears.

The pupils do not react to bright light; they have different diameters. This indicates severe injury to one of the hemispheres. The pulse is unstable - it becomes slow, then quickens, depending on this the respiratory rhythm changes.

If a child loses consciousness for a long time, this can cause irreversible consequences of a concussion, so this condition requires urgent resuscitation measures. Only a qualified specialist knows what to do in this case.

Differential complex diagnostics

In addition to taking a medical history, the doctor determines the circumstances of the injury and evaluates the external manifestation of the patient’s pathological condition. The examination includes hardware diagnostics, the choice of method depends on the symptoms.

The following procedures will help determine the severity of concussion in infants and prescribe adequate treatment:

1. X-ray – identifies bone damage.
2. Neurosonography is an ultrasound study that determines the condition of the brain and skull in infants and children under 3 years of age.
3. MRI - shows the presence of hemorrhages and formations in the brain.
4. CT scan makes it possible to see the same abnormalities as MRI, but does not last long, so it is more often prescribed to children.
5. EEG – performed after the concussion has been treated, in the presence of a third degree injury. The examination helps to identify pathological activity and adjust therapy.

Certain diagnostic methods (CT, MRI) require complete immobilization and are difficult to use with restless babies. Therefore, they are prescribed only in cases of extreme necessity and are carried out under anesthesia.

After an injury, the child must be provided with complete rest and an emergency medical team must be called. The baby should be positioned more comfortably: put down or seated in a position that is comfortable for him, so as to prevent falling. The child’s condition must be constantly monitored and not allowed to fall asleep for about an hour.

If the patient loses consciousness, he should be turned on his side, his knees bent, and his hand placed under his head. Call an ambulance, check your breathing, and, if necessary, perform artificial ventilation, but only carefully.

Artificial respiration is performed as follows:

• put the baby on his back, throw his head back;
• alternate between several breaths of oxygen and 30 compressions in the chest area from the heart;
• You can’t inhale a lot of air, since babies have a small lung capacity.

Check the pulse: in one-year-old children, feel it between the triceps and biceps at the fontanel. In older children, this can be done on the carotid artery. It should be noted that the pulse rate in the hand cannot be accurately determined, since a concussion in children impairs blood circulation. The child should not lie on his back so that the tongue does not fall into the larynx.

Complex therapy of pathological condition

Symptoms and treatment of traumatic brain injury require special attention from a specialist and parents. The main principle of therapy is rest, adherence to certain recommendations for some time:

1. Observation in a hospital setting for 2-3 days to determine severe consequences and injuries.
2. Limitation of physical activity, despite the absence of alarming symptoms in the child.
3. Refusal to play sports until complete recovery.

For mild pathological conditions, outpatient therapy is possible. Self-care involves complete rest, protecting the baby from negative emotions and sudden movements.

Of great importance in treating the disease and preventing possible negative consequences in schoolchildren is a complete restriction on watching television and using the computer - such rest has a stimulating effect on the nervous system and slows down recovery.

Treatment of concussion in children with medications involves the use of the following medications:

• diuretics to eliminate edema and other consequences after injury - Furosemide, Diacarb. These products are used in combination with potassium preparations “Panangin”, “Asparkam”;
• medications that promote the supply of nutrients that improve blood circulation in the brain - nootropic substances - Piracetam, Cavinton medication;
• sedatives – decoction of medicinal valerian, “Phenazepam”;
• antihistamines - “Fenistil”, the drug “Suprastin”, children’s “Diazolin”;
• painkillers - analgesics "Baralgin", medicine "Sedalgin";
• medications to eliminate severe nausea - Cerucal;
• taking multivitamin complexes.

During the recovery period, the baby must be protected from external irritating factors, excessive activity, exempted from attending physical education, and excluded from playing sports. When playing with friends, all the kids are quite active, so you should also avoid walking for now.

Once treated, the concussion will begin to gradually subside and the patient will be able to return to their previous lifestyle. But only after appropriate examination and permission from a specialist.

Traditional medicine recipes

Treatment with folk remedies in most cases involves the use of medicinal thyme. Traditional methods of therapy can be combined with the recipes of the ancient sages, as they have a positive effect in case of brain injuries.

Folk remedies for the treatment of pathological conditions:

1. Thyme decoction: dry ingredient - 10 g, pour boiling water - 0.4 liters, bring to 95 degrees. Cool, filter, drink ½ glass before meals. The product perfectly restores the functioning of the nervous system. Duration of therapy is 6 months.
2. Aralia tincture: herbs – 10 g, pour ½ cup of alcohol tincture, close the container, leave for 20 days, filter, drink 30 drops 2 times a day.
3. Arnica decoction: dry inflorescences - 20 g, crushed myrtle leaves - 10 g, pour a glass of hot water, leave in a dark container for 2-3 hours. Strain and drink 10 ml before meals.
4. Galega infusion: main raw materials – 30 g, larkspur and periwinkle – 20 g, lemon balm and chamomile – 10 g. The resulting collection – 20 g, pour 0.5 liters of hot water, leave for several days. Filter, take ½ cup before meals.

