Symptoms of Head Injuries and Concussions in Toddlers
Medically reviewed by Jonathan B. Jassey, DO
Toddlers may be more likely than adults to suffer a concussion after a head injury but less able to communicate what they feel if they have one. That's why it is important to know the signs of a concussion and to contact a healthcare provider if there is any loss of balance, change in behavior, or other symptoms consistent with a traumatic brain injury.
This includes delayed symptoms that can sometimes occur days after a blow to the head.
This article discusses the causes and signs of concussion in a toddler, including how head injuries are treated and prevented in smaller children.
Verywell / Jessica Olah
What Are Head Injuries and Concussions?
It is not uncommon for toddlers to trip and knock their heads, no matter how child-proof a space is. But a blow to the head doesn't instantly mean that a child has a concussion even if it results in a bump on the head.
By definition, a concussion is a mild traumatic brain injury caused by a bump or blow to the head—or a hit to the body—that causes the head and brain to move rapidly back and forth in the skull.
When this happens, the bouncing or twisting of the brain causes the excessive release of chemicals, called neurotransmitters, that overexcite nerve signals in the brain. The erratic firing of nerves, in turn, causes a cascade of symptoms that can affect vision, behavior, balance, and other functions directed by the brain.
In severe cases, brain cells can be severely injured, causing symptoms that can last for weeks, particularly in children.
The challenge in distinguishing between a head injury and a concussion is that you often can't until the child has been examined by a healthcare provider. This is especially true if symptoms are delayed.
Thus, it is best to err on the side of caution if any blow to your child's head seems serious.
Concussion vs. Brain Hemorrhage
It's important to note that a concussed brain does not bleed. In fact, a concussed brain can often look perfectly normal on an MRI or CT scan.
A concussion is ultimately an injury that disrupts the normal functioning of the brain rather than one that causes a brain hemorrhage.
Causes of Head Injuries and Concussions in Toddlers
When people think about concussions, they generally think about a severe blow to the head. But, it's actually more complicated than that.
Under normal circumstances, the brain is surrounded by cerebrospinal fluid that acts as a cushion whenever the head is struck or jostled. More severe impacts—or forces that cause the rapid acceleration and deceleration of the head—may not be absorbed by this cushion.
So, if there is a direct impact (such as a blow to the head) or an indirect impact (such as being roughly tackled), the brain can rotate or be propelled against the wall of the skull with such force that a concussion can occur.
Examples of direct and indirect impacts include:
Hitting your head as you fall
Being forcefully hit on your head by an object
Being body-checked in sports
Being in a vehicle collision
Being shaken violently, especially with smaller children
In addition to affecting nerve transmission, a severe concussion can cause changes in intracranial pressure (pressure inside the skull) that affect blood circulation. This can cause brain ischemia (inadequate blood flow in the brain), resulting in more severe and longer-lasting symptoms.
While the majority of concussion cases resolve within a week or two, severe concussions can take far longer to recover from.
Risk of Concussion in Children
The risk of concussion in a toddler is generally higher than in adults because:
Their skull is softer.
Their neck muscles are not well-developed and are less able to support the head.
They lack coordination and are at greater risk of uncontrolled falls.
Common Signs of Concussion in Toddlers
When a child has a concussion, symptoms may develop immediately or be delayed and take anywhere from 24 to 72 hours to appear.
Possible symptoms of concussion in small children include:
Appearing dazed (often described as looking "spaced out" or having glassy eyes)
Listlessness and disinterest in activities they usually enjoy
Headache (causing a child to cry, hold their head, or bury their head)
Blurred or double vision (causing a child to bump into things or miss objects they reach for)
Ringing ears (causing a child to tug at their ear)
Loss of hearing (causing a child not to respond to their name or loud sounds)
Light sensitivity (causing squinting, squirming, or crying in bright light)
Dizziness and falling
Refusal to eat or nurse
Irritability and crying
Trouble falling or staying asleep
Around one in every three people with a concussion experience post-concussion syndrome. This is when symptoms of concussion persist for four weeks or longer in children or more than two weeks in adults.
When to See a Healthcare Provider
If your child has any of the following symptoms after a fall or blow the head, go to the emergency room right away:
Seizure
Loss of conscious
Difficulty being awakened from sleep
Dilated or uneven pupils
Hearing loss
Vomiting
Crying that won't stop
Can a Concussion Cause Permanent Damage?
According to the American Association of Neurological Surgeons, a single mild concussion should not cause permanent brain injury. However, a second concussion that occurs soon after the first does not have to be very strong to be permanently disabling.
Treatment for Head Injuries and Concussions in Toddlers
Children with a suspected concussion need a medical assessment to confirm the diagnosis and rule out more serious head injuries. If a concussion is confirmed, medical observation in a hospital for 24 to 48 hours may recommended, depending on how severe the head injury is.
Resting for 24 to 48 hours is important no matter your age but is especially important for toddlers to prevent them from falling and bumping their heads again. Resting for longer than 48 hours has been shown to increase recovery times.
Headaches can be treated with over-the-counter painkillers like Children's Tylenol (acetaminophen) as directed by your pediatrician. Nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) or Aleve (naproxen) are not advised as they can increase the risk of intracranial bleeding.
The majority of children fully recover from a concussion, though care during the first 48 hours is crucial to recovering without incident or delay.
How to Prevent Head Injuries and Concussions in Toddlers
To help reduce the risk of head injuries and concussions in toddlers:
Childproof your home with furniture that won't hurt your kid if they fall. Put gates at the top and bottom of stairs, and used knob covers to prevent your child from entering spaces that may be hazardous, such as kitchens, bathrooms, or the backyard.
Always place your child in an approved car seat or booster seat when driving. Children ages 4 through 8 who measure less than 4'9" in height must use a booster seat.
Choose playgrounds with soft ground surfaces like mulch, and avoid those made of concrete.
Have your child wear a properly fitted child's helmet if you take them on a bike ride, jet ski, scooter, skateboard, or any recreational vehicle they might fall off of (including tricycles).
Summary
A concussion occurs when the brain is severely jostled due to a direct or indirect head injury, causing symptoms like headache, confusion, vision changes, dizziness, nausea, and ringing in the ears. Toddlers can get a concussion when falling and banging their heads, but can also get one by being shaken violently or being struck on the head.
Children suspected of having a concussion need to be seen by a healthcare provider and monitored for 24 to 48 hours to ensure they don't have a more serious head injury. Most children fully recover, but may experience permanent disability if another concussion happens soon after the first.
Read the original article on Verywell Health.
