Managing Your Child’s Concussion: The First 24 Hours

Parents know there’s a risk of concussion if their kids are involved in athletics. But children can have a concussion-causing accident during any activity, whether they’re at the playground, riding a bike, or playing at home.

Managing a child’s concussion in the first 24 hours can shorten their recovery time and protect their brain health. Our compassionate THINK Neurology for Kids team — Shaun S. Varghese, MD, Cristina R. Marchesano, MD, Lorena Herbert, MD, Barbara Kiersz-Mueller, DO, Lauren Weaver, MD, Alicia Walls, MD, Sundeep Mandava, MD, Patricia DeForest DO, Robby Korah, FNP-C, Jennifer E. Martin, CPNP-PC, Tammy DeLaGarza, FNP-C, and Heather King — is here to help.

Call us if you have any questions about your child’s head injury or what to do to support their healing. In the meantime, here are five steps to take during the first 24 hours after your child’s head injury:

1. Take your child out of the game (or play activity)

No matter the activity, pull your child from the game or stop them from playing after a head injury. Don’t let them return to physical activity even if they don’t have symptoms (or are desperate to rejoin their team).

Changes in the brain occur immediately after a concussion-causing injury. The nerves are damaged, and the blood supply decreases. Brain cells become vulnerable. As a result, another bump or injury can cause severe damage.

Second-impact syndrome (sustaining a second head injury before a previous injury heals) can cause rapid brain swelling.

Your first step is to protect your child, ensuring they avoid any activity that puts them at risk of a second concussion.

2. Require rest

Rest during the first 24 hours is essential because an injured brain needs reduced stimulation to start healing. Expect your child to feel more tired than usual or downright fatigued because their brain needs downtime.

Even if they don’t need to sleep, they should still take it easy. Limiting physical activity prevents re-injury, and restricting mental activity reduces stress on the brain, giving it time to regenerate.

Taking a leisurely walk is generally safe (because it poses a low risk of an injury). Your child can probably tolerate reading or watching TV — as long as it doesn’t aggravate their symptoms.

 

However, they should avoid loud music and restrict screen time. Limit video games and extend time on the smartphone or computer for the first 24-48 hours.

3. Don’t wait for symptoms

Don’t wait for symptoms before taking the first two steps. Why? Because symptoms may not appear immediately. Some children won’t have symptoms for several days.

Before symptoms appear, your child may stay active. This would increase their risk of a second concussion or cause ongoing brain changes that make symptoms worse and prolong recovery.

4. Watch for worsening symptoms

It's crucial to notice if your child's symptoms worsen during the first 24 hours (and the first few days). You should also watch for signs that your child needs immediate treatment.

In addition to common symptoms like headache, confusion, dizziness, nausea, vomiting, and memory loss (being unable to remember what happened right before the head injury), watch for other signs, such as:

• Blurry vision
• Slow response to questions
• Difficulty sleeping
• Mood changes (irritability, anxiety, overly emotional)
• Difficulty concentrating or paying attention
• Being easily upset or crying more than usual (in young children)
• Having no appetite or refusing to eat
• Losing newly acquired developmental skills (like toilet training)
• Not wanting to play or engage in favorite activities

Seek emergency medical attention if your child has any of the following:

• Convulsions or seizures
• Can’t wake up
• Obvious difficulty with mental function
• Coordination and balance problems
• Weakness or numbness
• Severe headache or one that gets worse
• Doesn’t recognize people or places
• One pupil is larger than the other
• Loss of consciousness

Losing consciousness, especially if they’re out five minutes or longer, is a sign of a more serious brain injury.

5. Seek a concussion evaluation

If your child bumped their head (or had a whiplash injury, which can also lead to a concussion), you should schedule a concussion evaluation right away.

An early assessment guides your child’s treatment during their recovery. Determining the right amount of rest and activity and when it’s safe to return to school or athletics is based on the severity of their injury and symptoms.

Get expert concussion treatment

A customized treatment plan created by our concussion experts will help speed up their recovery, protect their brain while it heals, and lower the risk of long-lasting symptoms.

Call the nearest THINK Neurology for Kids office to schedule a prompt concussion evaluation. We’re in The Woodlands, Katy, Sugar Land, Austin, San Antonio, and Gulf Coast, Texas.