Concussions affect how a child’s brain works after a blow or jolt to the head or body. They can cause headaches, dizziness, tiredness, trouble concentrating or remembering, sleep changes, and shifts in mood or behavior. Symptoms may appear right away or take hours or days to become clear. Most children improve within a few weeks, but a suspected concussion needs medical assessment and emergency care for danger signs.
What happens to a child's brain during a concussion?
A concussion is a type of traumatic brain injury that temporarily affects how the brain functions. It can happen after a direct blow to the head or an impact to the body that causes the head and brain to move rapidly back and forth. Falls, playground accidents, bicycle crashes, and sports injuries are among the situations in which children may sustain a concussion.
According to the Centers for Disease Control and Prevention (CDC), this sudden movement can lead to chemical changes in the brain and sometimes stretch or damage brain cells. These changes can affect a child's ability to think, learn, feel, behave, and sleep normally. A concussion does not always cause a child to lose consciousness, and the injury can be present even when there is no obvious external mark on the head.
How can a concussion affect a child's body and behavior?
The effects of a concussion can involve several areas of daily life. Some children mainly experience physical discomfort, while others notice changes in concentration, emotions, or sleep. Symptoms can also change during recovery. A child who initially complains of a headache may later struggle with schoolwork or become unusually irritable.
The CDC's concussion guidance describes several types of symptoms that children may experience after a head injury:
- Physical symptoms: Headaches, dizziness, nausea, tiredness, balance difficulties, blurry vision, or sensitivity to light and noise.
- Thinking and memory changes: Difficulty concentrating, forgetfulness, slower thinking, confusion, or trouble following instructions.
- Emotional and behavioral changes: Irritability, anxiety, sadness, increased frustration, unusual emotional reactions, or changes in usual behavior.
- Sleep changes: Sleeping more or less than usual, feeling unusually tired, or having difficulty falling asleep.
These experiences are examples of possible concussion effects, not a checklist that can confirm an injury. Headaches, nausea, or fatigue can have other causes, and some children experience only a few noticeable changes. Medical professionals consider the injury, the child's symptoms, the timing of those symptoms, and examination findings when evaluating a possible concussion.
Do concussion symptoms look different in babies, toddlers, and older children?
Yes. Age and development influence how a concussion may become noticeable. Older children can often describe a headache, dizziness, or difficulty remembering things. Babies and toddlers may not have the words to explain what feels different, so parents and caregivers may need to notice changes in their usual routines, movement, eating, sleep, or behavior.
Babies, toddlers, and preschool-aged children
In children from birth through about age 4, possible signs may be subtle. A child may become unusually clingy, cry more than usual, seem less interested in favorite toys, or need more comfort than normal. Changes in eating or sleeping, new unsteadiness, unusual tiredness, or vomiting after an injury may also be concerning. These changes are not specific to concussions, but they deserve attention when they follow a head injury.
Infants and toddlers need particular care because they may be unable to communicate symptoms reliably. A caregiver's observations of changes from the child's normal behavior can help a healthcare professional understand the situation.
School-aged children and teenagers
Children aged 5 to 17 may report headaches, dizziness, or difficulty concentrating. They may also answer questions more slowly, forget recently learned information, struggle with tasks that were previously manageable, or appear unusually confused or clumsy. Teenagers may have difficulty keeping up with lessons, reading for long periods, or participating in sports without symptoms becoming more noticeable.
Changes in mood can be especially confusing for families. A child may become easily frustrated, withdraw from friends, or lose interest in usual activities. These changes can be associated with concussion, particularly when they begin after an injury, and should be discussed with the child's healthcare professional if they persist or interfere with daily life.
When is a head injury an emergency?
A suspected concussion requires medical assessment, but certain symptoms after a head injury can indicate a more serious problem. Do not wait for a routine appointment if a child develops any of the following warning signs. Seek emergency medical care immediately or contact your local emergency service.
- A headache that becomes worse or does not go away.
- Repeated vomiting.
- A seizure or convulsion.
- Increasing confusion, agitation, unusual behavior, or difficulty recognizing familiar people or places.
- Slurred speech, weakness, numbness, or worsening coordination.
- One pupil becoming larger than the other or new double vision.