Traditional medicine can be used in conjunction with basic diagnostics. Only a doctor can determine how to treat a concussion after a full diagnosis.

Complications and possible consequences

A mild degree of pathology does not pose a particular threat to the baby’s health, but minor consequences of the injury may still be present:

• systematic prolonged attacks of headaches;
• lethargy when performing normal daily activities;
• short-term gag reflexes for no reason;
• psychoses during classes, games, which previously evoked only positive emotions;
• increased sensitivity to sudden weather fluctuations - malaise, migraine attacks;
• insomnia, restlessness in sleep.

Most often, a concussion in an infant or teenager after full treatment does not bother the patient, but if the disease constantly makes itself felt with various symptoms, you should consult a doctor.

Possible preventive measures

Traumatic brain injuries are impossible to predict. But you can try to reduce the risk of their occurrence by adhering to simple safety rules:

1. Newborn babies should not be left unattended on the sofa, changing chest, or stroller. This also applies to infants who cannot yet roll over without assistance.
2. It is better to lower the bottom of the crib or playpen as low as possible, without waiting for the baby to start getting up and sitting down. The best way to do this is to acquire interesting skills during the child’s first efforts.
3. If the house has stairs, guardrails should be used.

After the child learns to walk and move independently, he needs to be looked after more carefully. When playing on the playground, safety precautions should be observed. Explain to children how to behave, instill in them caution.

A concussion in a child is a common pathology, because children, due to their age and nature, are very curious and active. Injuries most often do not pose a danger, but if there are alarming symptoms or changes in the behavior of a teenager, you should immediately consult a doctor and undergo a full examination.

Is it possible to find in this world a creature more curious and fearless than a child? The thirst for knowledge and the lack of a sense of self-preservation that is natural for an adult pushes him on research adventures, which often end in injury.

Concussion is one of the most common and at the same time dangerous consequences of falls, impacts, sports injuries and other accidents that occur almost every day with children of all ages. You will learn from our article how to recognize a concussion, provide effective first aid, and what the consequences are if left untreated.

Nature provides everything so that the human brain, and especially a child, is reliably protected from damage. The severe consequences of impacts are prevented by the bones of the skull: they are not only very strong, but also mobile, and therefore have the ability to absorb shock when in contact with a hard surface. An additional shock-absorbing role is played by cerebrospinal fluid - a liquid that is located between the brain and the bones of the skull and during an impact prevents their collision.

Protection of the brain of newborns is additionally provided by the fontanel (a physiological opening in the parietal part of the skull) and the softness of the bones.

Thanks to these factors, most impacts, both to the head and to the head, end safely, especially in cases with small children whose weight is not yet sufficient to create strong inertia and a powerful push.

To get a concussion, it is not enough to just hit yourself - the shock must not be so strong as it must be amplitude, that is, it must occur on a large scale (often happens in car accidents and sports competitions). In this case, the cerebrospinal fluid does not cope with the role of a shock absorber and the brain hits the bones of the skull, resulting in a temporary disruption of its functionality of varying degrees of severity.

Symptoms and signs

Symptoms of a concussion in children depend on factors such as the severity of the injury, the age of the victim, and the presence or absence of integrity of the cranial bones.

The most characteristic immediate signs by which the disease can be quickly identified include:

• pallor of the skin, which can be replaced by severe erythema (redness of the face);
• temporary astigmatism (de-synchronization of pupil movements);
• single or multiple;
• children 2-3 years old and older may complain of a sharp headache;
• loss of consciousness of varying duration;
• change in heart rate (increased, slowed pulse);
• shortness of breath;
• nosebleeds;
• an increase or decrease in the size of the pupils, their lack of response to stimuli.

In the absence of timely diagnosis and adequate medical care, the signs of a concussion in a child become less pronounced, but at the same time protracted:

• general lethargy (decreased activity, lack of interest even in favorite activities;
• frequent aching pain in the head;
• noise in ears;
• dizziness and other vestibular disorders;
• excessive sleepiness, or, conversely, difficulty falling asleep.

In an infant, a concussion is rare and can manifest itself with minor symptoms, such as excessive regurgitation, increased restlessness and sleep disturbances, which are mistaken by parents for manifestations of a digestive disorder. If the blow was not severe, then the symptoms usually do not last longer than 1-3 days.

Regardless of age, the temperature does not change during a concussion, and if an increase is observed, this indicates an independently occurring viral infection.

