More Than Just an Ice Pack – How Cooling the Brain Could Help Treat Concussion

In the future, treating a concussion could be as simple as cooling the brain, according to researchers from the University of Wisconsin-Madison, whose findings support the treatment approach at the cellular level. Their study is published in PLOS ONE.

“There are currently no effective medical treatments for concussions and other types of traumatic brain injuries,” says Christian Franck, the UW-Madison associate professor of mechanical engineering who led the study. “We’re very excited about our findings because they could potentially pave the way for treatments we can offer patients.”

The process is a bit more finicky than just applying an ice pack to the head, the researchers note, in a media release from University of Wisconsin-Madison.

Conducting experiments on brain cells in a dish, Franck and his team discovered several key parameters that determined the effectiveness of therapeutic cooling for mitigating damage to the injured cells.

“We found that, for this treatment to be successful, there’s a sweet spot,” he says. “You can’t cool too little; you can’t cool too much; and you can’t wait too long following an injury to start treatment.”

And when the researchers identified that sweet spot, the results were striking, they share.

“I was amazed at how well the cooling worked,” Franck says. “We actually went back and repeated the experiments multiple times because I didn’t believe it at first.”

A traumatic impact to the brain can turn on biochemical pathways that lead to neurodegeneration, the progressive deterioration and loss of function in brain cells. Neurodegeneration causes long-lasting and potentially devastating health issues for patients.

In their experiments, the researchers looked at two of those biochemical pathways.

First, they created a network of neurons in a dish and delivered a mechanical stimulus that simulates the kind of injury and cell damage that people experience with a concussion.

Then they cooled the injured cells separately to four different temperatures. They found that 33 degrees Celsius (91.4 degrees Fahrenheit) provided the most protective benefit for the cells after 24 and 48 hours post-injury. Notably, cooling to 31 degrees Celsius had a detrimental effect.

“So there’s such a thing as cooling too much,” Franck adds.

Time also is a factor. For the best outcome, the team determined that cooling needed to begin within 4 hours of the injury and continue for at least 6 hours, although Franck says cooling for even 30 minutes still showed some benefits, the release explains.

When they adhered to those parameters, the researchers discovered they could keep the cells’ damaging biochemical pathways switched off. In other words, the cells remained healthy and functioning normally–even though they had just suffered a traumatic injury.

After six hours of cooling, the researchers brought the concussed brain cells back up to normal body temperature, curious about whether warming would cause the damaging biochemical pathways to turn on.

“The biggest surprise was that the molecular switches actually stayed off — permanently — through the duration of the lab experiment,” Franck says. “That was huge.”

He and his students compared their results with previous animal studies and randomized human trials that investigated cooling as a treatment for traumatic brain injuries.

“We found really good agreement between the studies when we dialed in to those specific parameters, so that’s a very encouraging sign,” Franck shares. “But this isn’t the end of the story. We think this warrants further investigation in animal studies.”

Franck notes there’s more to learn before cooling the brain could be a practical treatment for patients at a clinic. For example, it’s not as easy as simply lowering the temperature of a person’s whole body, which taxes the heart and can have a strong negative effect on the immune system.

Rather, isolating cooling to the brain is crucial, he notes.

“We hope our paper will spawn renewed motivation and interest in solving the technical challenges for getting this type of treatment to patients in the future,” Franck concludes, in the release.

“For a long time, the scientific literature was inconclusive on whether this would be a successful treatment. What we showed in our study was that, yes, as far as the cell biology is concerned, this is effective. And so now it’s really worth thinking about how we might implement this in practice.”

[Source(s): University of Wisconsin-Madison, EurekAlert]

Learn first aid for someone with a head injury

Watch how to help someone who has a head injury (1 minute 47 seconds)

Watch a British Sign Language version of how to help someone who has a head injury.

Common questions about first aid for someone who has a head injury

What can I apply to the injury to reduce swelling and pain?

What is concussion?

What are the signs and symptoms of concussion?

Should I watch a baby or child who has a head injury to see if they have concussion?

Are there any other reasons I might need to call 999 after a head injury

What if the person becomes unresponsive as the result of a head injury?

