In the past, if a child suffered a head injury, medical staff and parents would ensure the child stayed awake for twelve hours. If, after this time period, the child did not have a headache, blurred vision or impaired cognitive skills, the child could resume a normal schedule and continue playing sports.
Today, we know that when children and youth experience a concussion or traumatic brain injury (TBI), they can sustain serious repercussions if they are not diagnosed properly or if they do not receive the right treatment.

Ryan Lucas, the lineman for Winnipeg Blue Bombers experienced two serious concussions and suffered from post-concussion syndrome. He suggests that young athletes should be aware of signals their bodies are sending them. They may not remember the time of impact that led to the concussion, but "…if something feels wrong…get it checked out and do not suffer in silence," Lucas cautioned.
If a child with a concussion or TBI does not receive medical attention and physical rest, headaches and fatigue can last for months – even years. As well, mental acuity and cognitive skills can be greatly impaired causing further emotional and social trauma.
The Mayo Clinic suggests that children may require a lighter work load or a shortened school day after suffering a concussion or TBI. Something as simple as reading or jogging could cause headaches and fatigue.
Children who experience a second concussion before they fully recover from their first concussion may not regain normal brain function for many months or sustain permanent damage.

Signs & Symptoms
Signs and symptoms may develop within a few minutes or hours of impact - and may even occur in the following days. Symptoms in younger children can be more subtle and therefore difficult to ascertain.

Symptoms and Physical Signs: headache, nausea and vomiting, dizziness and balance problems, visual disturbances, sensitivity to light and sound, decreased playing ability, loss of consciousness and amnesia
Behavioural Changes: irritability, emotional liability, exaggerated mood swings, sadness and anxiety
Cognitive Impairment: slowed reaction times, difficulty concentrating, memory issues, confusion, feeling dazed and decreased attention span
Sleep Disturbances: drowsiness, trouble falling asleep or sleeping more than usual
“Children should rest from both physical and mental activities for a day or two after a concussion and then return to activities gradually as their symptoms allow,” recommends the Mayo Clinic.

Facts and Statistics
A concussion is a brain injury defined as a complex, pathophysiological process affecting the brain, induced by biomechanical forces resulting in the rapid onset of short-lived impairment of neurological function that resolves spontaneously.
Children and youth often take longer to recover from concussions than adults – usually 10 days to four weeks.
A concussion may result from direct or indirect impact to the head, neck or face, or somewhere else on the body that transmits a reactive, impulsive force to the head.
A child does not have to hit his head or be knocked out to suffer from a concussion or TBI. A child could receive a body blow that thrusts his/her head forward or backward or be forcefully shaken and jarred or rocked and twisted. Any physical action where the brain is bounced around can cause a concussion.
Concussion and TBI are common injuries among children and adolescents that participate in contact sports and recreational activities.

The Government of Canada acknowledges that 46,000 children and youth 5 to 19 years-of-age were diagnosed with concussions at hospital emergency departments in 2016 – 2017.
Ice hockey, rugby and ringette accounted for 44% of all brain injuries.
The Center for Disease Control and Prevention (CDC) states that over 170,000 children and youth are treated in hospital emergency departments each year for sports or recreation-related TBI and concussions.
The CDC estimates that 10% of all S. athletes playing contact sport sustain concussions.
Brain injuries account for 65% to 95% of all fatalities in football.
Concussions and Academic Impairment
The American Journal of Preventative Medicine published a report, ‘Concussion and Academic Impairment among US High School Students’ that examines the co-relation between sports and physical activity-related concussions and indicators of academic impairment among a nationally representative sample of US high school students. Key findings include:
- About 1 in 6 high school students reported experiencing a concussion in the past 12 months while participating in sports or physical activity.
- Students who reported a sports or physical activity-related concussion in the past 12 months were more likely to report symptoms of cognitive impairment.
- Students’ self-reported GPA was significantly lower among those who reported one or more sports or physical activity-related concussions in the past 12 months.

While an appropriate and properly fitted helmet during sports and other activities is highly recommended, even the best protective equipment can't prevent concussions.
Resources
For additional information, Diligencia Investigative Reporting recommends the following websites:
Canadian Paediatric Society – Sports Related Concussions
Living Guideline for Diagnosing and Managing Paediatric Concussion – Ontario Neurotrauma Foundation
Guideline for Concussion / Mild Traumatic Brain Injury and Prolonged Symptoms – 3rd Edition for Adults over 18 yeas of age - Ontario Neurotrauma Foundation
Recommendations for Health Care Professionals – Ontario Neurotrauma FoundationRecommendations for Schools and/or Community Sports Organizations/Centres
CDC – Brain Injury Safety Tips and Prevention
Concussion in Children: What are the effects? – Mayo Clinic
The Center on Brain Injury Research & Training – 16 Things about Concussions Every Parent Should Know
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