Recognizing and Responding to Concussions: A Caregiver’s Guide

When you’re packing up for your child’s game or a family road trip, you’re likely thinking more about gear or the weather than the possibility of a head injury. Even if it isn’t a thought that crosses your mind, knowing the causes and signs of a concussion and what to do about them can help keep your family healthy and safe. 

Concussions are mild traumatic brain injuries. Although mild may sound like no big deal, when it comes to concussions, mild is still serious. This type of injury isn’t usually fatal, but it requires medical attention, follow-up care and a significant recovery period. Still, this condition can be easy to miss. Here’s what you need to know. 

A Brief Jolt to the Brain 

Whether it happens at home, in the car or on the field, concussions are caused by a sudden bump, hit or jolt to the body or head. During this brief moment, the brain moves back and forth quickly or twists inside the skull. This movement causes chemical changes and may damage and stretch brain cells. 

Concussions can lead to a brief loss of consciousness. However, in many cases, signs or symptoms of this type of injury surface days or weeks after the event that caused it. 

Concussions at Different Stages of Life 

Anyone can get a concussion, but it's more likely in young children, teens and older adults. While symptoms are similar regardless of age, common causes of concussion vary by age group. Knowing these differences may be especially helpful if you’re a part of the sandwich generation: adults raising children while caring for their aging parents. 

Infants, toddlers and young children often get a concussion from being hit on the head by a ball or toy, a bike or tricycle accident, a car accident or falls. Older children and teens can also sustain a head injury in these ways, but sports injuries are also a common cause for older children. 

Falls are the leading cause of concussions in older adults. However, they are often misdiagnosed or missed because symptoms of a concussion may overlap with signs of dementia or other health conditions which are common later in life.  

An older adult needs to see a healthcare provider after hitting their head, even if no symptoms are present. Older adults have an increased risk of complications, including bleeding in the brain. Their risk is even higher if they take a blood thinner.  

Recognizing the Signs 

Symptoms of a concussion can range from mild to severe. In many cases, they develop soon after the injury but may appear hours, days or weeks later.  

In people of all ages, a concussion may cause: 

  • Balance issues 
  • Confusion 
  • Dizziness 
  • Fatigue or sluggishness 
  • Headaches or neck pain 
  • Nausea or vomiting 
  • Sensitivity to light or sound 
  • Sleep issues 
  • Vision changes 

A person with a concussion may also report they “don’t feel right.”  

You may notice some symptoms in a loved one before they do, such as difficulty following instructions, memory issues, slow responses or shifts in mood or personality.  

In addition to common symptoms, babies and toddlers frequently have changes in behavior, such as: 

  • Constipation, diarrhea or urination changes 
  • Difficulty feeding or poor appetite 
  • Heightened frustration or irritability 
  • Increased attachment to a caregiver 
  • More frequent crying or meltdowns 
  • Withdrawal from others 

It may be especially challenging for physicians to recognize signs of a concussion in infants, toddlers and others who are unable to report symptoms or follow directions during an exam.  

You know your loved one better than anyone. If you suspect a concussion and your loved one can’t speak for themselves, tell their doctor what you’ve noticed and how it differs from their norm. 

Diagnosis and Care for Concussions 

No matter the cause, if a concussion is suspected, it’s crucial to get medical attention as soon as possible.  

To diagnose a concussion, the healthcare provider will ask about what happened and the symptoms. Next, they’ll do a physical exam and may check balance, coordination, eye movements, memory or thinking. Depending on exam results, they may also order one or more imaging tests to look for bleeding or swelling in the brain or fractures in the skull.  

Before your loved one goes home from the clinic or hospital, their healthcare provider will provide information about any treatments needed, the recovery process and when to schedule follow-up care.  

Even with a solid post-concussion care plan, it’s vital to watch for new symptoms that may develop. Rarely, new symptoms are a sign of a serious complication called a hematoma, a potentially life-threatening collection of blood in the brain.  

If your loved one isn’t showing improvement after two to three weeks, or if symptoms worsen, let their healthcare provider know.  

Call 911 or go to the emergency department immediately if you notice any of these symptoms: 

  • Inconsolable crying in babies or toddlers 
  • Loss of consciousness 
  • One pupil—the center of the eye—is larger than the other one 
  • Refusal to eat or nurse 
  • Repeated vomiting 
  • Seizures or other shaking or twitching 
  • Slurred speech 
  • Unable to wake up 
  • Unusual behavior 

Recovery and Return to the Usual Routine 

Most people fully recover from a concussion. However, it usually takes several weeks. Recovery typically starts with two to three days of rest. Next, your child or parent can slowly return to their usual non-strenuous activities. If an activity makes symptoms return or worsen, avoid it. Always get approval from a healthcare provider before returning to driving or sports. 

After a concussion, children and adolescents may need additional support to succeed at school. Talk with your child’s teachers or a school counselor about their injury. If needed, a specialized educational plan can be created to provide extra support during recovery.  

In children and adolescents, concussions increase the risk of developing mental health issues, such as anxiety, depression or thoughts about self-harm. Similarly, teens often find it challenging to reintegrate into friend groups, school or teams long after concussion symptoms are gone. Because of this, your child may need mental health support to develop coping skills and resilience.  

Ensure your child or parent goes to all scheduled follow-up appointments. Even if they feel better, regular checkups ensure recovery is going as expected and allow providers to watch for signs of complications. The provider can also connect you to community resources, provide education and offer needed reassurance and support to your child or parent throughout recovery.  

If your loved one has signs of a concussion, Weill Cornell Medicine doctors are here to help. Find a doctor.