What should I do if the head injury is bleeding heavily?

What can I apply to the injury to reduce swelling and pain?

You could wrap a towel or clothing around frozen vegetables or ice and apply it to the injury.

Never place ice directly on the skin, as it’s too cold.

Back to questions

What is concussion?

 Concussion happens when the brain is shaken inside the skull because of a blow to the head.  

A person with concussion may be unresponsive for a few seconds to a few minutes. Most people make a full recovery from concussion, but occasionally it becomes more serious.  

Seek medical help if you think they have concussion.  

Back to questions

What are the signs and symptoms of concussion?

A person may have concussion if they:

• are temporarily unresponsive
• are dizzy
• have a headache
• are confused
• feel sick
• have blurred vision
• loss of memory of what happened immediately before or during the head injury

Back to questions

Should I watch a person who has a head injury to see if they have concussion?

Yes, you should watch anyone who has had a head injury for the signs of concussion. Sometimes you may not see the signs immediately. Call 999 if you suspect they have concussion.

Back to questions

Are there any other reasons I might need to call 999 after a head injury?

 Call 999 if:   

• They become less responsive or unresponsive  
• They have numbness or weakness in any part of their body  
• They have clear fluid or blood coming from their ears or nose  
• They have a seizure  
• They have been in a serious accident or had a severe blow to the head  

They should also seek medical advice if:  

• They are over 65  
• They have had a previous brain injury  
• They are taking medicines to thin their blood  
• They have been drinking alcohol or taking drugs  
• There is no one to look after them  

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Treatment of mild concussion in adults: effective methods

Content

• 1 How to properly treat mild concussion in adults: tips and tricks
  • 1. 1 Causes of mild concussion
    • 1.1.1 Injuries

    90 005 1.1.2 Sports injuries

    • 1.1.3 Explosions
    • 1.1.4 Other causes
  • 1.2 Symptoms of mild concussion
  • 1.3 Diagnosis of mild concussion: approaches and methods
  • 1.4 First aid for mild concussion
  • 1.5 Home treatment for mild concussion
  • 1.6 Medicines for mild concussion
  • 1.7 Diet for mild concussion
    • 1.7.1 What to do include in your diet?
    • 1.7.2 What should be eliminated from the diet?
  • 1.8 Physical rehabilitation for mild concussion
  • 1.9 Psychological support for mild concussion
  • 1.10 Importance of rest in the treatment of mild concussion
  • 1.11 Prevention of mild concussion in adults
    • 1.11.1 Wear protective equipment when playing sports
    • 1.11.2 Practice safety in everyday life

    9 0005 1.11.3 Learn how to fall

    • 1.11.4 Avoid unhealthy diets and eating habits
    • 1. 11.5 Get your head and neck checked regularly
  • 1.12 Related videos:
  • 1.13 Q&A:
    • • 1.13.0.1 What are the symptoms of a mild concussion?
      • 1.13.0.2 How is mild concussion diagnosed?
      • 1.13.0.3 What are the treatments for mild concussion?
      • 1.13.0.4 How long does it take to treat a mild concussion?
      • 1.13.0.5 Can the consequences of a mild concussion be dangerous to health?
      • 1.13.0.6 Who can play professional sports after a mild concussion?

Find out what treatments are available for mild concussion in adults, what drugs help restore brain function, and how to properly organize your daily routine after an injury.

Mild concussion is a common head injury that can occur as a result of a blow, fall, or other forceful impact on the head. This condition can lead to headaches, dizziness, nausea, and other discomforts. However, in most cases, a mild concussion goes away on its own after a few days. But what if it doesn’t happen and the symptoms continue?

You will learn about how medications can help protect the brain from further damage and what to do if symptoms continue for days or weeks. Our article will help you understand which treatments can be effective in a particular situation and how to properly take care of your health after a head injury.

Causes of mild concussion

Injuries

Concussion can occur due to various types of head trauma. This can happen during a blow to the head, a fall, an accident, or other events that cause the brain to vibrate violently.

Also, concussion can occur even without a direct blow to the head, when the head shakes sharply and strongly, for example, when shaking.

