Concussion in children is one of the most common diagnoses in traumatology. In general, head injury is one of the most common causes of all injuries in preschool children requiring hospitalization. Annually, about 120 thousand children with a concussion arrive at Russian hospitals. Let us consider in more detail the symptoms and treatment of concussion in children.
General injuries
Head injuries are quite dangerous and require hospitalization of the victim in a medical facility. In children, due to high activity, natural curiosity, mobility and energy, injuries occur more often than in adults. Among all injuries requiring hospitalization of a child up to a year, a preschooler or a schoolboy, concussion is diagnosed in 90% of cases.
The human brain is protected from damage by the skull, bones. In children, the bones are strong, but movable, which provides a certain degree of amortization when falling or hitting. The role of the additional shock absorber is also played by the fluid, which fills the free space between the bones and the brain. With such reliable protection, most strokes end safely (which is especially true for young children who have a little inertia due to their low weight).
However, a shock may cause a concussion. In children and adults, all head injuries can be divided into the following types:
- Concussion. This is the easiest kind of blow a baby can get.
- Bruised brain. Serious damage, in some cases, may be accompanied by a fracture of the bones that form the arch of the skull.
- A brain injury with a hematoma. The most difficult diagnosis, which is accompanied by a fracture of the cranial vault and internal hematoma.
Such an injury has a positive prognosis; fortunately, there are no major changes in a concussion. But it is important to know that the signs of concussion in a child can radically differ from the symptoms that occur in adults with the same injury. Features of the baby’s body lead to the fact that immediately after an injury, he may feel normal, but after a certain time the victim will sharply become worse.
Concussion Causes
As mentioned above, a mild concussion in a child or more severe types of trauma occur due to innocent childish immediacy, curiosity, activity and mobility. Young children are just starting to explore the world, they are not very firm on their feet and often fall, older kids already feel more confident and bold to climb the slides in the playground, and schoolchildren love outdoor games, during which you can easily encounter a friend or what something object.
A concussion in a child up to a year often occurs due to the fall of a bed or sofa, parental hands, from the changing table. The baby must be constantly monitored so that there are no injuries. As soon as the child begins to move independently, the number of injuries decreases slightly. Concussion in children occurs when falling from a ladder or from a children's slide, from a height of their own growth. More often at this age, injuries and fractures of the limbs occur.
Children aged one to six years receive head injuries in 20% of the total number of ailments requiring treatment in pediatric traumatology. Schoolchildren are more often diagnosed with concussion - in 45% of cases of treatment in traumatology. Older children, which is characteristic, often withhold trauma for various reasons. Even preschoolers and primary schoolchildren may have brain damage that occurs when exposed to strong acceleration or inhibition, but without a head injury.
Most common symptoms
How to determine a concussion in a child? Symptoms depend on many factors, including the age of the victim, the extent of the injury, the degree of damage, the presence or absence of integrity of the cranial bones. The most common symptoms of a concussion in a child may include the following:
- Pallor of the skin, immediately after which there is redness of the skin. This symptom appears in most cases, but it may not be.
- Astigmatism. During a concussion, a child experiences temporary astigmatism, if we say otherwise, the pupils are not synchronized, they move differently.
- Vomiting is another characteristic sign of a concussion in a child. Vomiting can be observed, both single and multiple. The child is sick, he refuses food.
- Severe migraine. A headache is something that children often complain of during a concussion. Babies can still talk, so it’s impossible to learn about headaches in children of this age.
- Fainting. Some cases of concussion in children may be accompanied by fainting, this condition can last a long time or be short-lived.
- Change in the frequency and rhythm of breathing. After an injury, confused breathing can be observed, this indicates a concussion only indirectly, but you still need to see a doctor.
- Heart rate change. Another sign is a change in the heart rate, and the pulse can either accelerate or slow down.
- Bleeding from the nose. Epistaxis after head injury may indicate a concussion or even more serious injury.
- Change the size of the pupils. If the pupils have increased or decreased, there is no reaction to irritation, then this may indicate a concussion.
Other signs of injury
Not always obvious symptoms of concussion appear immediately after an injury, especially in children. But then you can identify other signs that are more protracted. These include:
- Lethargy, apathy and weakness. The child often disappears even in those activities that he likes, he becomes less active and cries for no reason, his mood disappears.
- Aching in the head. A small child, preschooler, primary school student or teenager often complains of headache. The sensations are not as intense as the first time after the injury, but have a lingering character. Pain may increase or recede from time to time.
- Noise or ringing in the ears. Another child may complain of stuffy ears, slight hearing loss.
- Violations of the vestibular apparatus. The victim may become distracted, fall or stumble more often, and he may periodically feel dizzy.
- Sleep disturbances. Often immediately after getting injured, the child becomes drowsy, but sometimes certain difficulties with falling asleep, insomnia are possible.
It is important for parents to know that the temperature during concussion in children remains unchanged. If this symptom also appeared in the clinical picture, then most likely the child has a viral infection against the background of the injury. Elevated body temperature does not indicate direct concussion and is not a symptom of this kind of injury.
Symptoms in children up to a year
In infants and children up to a year, concussion is rare. Newborns make up only 2% of the total number of victims, infants - 24%, and nursery - 8%. If trauma occurs, then, as a rule, the clinical picture of the concussion is very weakly expressed. Often, parents take the symptoms for an upset digestion or just feeling unwell or in a mood.
How to determine a concussion in a child up to a year? The following symptoms are most common for infants:
- pallor of the skin;
- poor appetite; refusal of food;
- frequent and plentiful regurgitation;
- fontanel swelling;
- concern for no reason;
- frequent crying, irritability;
- vomiting (both single and multiple);
- restless sleep, but excessive drowsiness.