From one blow (bruise), the brain can receive two injuries due to the so-called counter-impact

A symptom such as a violation of the integrity of the skull bones requires special mention. If a fracture is noted after the impact, this is an indication for a diagnosis of traumatic brain injury. This diagnosis may be accompanied by the same symptoms as with a concussion.

It is impossible to differentiate these conditions independently at home - this requires special medical equipment. The first and main task of parents is to transport the child to the emergency room as quickly as possible.

Severity

With careful observation, you can determine not only the fact of the concussion itself, but also the severity of its occurrence. According to the generally accepted medical classification, there are three degrees of the disease.

Knowledge of their distinctive characteristics will tell parents how to identify a concussion in a child at home, help them better navigate the situation and respond correctly.

• First degree

Characterized by minor physiological disorders such as headache, dizziness, short-term weakness. Additional symptoms of a mild concussion: nausea, single vomiting, in a child under one year old -.

The main difference between the first degree of the disease and more severe ones is the time during which symptoms appear. If within 30-60 minutes the patient’s condition improves, he strives to return to his usual activities, his complexion improves, this indicates that the most dangerous period is over.

However, this does not mean that a mild concussion does not require hospital diagnosis and treatment - in any case, the child should be taken to the hospital, where they will take an X-ray of the skull and make sure there are no microcracks or internal hematomas. This measure will allow you to avoid possible negative consequences of injury, such as headache of unknown etiology, etc.

• Second degree

The first signs of a second-degree concussion appear in the same way, but are observed over a longer period of time. The disease can be complicated by short-term loss of consciousness (1-2 minutes), lack of ability to concentrate, and clouding of mind.

Older children (10-12 years old) complain of a feeling of fog in the head, extraneous noise, and inability to maintain balance. The condition is often accompanied by profuse, repeated vomiting. The pupils react to light more slowly than normal.

You can understand that a child has a second-degree concussion if you ask him the simplest, age-appropriate questions. For children under 1 year of age and a little older who still speak poorly, only a doctor can carry out a differential diagnosis.

• Third degree

In the third degree, the patient may lose consciousness for up to 5 minutes. He is very pale, lethargic, and is unable to change his body position on his own. Sometimes short-term amnesia is observed - the child is not able to remember his name, does not recognize those around him, and has no orientation in time.

With a third degree concussion, the pupils do not react to light; there is a difference in their size. This indicates severe damage to one or both hemispheres of the brain. The child's pulse is uneven - it either quickens or becomes slow, depending on this, the intensity of inhalations and exhalations changes. The condition is accompanied by increased sweating, and perspiration appears on the forehead.

If loss of consciousness lasts longer than 5 minutes, this leads to irreversible consequences and requires urgent medical resuscitation measures.

When do the first symptoms appear?

Diagnosing a concussion in a child is often difficult for parents for two reasons:

1. Lack of injury information.
2. A long period of time between injury and the onset of symptoms.

Fearing their parents' anger, children often hide from them the fact that they fell or hit themselves during a walk, school break, fight, or training. A situation in which brain damage begins to appear several hours later also disrupts the apparent connection between the cause of the disease and its consequences, making diagnosis and treatment difficult.

Therefore, it is important to remember that severe degrees of the disease make themselves felt immediately after injury, but mild ones are more insidious and can make themselves felt after 2-3 hours. Pay attention to the combination of symptoms. If this is vomiting accompanied by dizziness and/or headache, be sure to ask your son or daughter about possible blows, falls, collisions and other troubles that could happen.

Regardless of how long it takes for a child to develop a concussion, it must be shown to a doctor to clarify the diagnosis.

First aid

First aid depends on how the child’s concussion manifests itself, but the very first action of an adult is to call an ambulance. After this, it is necessary to examine the head and, if there is damage to the skin, treat the wound with a non-alcoholic antiseptic (chlorhexidine, hydrogen peroxide), stop the bleeding with a cotton-gauze swab, and apply a bandage. Using an alcohol antiseptic can cause painful shock in a child.

If the soft tissues of the head are damaged, but there are no signs of a concussion, be sure to call an ambulance - symptoms may appear later.

At first degree

If the victim is conscious and his condition does not cause concern (vomiting may be absent during a first-degree concussion, there are complaints of a mild headache, slight dizziness), you can take him to the hospital yourself, but in no case on public transport . However, this is an extreme, undesirable measure, since it is impossible to secure the patient well in the car in case of shaking and provide him with a horizontal position in compliance with safety precautions.

Diagnosis and treatment are carried out by surgeons, neurosurgeons and neuropathologists, but if you do not know exactly who to take your child to if he has a concussion in your area, go to the nearest traumatology department - there he will be provided with medical care and, if necessary, transported to his destination.

In the second degree

In case of a second degree concussion, that is, when vomiting, nausea, headache are present, but there is no prolonged fainting, the child must be provided with a horizontal position. Do not let him fall asleep until the doctors arrive - after sleep, against the background of a traumatic brain injury, the symptoms may become stronger, the patient will become more lethargic, and consciousness may be disturbed.