Sports injuries

People who play sports can often get concussions, especially if they play contact sports. Such sports injuries can occur when a player is hit in the head or collides with another player.

Explosions

Explosions can be one of the causes of concussion, especially if the person was near the explosion. This can happen during hostilities, terrorist attacks or accidents.

Other causes

Concussion can also be caused by other causes, such as illness, hypoglycemia, or other illnesses.

Mild concussion symptoms

Mild concussion is a form of traumatic brain injury that can result from both a blow and sudden head movements. The main symptoms of a concussion include:

• Headache – pain can be of varying intensity and localization, but most often it manifests itself in the form of “heaviness” in the head, and sometimes accompanied by dizziness.
• Nausea and vomiting – not all patients experience, but if they do, they may indicate severe brain damage.
• Increased fatigue – a person becomes tired more quickly, even when performing normal activities.
• Sleep disorders – sleep may become more shallow and interrupted, and sometimes absent altogether.
• Increased sensitivity to light and sound – sounds become louder and sharper, light can irritate the eyes.

If these symptoms occur, seek immediate medical attention to rule out a more serious brain injury and start treatment if a mild concussion is confirmed.

Mild concussion diagnosis: approaches and methods

Mild concussion is a common injury that anyone can experience. It occurs as a result of an impact or violent movement of the head and can lead to temporary impairment of brain function.

Proper treatment of mild concussion requires an accurate diagnosis of the injury. The doctor will do a physical examination and neurological tests to look for symptoms consistent with the injury. Among them may be:

1. General symptoms: dizziness, weakness, nausea, loss of consciousness
2. Behavioral symptoms: irritability, aggressiveness, poor coordination of movements
3. Psycho-emotional symptoms: headache, memory impairment, concentration problems, depression

Computed tomography (CT) or magnetic resonance imaging (MRI) of the brain may also be ordered to look for possible damage or bleeding in brain tissue.

Method of diagnosis Advantages Disadvantages

Once an injury has been diagnosed, treatment may be given, depending on the severity of the injury and its effects on the person’s health.

First Aid for Mild Concussion

Mild concussion can occur as a result of a blow to the head, a fall, or other head injury. The main goal of first aid for a mild concussion is to prevent worsening of symptoms and complications.

Step 1: Signs of a concussion

Signs of a mild concussion can vary, including headache, nausea, vomiting, dizziness, momentary loss of consciousness, difficulty speaking, weakness, and trembling. If the victim has similar symptoms, immediate action should be taken.

Step 2: Examine the casualty

Carefully examine the casualty for bruises, abrasions, or other signs of injury. You should also check for bleeding from the ears, nose, or other openings. If the victim has such injuries, an ambulance should be called immediately.

Step 3: Providing rest

The victim must be kept calm, avoid sudden movements and overloads. It is necessary to offer to lie down on a flat surface and relax. From a headache, a cold on the forehead or the back of the head will help.

Step 4: Observation and consultation with a doctor

After giving first aid, the victim should be monitored and symptoms controlled. If the symptoms do not improve and/or new ones occur, it is necessary to consult a doctor for additional examination and treatment.

Mindfulness and quick action can save lives or prevent future ailments. You should not lose your head and be on the head of people who have a cold, which can help you at the moment when you are faced with danger.

Home treatment for mild concussion

Mild concussion can result from a blow, fall, accident or sports injury. Symptoms include headache, dizziness, nausea, and loss of consciousness for a short time. There are several things you can do to relieve symptoms at home.

• Rest for a few days: After suffering a brain injury, you must remove all stress and take time to rest and recover. Try to limit your gadget use and avoid mental stress.
• Set up for recovery: Consider making changes to your daily routine to help your body recover. This may include increasing sleep time, changing your diet, yoga or meditation.
• Apply ice: Apply ice to reduce swelling and reduce pain. Apply an ice pack to the injured area for 20 minutes every 2 hours.
• Apply heat: Especially a few days after injury, when swelling has subsided, heat can be applied to the injured area. This will help relieve pain.

If your condition worsens or you experience severe pain, seek medical attention. Cases of serious injury can lead to long-term consequences if not treated properly. Following your doctor’s advice and following the guidelines above will help you get back to health faster.

