Understanding concussions in children

This week is Brain Awareness Week across the country, and we’re taking the opportunity to share some of the important work happening in this area right here at the Children’s Hospital Research Institute of Manitoba (CHRIM).

One area of brain health that our researchers are working on is concussion prevention and treatment in children. Dr. Kelly Russell is a CHRIM research scientist and assistant professor at the University of Manitoba, whose research focuses on the prevention of concussion and the clinical and psycho-social outcomes after concussion. Dr. Russell also works on identifying risk factors for other sport injuries among children and preventing these injuries through health promotion initiatives, protective equipment use, and improving the sports-related built environment.

“Sports were a huge part of my childhood and I continue to be very active and coach Special Olympics Power Lifting.  Having had a couple sport-related injuries, including a couple of concussions, I have always been interested in injury prevention and recovery,” says Dr. Russell.

Many parents and coaches may not have enough, or up-to-date, information on how to identify and treat concussion.  Most children do not lose consciousness or get knocked out when they sustain a concussion.  It’s easy to assume that if a child gets up after a fall or knock to the head, and appears to be fine, there is no serious injury and they can get straight back to play. However, concussion symptoms can be immediate or take up to 24 hours to appear. Symptoms include headache, dizziness, vomiting, and light or noise sensitivity, but can also include change in sleep patterns, sadness, heightened emotional response, or difficulty concentrating. It’s not always obvious for parents and guardians to link these symptoms – especially if the onset is delayed – to the fall or incident, or to understand that these can be signs and symptoms of something more serious.

“A big part of what we do as researchers is try to help educate the general public on what we know, and continue to learn, about concussions, and help modify guidelines in schools and among children’s sports organizations to better protect children from becoming concussed in the first place, and to ensure they receive proper care when it does happen,” says Dr. Russell.

Concussions can have serious and lasting repercussions on overall health, such as developing a new, or worsening of a pre-existing, psychiatric illness – most commonly depression and anxiety – headaches, or difficulty concentrating. So it’s critical that parents, coaches, guardians, and even children themselves understand the importance of seeking medical care from a physician, who will assist the child with returning to school and sport activity as tolerated.  Research has debunked old wives tales and shown that it is not helpful for children to sit in a dark, quiet room until their symptoms are gone.

One of the most important rules to keep in mind is “when in doubt, sit them out” – meaning that kids with a suspected concussion should be immediately removed from the activity, whether it be a sports game, sports practice/training, or just general play. If a child has a suspected concussion, they should see a medical doctor as soon as possible. This can be a family physician or a doctor at the emergency room. From there, they can be referred to the Pan Am Concussion Program – Canada’s only provincially funded, multi-disciplinary pediatric concussion clinic.

“If a child is diagnosed with concussion, they should return to sport/exercise only when cleared by a medical doctor,” says Dr. Russell. “It’s important to keep in mind that children can take longer to recover from concussions than adults – usually about 20 days. So just because a parent or older friend was cleared after a shorter period of time, it doesn’t mean that same timeframe is appropriate for younger children or adolescents.”

The most common causes of sport-related concussion in Manitoba are hockey, soccer, and football. However, concussion can happen in any sport and whether the child is wearing a helmet or not.

Dr. Russell and her team at the Children’s Hospital Research Institute of Manitoba are currently working on a study funded by the Canadian Institutes of Health Research (CIHR) to look at the long-term effects of concussion on mental health, and a second study funded by Research Manitoba to examine short-term mental health outcomes after concussion.  They are also examining the role of gradually reintroducing exercise as a treatment for concussion symptoms.

For more information on how to protect and treat concussions in children, visit the Parachute Canada page, a national, charitable organization dedicated to preventing injuries and saving lives.

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@CHRIManitoba @KellyRussellPhD
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