In the third degree

In case of serious injury accompanied by loss of consciousness, the patient should be placed on a horizontal, flat surface on his right side, with his right arm placed under his head, and his legs slightly bent at the knees. Bend your left arm at the elbow and place it loosely along your body. This will help give the victim an optimal physiological position, temporarily stabilize him in case of sudden convulsive movements, and also protect him from choking if vomiting suddenly begins.

What is unacceptable to do:

• leave the patient unattended, regardless of the severity of the symptoms;
• if he loses consciousness, shake him, trying to bring him to his senses;
• lay on your back;
• put in a position in which the head is located below the body;
• ignore symptoms, self-medicate.

Also, you should not make a fuss around the victim, frighten him, upset him, make noise - all of the above will only aggravate the condition.

Hardware diagnostics

In addition to the doctor’s collection of anamnesis, clarification of the circumstances of the injury and his objective assessment of the external manifestations of the disease, the diagnosis necessarily includes hardware techniques, the choice of which depends on the severity of the symptoms.

Their arsenal includes:

1. X-ray – helps determine a fracture of the skull bones.
2. Neurosonography is an ultrasound examination that shows the condition of the skull and brain in children from birth to 2-3 years.
3. Magnetic resonance imaging (MRI) - shows the condition of the brain, the presence of tumors and hemorrhages in it.
4. Computed tomography (CT) allows you to see all the same nuances as an MRI, but takes less time, so it is more often used with young children.
5. Electroencephalographic study (EEG) - used after treatment if the injury was severe. With this examination, you can see which parts of the brain show pathological activity and adjust the treatment of the consequences.

Some types of examinations (MRI, CT) require prolonged immobilization, and therefore are difficult to use with small, restless, and hyperactive children. Therefore, they are prescribed only in cases of extreme necessity and are performed under general anesthesia.

Treatment

Treatment of second and third degrees of concussion is carried out in a hospital setting. This allows the patient to quickly recover from a serious condition and minimizes the negative consequences of the disease. The child is provided with rest and bed rest; the optimal method of administering medications is oral or intravenous (through a drip).

Treatment of concussion in children necessarily includes diuretics that prevent swelling, nootropics that accelerate the process of restoring brain functionality, as well as anticonvulsants and drugs that normalize intracranial pressure. Symptomatic treatment consists of taking painkillers and sedatives, and sometimes antihistamines may be needed.

For the first degree of concussion, outpatient treatment is allowed. Home care involves ensuring peace, protecting the child from sudden movements and negative emotions. Of great importance in the treatment of the disease and its consequences in a school-age child is strict restrictions on watching TV and computer games - such entertainment has a stimulating effect on the nervous system and slows down the healing process.

A patient undergoing outpatient treatment must be ensured that all medications prescribed by the doctor are taken in a timely manner. Despite the absence of severe symptoms, he is also prescribed light nootropics, the use of which improves cerebral circulation, helps improve memory and attentiveness, and also prevents the development of complications.

During the recovery period, the child should be limited in physical activity, exempted from physical education lessons at school, and take a break from sports activities. When walking with friends, children can be very active, so such pastime is also temporarily prohibited. A return to a full life is possible after the diagnosis is removed and the doctor’s permission.

Complications

Timely diagnosis and treatment are two components of a complete recovery from the consequences of injury. In the absence of them, even a mild concussion is dangerous with various consequences, many of which can overshadow the rest of life.

Among them:

• poor memory;
• decreased concentration;
• weather dependence;
• migraine;
• dizziness;
• fear of heights and other phobias;
• pressure surges;
• anxiety;
• neuroses (,);
• tendency to seizures;

A moderate or severe concussion suffered at any age also increases the likelihood of senile dementia, accelerates its onset, and aggravates its course. In girls, trauma can negatively affect subsequent pregnancies, which are often complicated by the threat of termination due to hypertensive crises.

Can it be prevented?

“If I had known where you would fall, I would have laid out straws.” This proverb fully reflects the degree of unpredictability of any injury. However, it is possible to reduce risks if you follow basic safety precautions.

With infants, this means under no circumstances leaving them on changing tables, sofas or any other elevated surfaces unattended. This rule applies even in the case of newborns who do not yet know how to turn on their own.

Lower the bottom and/or playpen early without waiting for your child to learn how to sit up or stand up. This should be done in advance, during the baby’s first attempts to move to the next level of physical development. If there are stairs in a private house, install special fences.

When the baby learns to crawl and walk, supervision should become even more careful, because the likelihood of injury increases many times over. Observe safety measures on the playground and gradually accustom your child to this. As he grows up, explain to him the rules of behavior in public places - kindergarten, school, instill prudence, caution and a tendency to self-preservation.

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