Mild Concussion Medicines

Mild Concussion Medicines may include blood circulation and anti-inflammatory medicines. Acetaminophen and ibuprofen are the two most common medications used to relieve headaches and other symptoms after a mild concussion.

In addition, your doctor may prescribe sedatives to help relieve the tension and anxiety that can accompany a mild concussion. Some of these include diazepam, lorazepam, and xanax.

If you have a severe headache after a mild concussion, your doctor may recommend narcotic analgesics such as oxycodone, organization, and fentanyl. These drugs should only be taken when prescribed by a doctor, as they can be highly addictive and have negative side effects.

Drug name Action

Mild concussion diet

With mild concussion, diet plays an important role in the healing and recovery process.

What should you include in your diet?

• Proteins. Animal proteins help repair damaged neurons. Protein sources can be meat, fish, eggs, dairy products.
• Fats. Good sources of fats are fish oil, nuts, olives, avocados, linseed and sesame oils.
• Carbohydrates. With mild concussion, you need to limit the intake of fast carbohydrates and increase the intake of slow carbohydrates, which are contained in cereals, vegetables, fruits.
• Vitamins. Vitamins contained in fresh vegetables and fruits improve brain function and promote rapid recovery of nerve cells.

What should be eliminated from the diet?

During the treatment of mild concussion, foods that can worsen health should be excluded from the diet:

• Alcoholic beverages.
• Coffee and tea.
• Fatty and fried foods.
• Store-bought convenience foods and ready meals.
• Sweets and baked goods.

Mild Concussion Physical Rehabilitation

Mild concussion is a common brain injury and can lead to a variety of unpleasant effects such as headache, nausea, dizziness, and trouble concentrating. Physical rehabilitation can be an effective treatment after a mild concussion and help restore the health and function of the body.

Physical rehabilitation may also include gentle cardio exercises that can help reduce concussion symptoms and speed up the recovery process. These exercises include walking, running and cycling.

Typically, physical rehabilitation for mild concussion lasts from several weeks to several months, depending on the severity of the injury and the speed of recovery. Rehabilitation specialists will work closely with the patient to help them recover fully and have the best quality of life after a concussion.

Psychological support after a mild concussion

A mild concussion can leave traces not only on the physical but also on the psychological level. A person may need the help of a specialist to help cope with the emotional and psychological discomfort caused by the injury.

A psychological approach to treating mild concussion includes counseling and advice to reduce stress and anxiety. The specialist can help the patient understand and deal with the possible consequences of the trauma, such as increased irritability or sleep problems.

• Therapeutic exercises. A psychologist can recommend various therapeutic exercises, such as breathing exercises, meditation, or yoga, to help relieve tension and calm the nervous system.
• Psychotherapy. Individual or group psychotherapy may be required in some cases. The therapeutic process allows the patient to communicate with an experienced specialist who will help him find ways to solve problems and overcome personal difficulties.
• Recommendations for daily routine and healthy lifestyle. The psychologist may recommend that the patient exercise, improve nutrition, adjust their daily routine, and increase their level of physical activity, which can contribute to better well-being and health.

Psychological support after a mild concussion can help the patient return to a fulfilling means of life and improve the quality of life, as well as prevent possible psychological consequences of the injury.

The importance of rest in the treatment of mild concussion

A mild concussion is an injury that can occur as a result of a blow, fall or other impact on the head. One of the main methods of treatment is rest.

When symptoms disappear, your healthcare professional may allow you to gradually resume physical activity. Patients who play sports, especially those with contact elements, should stop doing so completely within the first few days after injury.

• After receiving a mild concussion, it is recommended:
• Avoid talking on the phone and look at screens
• Do not exercise the head physically
• Do not amplify the sound, do not go to concerts and do not listen to music through headphones

9000 2 If you If you are afraid that you may have a mild concussion in your head, if you experience symptoms such as headaches, nausea, dizziness, itchy eyes or weakness, do not hesitate to contact a medical specialist.

Prevention of mild concussion in adults

Wear protective gear when playing sports

Many cases of mild concussion occur as a result of sports-related injury. To prevent such injury, wear protective gear when playing sports. For example, a helmet while cycling or rollerblading, head and face protection while playing hockey or football.

