Headaches after Concussion
Part I of II
Headaches are one of the most common symptoms after concussion in both children and adults. Fortunately the symptoms of a single simple concussion resolve in a week or less for most kids, but a few children and teenagers will have headaches and other symptoms related to concussion for weeks or even months after their injury.
Concussion is a traumatic brain injury that changes the way the brain functions. Concussions can occur as a result of a direct hit to the head (by the ground or an object) or from violent shaking of the head and neck (like “whiplash” injury). Immediately after a head injury a child can have symptoms that include headache, confusion, memory loss/amnesia for the time around the injury, foggy thinking, dizziness, double vision, slurred speech, problems with coordination, or loss of consciousness. Sometimes kids may not realize they’ve had a concussion so it is important for parents, coaches, and team members to watch for these signs after a fall or hit to the head. Any person suspected of having a concussion during a sporting event (episode with trauma to the head and/or neck from the ground, another player or an object) should stop playing and be evaluated by a trained professional. Anyone who has had a concussion (any symptoms of concussion listed below after a head injury) should not return to play that day no matter what. (For more information and materials see the CDC “Heads Up” website: www.cdc.gov/concussion/HeadsUp/youth.html
After a concussion it is important for a child to be evaluated by a trained medical provider to make sure there are no signs of a dangerous problem like bleeding in the brain or brain swelling; however these problems are very, very rare following a single simple concussion. If a child has prolonged confusion or loss of consciousness, continued vomiting or new symptoms of weakness or change in speech, or worsening of symptoms with time after a concussion they need to be evaluated emergently by a medical professional.
After critical and emergent problems have been ruled out (brain scans are NOT usually needed to do this) then headache and other symptoms that relate to the concussion can be addressed by the doctor, patient and family. Symptoms after concussion can include:
- Balance Problems
- Sleep Problems, sleeping too much or too little
- Mood changes, irritability
- Sensitivity to light and/or noise
- Foggy thinking
- Problems with concentration or focus
If the child continues to have these symptoms for more than a week after the concussion or if symptoms get worse with time instead of better, you should contact your medical provider again to make a plan for further evaluation and management.
Heidi Blume, MD, MPH, Assistant Professor, Division of Pediatric Neurology, Seattle Children's Hospital and Research Institute, Seattle, WA.