- Loss of consciousness, increasing drowsiness, difficulty staying awake, or being difficult to wake.
For babies and toddlers, other emergency warning signs include crying that cannot be soothed or refusing to nurse or eat after a head injury. The CDC's list of concussion danger signs provides further guidance on symptoms that require immediate care. A child's condition can change after the initial injury, so new or worsening symptoms should never be dismissed because the child appeared well at first.
How do healthcare professionals assess a possible concussion?
A healthcare professional will ask how the injury happened, whether the child lost consciousness or has gaps in memory, what symptoms have appeared, and whether there have been previous concussions. The assessment may include a physical and neurological examination, checks of balance and coordination, and questions or tests involving memory, attention, and thinking.
The Mayo Clinic's guidance on concussion diagnosis explains that brain imaging, such as a CT scan or MRI, may be needed in selected cases. Most children with a suspected concussion do not need a brain scan. A clinician decides whether imaging is appropriate based on the injury, examination findings, symptoms, and concern for a more serious injury. In children, the decision to use CT imaging also takes radiation exposure into account.
How long do concussions affect children?
Most children feel better within about 2 to 4 weeks, although recovery varies. Some symptoms improve quickly, while others, such as difficulty concentrating, tiredness, headaches, or changes in mood, can take longer to settle. A smaller number of children experience ongoing symptoms for months or longer, which may affect their learning, relationships, and everyday activities.
Previous concussions and more noticeable symptoms soon after an injury are among the factors associated with a longer recovery. Existing sleep problems, learning difficulties, neurological conditions, mental health concerns, and family or social stress can also affect recovery. Children with symptoms that persist beyond 2 to 4 weeks, worsen, or continue to disrupt normal activities should be reassessed by a healthcare professional. Further evaluation or referral to a specialist may be appropriate.
What helps children recover after a concussion?
Recovery involves gradually returning to normal activities while avoiding situations that could cause another head injury. The CDC's guidance on concussion recovery recommends relative rest during the first day or two rather than prolonged isolation or bed rest. Children can generally continue sleeping according to their usual routine. Short walks and other light activities may be introduced as tolerated, with a temporary reduction in activity if symptoms worsen.
During the initial recovery period, families may need to reduce screen time and activities requiring sustained concentration, especially if they aggravate symptoms. Medication for headaches or other symptoms should be discussed with the child's healthcare professional, who can advise on appropriate options for the child's age and circumstances.
Returning to school
Many children can return to school within 1 to 2 days, even if some symptoms remain. Staying home until every symptom has disappeared is not always necessary. However, the child may need temporary adjustments, such as shorter work periods, extra time for assignments, rest breaks, reduced screen exposure, or a quieter place to study.
According to the CDC's guidance on returning to school, school support should reflect the child's symptoms and ability to participate. Parents can work with the child's healthcare professional, teachers, and school staff to decide which adjustments are useful. The plan can be reviewed and changed as the child improves.
Returning to sports and physical activity
Children should not return to sports on the day of a suspected concussion. While recovering, they should avoid activities with a risk of another head impact, including contact sports, rough play, and activities such as cycling or skateboarding when a fall could occur. Returning to sports requires approval from a healthcare professional and a step-by-step progression through activity, with each stage completed safely before advancing.
A child should be able to manage regular non-sport activities without concussion-related symptoms or school accommodations before completing the return-to-sport process. If symptoms return during an increase in activity, the child should stop that activity and seek guidance on the next step. Returning too early can expose a still-healing brain to another injury.
How can parents support a child during recovery?
Parents and caregivers can help by keeping track of changes in symptoms, sleep, behavior, and school performance. Sharing these observations with the child's healthcare professional can help guide follow-up care. It is also useful to explain the injury in age-appropriate language and reassure the child that temporary difficulty with schoolwork, sports, or emotions can occur during recovery.
Children may feel frustrated when they cannot take part in their usual activities. Maintaining contact with friends, offering encouragement, and allowing a gradual return to normal routines can help them feel supported. Follow-up appointments are important for reviewing progress and adjusting activity recommendations. If symptoms persist, worsen, or interfere with everyday life, arrange another medical assessment rather than assuming the effects will resolve without further support.