Practice safety in everyday life

Any activity with a risk of head injury must be carried out in a safe manner. For example, do not jump from a height without a safety device, do not skateboard without head protection, etc. You should also be more careful in everyday life and avoid places where there may be an increased risk of falls and head injury.

Learn how to fall correctly

If you are into active sports, then you should learn how to fall correctly. Often, if we fall, we fall on our heads, which can lead to concussions and other serious injuries. By learning how to fall properly, you can prevent many injuries, including a mild concussion.

Avoid unhealthy diets and eating habits

Unhealthy diets and eating habits can lead to a lack of nutrients that are essential for brain health. To prevent mild concussion, watch your diet and make sure you’re getting enough nutrients.

Get regular head and neck exams

Regular head and neck exams can help identify any problems that could lead to a concussion. Contact a specialist who will conduct an examination and advise on what measures to take to prevent a mild concussion.

Related videos:

Q&A:

What are the symptoms of a mild concussion?

The person may experience headache, dizziness, nausea, vomiting, weakness, lethargy, loss of attention or consciousness, hypersensitivity to light, sounds or smells, sleep disturbance, behavior changes.

How is mild concussion diagnosed?

Diagnosis consists of an objective assessment of the patient’s condition, including assessment of coordination, need for analgesics, and observation of symptoms during the first 24-48 hours after injury. In severe cases, a CT scan of the brain may be required.

What are the treatments for mild concussion?

Treatment for mild concussion includes rest and limitation of physical activity, pain control, antidepressants, antibiotics, and anti-inflammatory drugs. It is also recommended to observe a doctor and gradually return to a normal daily routine after the symptoms have ended.

How long does it take to treat a mild concussion?

The duration of treatment for mild concussion depends on the severity of the injury, the individual patient, and the extent of treatment. On average, the usual treatment takes from a week to several months.

Can the consequences of a mild concussion be dangerous to health?

The consequences of a mild concussion can vary and depend on the severity of the injury, the health of the patient, and the timing of treatment. In some cases, complications such as headaches, irritability or depression may occur. In rare cases, vision or hearing may be affected, cognitive impairment or severe neurological impairment may occur.

Who can play professional sports after a mild concussion?

Before continuing to engage in professional sports after a mild concussion, it is necessary to consult a doctor and undergo a complete diagnosis. If you continue to exercise despite having symptoms of a concussion, it can make the condition worse and lead to serious health problems.

Symptoms of concussion in a child

Most often, concussions are defined as a transient impairment of brain function caused by traumatic exposure. As a result of direct or indirect head trauma, damage occurs at the biochemical and cellular level in the brain, they are functional in nature and disappear with time. There are no structural damages. Thus, the prognosis in most cases is favorable: the symptoms disappear after a while, and the treatment is aimed at improving the condition of the victim and speeding up recovery. But in some cases, the consequences (the so-called postconcussion syndrome) persist in the form of headaches, dizziness and some other symptoms.

In general, concussion in a child, like other types of traumatic brain injury, is more common than in adults. This is due to the fact that children are more active, often behave carelessly.

Concussion and contusion of the brain in a child of a mild degree corresponds to a score of 13–15.

Possible causes

A concussion in a child occurs when a head injury is direct or indirect. Direct is a blunt blow to the head. Indirect injuries include sudden acceleration, deceleration, turns.

In young children, TBI most often occurs due to parental oversight. For example, a baby may fall off a bed, stroller, changing table, or other surface, or knock over a heavy object. A typical example of indirect trauma is the so-called shaken baby syndrome. It occurs when the child is treated rudely, carelessly, shaken violently, rocking him.

Many head injuries in children occur during walks: when falling from slides, swings and other structures in playgrounds, from roofs, trees, in winter during ice. TBI can be contracted in a fight and is a common cause of concussions in teenagers. The reasons also include:

• road traffic accidents – children can be injured during them, both inside the car and as pedestrians
• engaging in traumatic sports

• falling out of the window – sometimes there are cases when a small child, being on the windowsill of an open window, leans against a mosquito net and falls out with it
• child abuse, beatings

As we mentioned above, children are more active than adults, and they have a less developed sense of danger and lack of experience. The risk of injury is also increased by such factors as increased activity, restlessness of the child compared to peers, lack of supervision, traumatic objects in the house – for example, a large flat-screen TV standing on the floor or on a low pedestal, which is easy to tip over.

