Most children recover well from a concussion, but some may
experience lasting effects. Dr Yeo Tong Hong, senior consultant
paediatrician and paediatric neurologist, explains the dangers of
repeated head injuries.
Minor accidents like falls and bumps to the head are often
part of childhood, and usually not cause for immediate
concern
However, in some cases, a child can sustain a concussion.
What is a concussion?
A concussion is a type of mild brain injury that occurs
after a sudden bump or blow to the head, face or neck
that prevents the brain from functioning normally
Concussions can happen at any age and during any
activity that causes the brain to be shaken or jolted. Some
of the most common causes of concussion-related visits
to the children’s emergency department include biking,
football, playing in playgrounds, and basketball, according
to Dr Yeo.
Concussions may also occur during everyday activities.
In fact, Dr Yeo notes that falls are the most common
non-sports-related cause of concussions. Unfortunately,
there is no guaranteed way to prevent a concussion.
Helmets are made to protect against serious head injuries
like skull fractures, but they do not fully prevent concussions.
The good news, Dr Yeo says, is that most children, around
90%, are able to recover fully from a concussion although
some may experience long-term effects.
How to tell if a child is not recovering from a concussion
There are times when a child suffers from multiple head
injuries and is unable to recover well. Parents or
caregivers should look out for the following warning signs:
- Child becomes unusually sleepy, drowsy, or difficult to wake
- Frequent or constant headaches
- Persistent or recurrent vomiting
- Weakness of arms or legs, walking difficulties, unsteadiness or poor coordination
- Confusion or unusual behaviour
- Blood or fluid coming out from ear or nose
- Seizures or convulsions
If your child has sustained a head injury and is exhibiting
any of these signs, it is best to seek medical care
immediately.
Potential long-term effects of repeated concussions in children
Suffering from repeated concussions may also lead to
more serious long-term effects such as:
- Fatigue
- Chronic headaches
- Emotional regulation difficulties
- Cognitive impairment such as poor concentration or memory issue
- Sensitivity to external stimuli, such as light or noise
Risks of repeated concussion
Not letting the child recover fully before resumption of
normal activities bears the risk of a repeated concussion.
“After a concussion, the brain is more sensitive and needs
time to heal. If someone resumes regular activities too
soon, especially sports or anything with a risk of further
head injury, they could face serious consequences,” says
Dr Yeo.
If a child does not fully recover, they may experience the
following:
- Prolonged concussion symptoms, such as chronic headaches, dizziness, or cognitive difficulties
- Potential long-term health problems, including psycho-emotional issues or diseases that affect the brain over time
- A second concussion. This could be life-threatening if it happens before the first one has fully healed. It can cause dangerous brain swelling, a condition called Second Impact Syndrome.
Helping the child resume physical activity
After a concussion, parents play a key role in supporting
their child’s recovery. They should closely monitor for any
cognitive, physical or behavioural changes in their child,
and seek medical advice if necessary.
If a child has previously experienced a concussion, the best
way to prevent another is to ensure that they have fully
recovered, and have been medically cleared by a doctor
before resuming regular activities – particularly sports.
Proper recovery involves both physical and psychological
healing. According to Dr Yeo, current guidelines recommend avoiding sports for at least two weeks after all symptoms
have completely resolved.
He advises parents to work with their child’s school or
sports centre to develop a clear return-to-activity plan
before allowing them to return to their regular routine.
“
It is very important that the child has a
phased return to school – starting with
half-day sessions or three to four days a
week, depending on what they can tolerate.
For physical activities or sports, they should
begin with five minutes of light aerobic
exercise, and gradually increase the duration
as tolerated."
– Dr Yeo Tong Hong
Symptoms of a concussion
- Headache or "pressure" in the head
- Nausea or vomiting
- Dizziness or balance problems
- Blurred or double vision
- Sensitivity to light or noise
- Confusion or appearing dazed
- Trouble concentrating or remembering
- Slurred speech
- Feeling sluggish, hazy, or groggy
- Changes in mood, behavior, or personality
- Loss of consciousness (even briefly)
- Sleep disturbances (sleeping more or less than usual)
