Mild brain injury - child - discharge; Brain injury - mild - discharge; Mild traumatic brain injury - child - discharge; Closed head injury - child - discharge

Your child was treated for a concussion, a mild brain injury that can result when the head hits an object, or a moving object strikes the head. It can affect how your child’s brain works for a while. It may also have made your child lose consciousness for a while. Your child may have a bad headache.

Healing or recovering from a concussion takes time. It may take days to weeks, or even months. Your child’s condition will slowly improve.

Your child may use acetaminophen (Tylenol) for a headache. Do NOT give her aspirin, ibuprofen (Motrin or Advil), naproxen, or other similar drugs.

Feed your child foods that are easy to digest. Light activity around the home is okay. Avoid letting your child do rough play and heavy activity. Your child needs rest but does not need to stay in bed. It is especially important to avoid play that would result in another, similar, head injury.

Have your child avoid activities that need concentration, such as reading, homework, and complex tasks.

When you go home from the emergency room, it is okay for your child to sleep.

• For the first 12 hours, you may want to wake up your child briefly every 2 or 3 hours.
• Ask a simple question, such as their name, and look for any other changes in the way they look or act.
• Make sure the pupils of your child's eyes are the same size and get smaller when you shine a light in them.
• Ask your doctor how long you need to do this.

While symptoms are present, your child should avoid sports, hard play at recess, being overly active, and physical education class. Ask the doctor when your child can return to their normal activities.

Make sure your child’s teacher, physical education teacher, coaches, and school nurse are aware of the recent injury.

Talk to teachers about helping them catch up on school work and about timing of tests or major projects. Teachers should also understand that your child may be more tired, withdrawn, easily upset, or confused. Your child may also have a hard time with tasks that require remembering or concentrating. Your child may have mild headaches and be less tolerant of noise. If your child has symptoms in school, they may need to stay home until they feel better.

Talk with teachers about:

• Not having your child make up all of their missed work right away
• Reducing the amount of homework or classwork your child does for a while
• Allowing rest times during the day
• Allowing your child to turn assignments in late
• Giving your child extra time to study and complete tests
• Being patient with your child’s behaviors as they recover

Based on how bad the head injury was, your child may need to wait 1 - 3 months before doing these activities. Ask your child’s doctor first:

• Playing contact sports, such as football, hockey, and soccer
• Riding a bicycle, motorcycle, or off-road vehicle
• Driving a car (if they are old enough and licensed)
• Skiing, snowboarding, skating, skateboarding, gymnastics, or martial arts
• Participating in any activity where there is a risk of hitting the head or of a jolt to the head

Some organizations recommend that your child stay away from sports activities that could produce a similar head injury, for the rest of the season.

If symptoms do not go away or are not improving a lot after 2 or 3 weeks, follow-up with your child’s doctor.

Call the doctor if your child has:

• A stiff neck
• Fluid or blood leaking from the nose or ears
• Any change in awareness, a hard time waking up, or has become more sleepy
• A headache that is getting worse, lasts a long time, or is not relieved by acetaminophen (Tylenol)
• Fever
• Vomiting more than 3 times
• Problems walking or talking
• Changes in speech (slurred, difficult to understand, does not make sense)
• Problems thinking straight
• Seizures (jerking arms or legs without control)
• Changes in behavior or unusual behavior
• Double vision
• Changes in nursing or eating patterns

Heegaard WG, Biros MH. Head injury. In: Marx J. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 38.

Halstead ME, Walter KD. Clinical report -- sport-related concussion in children and adolescents. AmericanAcademy of Pediatrics; Council on Sports Medicine and Fitness. Pediatrics. 2010 Sep;126(3):597-615.