Symptoms

Symptoms of a concussion in a child can be divided into four large groups: physical, cognitive, related to the emotional sphere and sleep. They are presented in the table:

Depending on the time of occurrence, all symptoms are divided into two groups: early and delayed. Early manifestations include headache, dizziness, unsteady gait, confusion, amnesia, visual disturbances, nausea and vomiting during concussion (in the first hours). In some cases, seizures may develop. Delayed symptoms occur hours or even days later.

Also, the symptoms of TBI, depending on the nature, are divided into two groups:

• Cerebral – they generally indicate brain damage. For example, it is a headache, nausea, dizziness.
• Focal – indicate damage to certain nerve centers and manifest themselves as violations of their function. With a concussion, cerebral symptoms predominate.

The easiest way to recognize a concussion is in older children and teenagers: they can talk about having a head injury and describe their symptoms. In a young child, the signs are not so obvious, especially if the parents did not see him hit. Most often in children, the clinical picture is limited to such manifestations as:

• loss of appetite
• bad dream
• increased irritability and frequent crying for no apparent reason
• restless feeding behavior
• profuse regurgitation, vomiting

Concussion First Aid

If child has a head injury , lay him on his back with his upper body elevated. Unbutton the collar of your clothes, provide fresh air if everything happens indoors. It is impossible to immediately determine the severity of the injury on your own, so it is necessary that the child be examined by a doctor as soon as possible. You can apply an ice pack or other cold to the head.

If the child is unconscious , he must be laid on his side, bending the arm and leg that are at the bottom to give a stable position. The same should be done if vomiting has begun. If possible, record the time when the loss of consciousness occurred, so that later you can calculate how long the child was in this state.

Examine the child’s head : if abrasions or other skin lesions are found, they should be treated.

Even if it seems that the child feels fine, you should not leave him unattended after an injury. He may vomit and fall when he tries to stand up on his own. Just in case, there should always be an adult nearby.

Which doctor should I contact?

pediatric traumatologists deal with the treatment and diagnosis of traumatic brain injuries in children. Reception in emergency rooms is conducted around the clock – they are always ready to quickly conduct the necessary examination and provide emergency assistance. After any head injury, the child should be immediately shown to the doctor, especially in cases where the following symptoms are present:

• headache, nausea
• loss of consciousness – even momentary
• headache that does not improve after taking painkillers
• behavioral changes, especially in children under 5 years of age
• prolonged crying in an infant
• memory violation
• head injuries in children with bleeding disorders (eg hemophilia)
• head trauma after previous cranial cavity surgery

Warning symptoms for which an ambulance should be called immediately:

• prolonged loss of consciousness
• the child sleeps for a long time, does not open his eyes

• seizure
• impaired vision, hearing
• bruising around the eyes, ears, bleeding from the ears
• discharge of clear fluid from the nose, ears – may indicate a skull fracture, damage to the meninges and leakage of cerebrospinal fluid
• numbness, weakness in arm or leg
• violation of the sense of balance, gait, speech
• open wound on the head

These symptoms often indicate that the child does not have a concussion, but a more severe TBI, which can lead to serious consequences.

On the spot, without a doctor, it is difficult to determine the severity of the injury. Even if at first it seems that the child feels well, later his condition may worsen due to increasing bleeding, swelling, and brain damage.

Pathogenesis

If you take pictures of the head after a concussion, they will not show any structural changes. Damage to the nervous tissue is functional and temporary, manifests itself at the cellular and biochemical level. This creates certain difficulties: concussion can only be diagnosed by symptoms and excluding more serious injuries, manifested by structural changes. Scientists still do not fully understand why some people endure a concussion easily and recover fairly quickly, while others have more severe symptoms and persist for a long time.