Another symptom of concussion in children is a violation of the integrity of the bones. It is impossible to determine this on your own, but if the doctor diagnoses a violation of integrity, then he will make a diagnosis of “head injury”. Such an injury may be accompanied by the same symptoms as a concussion. In this case, parents need to identify the problem as soon as possible and show the child as soon as possible to a qualified doctor.
Signs in Preschoolers
A concussion in a child (1 year to 6 years) of preschool age can often be established by the fact of loss of consciousness, vomiting and nausea immediately after an injury. Parents can guess about the loss of consciousness if the child did not start to cry immediately after receiving the blow. In addition, usually the child is very thirsty to drink, eat or sleep in the first two hours after the incident, but he absolutely must not be allowed to do this, you need to immediately call a doctor.
Children four to six years old can talk about headaches, sometimes post-traumatic blindness is also observed. It can develop immediately after an injury or after some time, the symptom persists for several minutes or even hours, and then disappears on its own.
After an injury in a child from a year to six years, that is, of preschool age, parents need to pay attention to such signs of concussion:
- excessive sweating;
- slowing or increasing heart rate;
- dizziness;
- general weakness and tearfulness;
- sleep disturbance, insomnia;
- increased drowsiness;
- unwillingness to eat;
- nausea and vomiting;
- pallor of the skin;
- headache.
The most common symptoms of concussion in preschool children are vomiting and nausea, headaches, changes in heart rate and pressure, and loss of consciousness. A little less common are sleep disorders, poor appetite, moods and frequent mood swings. Poor orientation in a familiar space, weakness, partial visual impairment may be noted.
Symptoms in schoolchildren and adolescents
If the concussion occurred in a school-age child or adolescent, the symptoms are more similar to those experienced by an adult with the same diagnosis. What specifically will determine the fact of a concussion in a child? The following symptoms are characteristic:
- repeated vomiting;
- fainting, which lasts up to 15 minutes;
- impaired motor activity;
- impaired coordination of movements;
- short-term memory loss is possible;
- confusion of consciousness;
- there may be unclear speech;
- orientation problems even in a familiar environment.
Often in school-age children, the symptoms completely disappear on the third day after the injury. And sometimes the condition of the child improves significantly the next day after the incident, but you should know that this does not mean a decrease in the health hazard. The process of disturbances has already begun, which can lead to serious consequences of a concussion in a child.
The provision of first aid
In case of head injuries, first aid is of great importance. If the child hits his head, you must first call an ambulance, and then carefully examine the child's head for visible damage. In the event that they exist, it is necessary to treat damage with an antiseptic without alcohol (for example, chlohexidine or hydrogen peroxide). If you use alcohol-based disinfectants, pain shock may develop. If there is blood, it can be stopped with a cotton swab and gauze, after which a bandage is applied.
Even if there are no concussion symptoms after the injury, the child should still be shown to the doctor. Signs of such a dangerous condition may appear after some time, and time for assistance will be missed.
Assistance before the arrival of doctors depends on the severity of the damage. At the first degree, dizziness and slight weakness are possible, overall health remains satisfactory. Not very severe pain may occur. If the child is conscious, and his health is normal, then you can take the victim to the hospital yourself. Just do not do this using public transport, shaking is extremely undesirable when the child is in a similar condition. In the car, you need to hold the victim's head so that it does not sway. Provide it with a horizontal position.
The second degree is characterized by a loss of consciousness for a short period and a slight clouding of the mind, a disorder of the vestibular apparatus. Nausea and vomiting, severe headache may also occur. Before the doctor arrives, you should not let your child sleep, but you need to ensure that he is in a horizontal position. After sleep, symptoms may become more pronounced, and consciousness - significantly impaired.
With a third degree of severity, a faint is possible for five minutes or more, the patient is very weak and often can not change the position himself. In this case, the child needs to be laid on its side, put a hand under the head. The legs should be slightly bent at the knees. This is the optimal position that will allow you to correctly fix the body during convulsions or prevent choking if vomiting begins. It is necessary to call an ambulance and not leave the child until the arrival of doctors.
Concussion treatment
The treatment for a concussion in a child depends on the degree of damage. At the first degree, doctors can give recommendations and send the victim home if his condition does not cause concern. In other cases, that is, with the second and third degree, as a rule, the patient is left in a hospital. This will help treat a child's concussion more effectively and minimize the dangerous effects of trauma.
Drug therapy involves the use of diuretics, which will prevent the occurrence of swelling, nootropic drugs, anticonvulsants, and medications that normalize intracranial pressure. Symptomatic treatment will include the use of painkillers and antihistamines.
Treatment of concussion in children, if the first degree of severity is confirmed, can be done on an outpatient basis. At home, the victim needs to ensure bed rest, protect him from negative emotions and sudden movements. It is necessary to introduce restrictions on reading books, watching TV shows and films, using a computer and other gadgets, as this puts a serious strain on the child’s brain.
What to do is unacceptable
If there is a suspicion that the child has a concussion, it is forbidden to leave him alone. This applies to injuries of any severity and injuries of any age. If a preschooler, teenager or a very small child faints, then you do not need to shake him, it can only make it worse. It is also not allowed to lay the child on his back or in a position where the head is lower than the body. It is strictly forbidden to self-medicate and the symptoms of injury cannot be ignored. The victim must be shown to a pediatrician and traumatologist (even if the injury is minor). In addition, you can not disturb the child, do not panic, as this can only worsen his condition.