Impact acceleration and inertial trauma are the primary cause of brain damage during concussion. During direct and indirect trauma, the brain tissue rapidly accelerates, and then there is a sharp deceleration. There is a vibration that spreads to all parts of the brain. It is believed that this leads to the following processes:

• Connections between nerve cells are temporarily broken, their long processes – axons – may suffer.
• Disruption of nerve centers , which regulate the tone of the vascular wall, and because of this, a disorder of cerebral circulation occurs.
• At the time of injury, there is a sharp displacement of the cerebrospinal fluid . It hits the walls of the ventricles of the brain, stretches them. As a result, the neighboring nerve centers are irritated.
• There are disturbances in the brain at the biochemical level . In the central nervous system, there are many different substances, called neurotransmitters, that transmit certain types of nerve impulses between cells. A head injury can disrupt their work.

Classification

There are three degrees of severity of concussion (they should not be confused with the severity of TBI!):

• Mild – when the child remains conscious, the symptoms persist for 15-20 minutes, and then the condition returns to normal.
• Medium – when the child is conscious but the symptoms persist for more than 20 minutes.
• Severe concussion with loss of consciousness.

Possible complications

Possible consequences of a concussion in a child include:

• Post-concussion syndrome is a condition that manifests itself in the form of persistent symptoms that persist for weeks and months after an injury. One study reported that, on average, manifestations persisted for seven months. These can be any of the symptoms that the concussion itself manifested. There are no signs by which it would be possible to determine in advance who will develop postconcussion syndrome. It does not depend on the severity of the injury.
• Reconcussion Syndrome is a rare but dangerous complication that develops as a result of repeated head trauma before full recovery from the first concussion has occurred. In this case, a strong swelling of the brain quickly occurs. Reconcussion syndrome can lead to life-threatening complications (such as brain herniation) and death.
• Post-traumatic epilepsy is diagnosed when a child has two or more seizures one week after an injury that is not triggered by other causes. Most often, this occurs after severe TBI – in 10–20% of children, but there is a risk of developing epilepsy after mild TBI.
• Chronic traumatic encephalopathy – brain damage due to repetitive head trauma and deposition of tau protein in the nervous tissue. This condition manifests itself in the form of memory problems, speech disorders, gait, personality changes, behavior. Symptoms increase gradually as neurodegeneration progresses. The cause-and-effect relationship between concussion and chronic traumatic encephalopathy has not been fully established, scientists have yet to figure it out.

Diagnostic methods

When an injured child arrives at the clinic, he is examined by a pediatric traumatologist (usually a pediatric surgeon), a pediatric neurologist. Physicians should take a careful history and conduct a complete neurological examination: a concussion is diagnosed by the clinical picture, nothing will be visible in the pictures.

In most Russian clinics, all children with traumatic brain injuries immediately undergo head x-ray . This is a quick, simple and affordable examination, it can immediately show gross injuries, such as skull fractures. In foreign manuals, computed tomography is preferred as a method of excluding serious damage. It is able to provide more useful information than x-rays. But CT is not recommended for everyone. In some cases, simply observing the child without pictures is sufficient.

The two most popular systems in the world today to help clinicians decide whether to take pictures are the Pediatric Emergency Care Applied Research Network (PECARN) guidelines for head trauma and the Canadian Head CT Guidelines. CT Rule). Online calculators have been compiled for these systems, they are freely available. Any doctor can use them, and these tools are very effective. It is believed that most concussion patients do not need head imaging. At the same time, if a CT scan showed a normal result, this does not mean that the child does not have a concussion.

Magnetic resonance imaging is usually recommended if symptoms persist for more than seven days. This study provides the most detailed visualization of the structures of the central nervous system and provides the doctor with maximum useful information. It is not necessary to perform this study with every fall, as it requires the child to lie down for a long time. And the noise during the study can frighten the baby or increase the post-traumatic headache.

There are no laboratory tests to diagnose a concussion. Scientists propose to measure the levels of some biomarkers in the blood, but the matter has not gone further than research. Perhaps in the future such analyzes will appear. The most promising candidates for concussion markers are glial fibrillar acidic protein and ubiquitin C-terminal hydrolase. There is evidence that their levels increase in the acute period after injury.

Methods of treatment

In Russia, a typical tactic for treating concussion in children is as follows:

Firstly, such a child is immediately hospitalized in the Department of Pediatric Traumatology. He stays in the hospital for 7-10 days, and the doctor monitors his condition. At the same time, they limit physical and cognitive (mental) activity, forbid reading books, watching TV, using a laptop, smartphone.

Many clinics prescribe drug therapy, which supposedly should improve the child’s condition and prevent complications ( spoiler: it does not work ):

• diuretics – to prevent cerebral edema
• nootropics and B vitamins – to improve the functioning of the nervous system
• sedatives (sedatives)
• painkillers – for headaches
• antiemetics – for nausea and vomiting

If we turn to the results of scientific studies, then there is no reliable evidence that drug therapy can significantly affect recovery after a concussion.

By and large, only the use of painkillers for headaches is advisable. Many experts do not recommend the use of drugs that affect the clinical picture, such as sedatives that improve cognitive function, as they mask the symptoms of a concussion and prevent the doctor from correctly assessing the patient’s condition.

Limitation of physical and mental stress is important, especially in the acute period – within 24-48 hours from the moment of injury. Then the child can gradually return to their usual activities under the supervision of a doctor. The terms are individual – there are no unambiguous recommendations on what day you can return to certain types of activities. There is evidence that certain therapies aimed at correcting certain disorders may be useful, for example, eye exercises for oculomotor dysfunction, cognitive behavioral therapy for mood disorders.

Forecast

The prognosis is favorable in most cases. Symptoms usually improve significantly within 1 to 2 weeks after the injury. Some studies have shown that, on average, full recovery occurs after 10 days. In 2017, at the 5th International Conference on Concussion in Sports, experts stated that full recovery occurs after a month. The most important indicator influencing the prognosis is the severity of symptoms in the first few days after injury.

Prevention

The main measures to prevent TBI in children are as follows:

• Children under three years old must be supervised at all times by an adult . In the house, they need to provide a safe environment so that they cannot fall from a height or drop something on themselves.
• Older children need to be taught basic safety rules on the street, on the roadway.
• If the child is involved in sports, then he must wear appropriate equipment , follow the safety rules.

Main

• A concussion is a type of mild traumatic brain injury. It is accompanied by functional disorders in the brain at the cellular and biochemical, but not at the structural level.
• Concussions are more common in children than in adults because they are more active and have a less developed sense of danger.
• Only a doctor can establish the correct diagnosis and assess the severity of the injury. The injured child must be immediately taken to the emergency room or call an ambulance.
• Concussion is diagnosed by clinical presentation. The pictures do not show any changes: they are performed only in order to rule out a more serious injury.
• In Russia, a child with mild TBI is usually admitted to a hospital for 7-10 days.
• Treatment is supportive. In the first days after the injury, it is necessary to limit physical and mental stress, exclude activities associated with eye strain (reading, working with a laptop, tablet, smartphone).
• The effectiveness of drug therapy is limited, there is no clear scientific evidence that it can affect recovery after a concussion.
• The prognosis is favorable in most cases. Complications are rare.

Sources

https://www.ncbi.nlm.nih.gov/books/NBK537017/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658671/
https://probolezny.ru/sotryasenie- golovnogo-mozga-u-detej/
https://www.krasotaimedicina.ru/diseases/children/concussion
https://fantasyclinic.ru/encyclopedia/travmy/sotryasenie-mozga-u-rebenka/
https://emedicine.medscape.com/article/ 92095-clinical#b3
https://emedicine.medscape.com/article/3-overview#a7
https://www.frontiersin.org/articles/10.3389/fneur.2018.00203/full
https://kidshealth. org/en/parents/concussions.html
https://www.nhs.uk/conditions/head-injury-and-concussion/
https://pubmed.ncbi.nlm.nih.gov/26918481/
https://www.ncbi.nlm.nih.gov/books/NBK537017/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6684694/
https://www.ruans .org/Text/Guidelines/pediatric-head-injury-2021.pdf
https://ruans.org/Text/Guidelines/mild_head_injury.