Concussion and Related Neurotrauma

All brain injuries are serious. That’s why Gillette Children’s Specialty Healthcare offers comprehensive evaluations and outpatient follow-up care for infants, children and teens who experience concussions and related neurotrauma. The goal of our Neurotrauma Clinic is to promote a full recovery and eliminate the risk of recurrent or permanent injury.

Gillette is a credentialed provider of ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). Our highly trained specialists offer extensive family support. In addition, our services include evaluations and treatments specially designed for infants and toddlers.

Why Choose Gillette?

  • Gillette is one of the nation’s Best Children’s Hospitals in pediatric neurology and neurosurgery.
  • We offer complete diagnostic services and comprehensive outpatient follow-up care for infants, children and teens who experience concussions and related neurotrauma.
  • Our goal is to eliminate the risk of recurrent injuries or chronic symptoms and promote a full recovery.
  • We support families by coordinating Gillette services with those available in the community.
  • Our experts can help patients, families and coaches make decisions about returning to activities.

Definition and Types

A traumatic brain injury can occur when the head experiences a hard hit or the body endures a sudden impact that causes the brain to move within the skull. Traumatic brain injuries can range from mild to severe. Mild traumatic brain injuries are often called concussions.

Concussions can occur along with injuries to the cervical spine (neck and upper spine). Examples include whiplash and “stingers” (sports injuries that affect the nerves in the neck or shoulder).


Concussion Incidence, Causes and Prevention

The Centers for Disease Control estimate that, in the U.S. as many as 1.7 million people might experience a concussion every year. Infants and preschoolers (ages 0 to 4) and teenagers and young adults (ages 15-19) are among those at highest risk for traumatic brain injuries.

Team sports, biking, skiing, skating, motor vehicle accidents, falls and physical violence are some activities that can lead to a concussion and related neurotrauma.

To help prevent a concussion or lessen its damage, always use seat belts. Wear helmets appropriate for activities such as biking, horseback riding, skiing, and in-line skating.


Concussion Symptoms

A person who experiences a concussion might or might not lose consciousness (be knocked out). Either way, the injury can damage cells, blood vessels and nerves in the brain.

Each person’s response to a traumatic brain injury is different. Some or all of the following symptoms may be present:

  • Balance problems
  • Changes in school performance
  • Dizziness
  • Emotional changes, such as irritability, sadness, nervousness or lack of interest in favorite activities
  • Fatigue
  • Feeling foggy or confused
  • Having trouble falling asleep or staying asleep
  • Headache
  • Impulsive behavior
  • Nausea
  • Sensitivity to noise or light
  • Sleeping more or less than usual
  • Slower reaction times
  • Taking longer to understand or process information
  • Trouble concentrating, remembering or paying attention

Often the signs of a concussion are subtle and can be mistaken for something else. For example, a teen might be foggy and irritable due to ordinary sleepiness. But those symptoms might indicate a traumatic brain injury if the teen recently experienced a head injury.

Recognizing symptoms in infants and toddlers can be difficult as well, because they might not be able to describe how they feel. A young child who has experienced a traumatic brain injury might have symptoms such as:

  • Changes in play or loss of interest in favorite activities
  • Excessive crying
  • Listlessness
  • Refusal to eat or nurse
  • Swelling of the scalp or “soft spot”

Concussion Evaluations and Treatments

Concussions require time and proper care to heal, but most people recover fully. If a person experiences a second concussion before the first has healed, however, serious and long-lasting symptoms can occur. At Gillette, we provide comprehensive evaluations, expert follow-up care and consultations about returning to activities.

Initial Assessment

Whether or not a person loses consciousness, all head injuries require evaluations by trained medical professionals, such as urgent care doctors, nurse practitioners or other primary care providers.

As part of the physical exam, a health care provider will check for signs of injury to the nervous system, especially the brain and spinal cord. Sometimes patients have X-rays to check for fractures or MRIs or CT scans to check for signs of tissue damage and swelling.

Because changes often occur on a cellular level, imaging tests don’t always show damage that has occurred. A complete assessment of symptoms and physical exam is critical.

Specialty Evaluation

If the initial assessment indicates a concussion, patients should undergo a complete medical evaluation before returning to school, sports, work or other daily activities. Many primary care providers will refer patients to Gillette’s Neurotrauma Clinic for a specialty evaluation and follow-up care.

At Gillette, nurse practitioners who specialize in pediatric rehabilitation or neurosurgery perform assessments and develop care plans. As part of an evaluation, we might conduct tests, such as ImPACT, to screen for neurocognitive changes and track healing.

Brain Rest

The best way to treat a concussion is to let the brain rest for days or even weeks, depending on the severity of injury. Often, concussion care plans will include recommendations to eliminate or limit:

  • Reading (books, computers, cell phones) and video games
  • Working and driving (for teens)

Physical Rest

In addition, people who experience concussions should limit their physical activity, allowing the brain to rest and heal. Avoiding activities that place someone at risk for a repeat injury during the healing process is critical. Reintroduce physical activity gradually, as your brain and body tolerate it.

Gradual Return to Activities and School

Patients gradually return to regular activities, as recommended by their care providers. If symptoms don’t return, the amount of time spent on activities such as schoolwork or exercise can increase.

Follow-up Care

The need for follow-up care depends on a patient’s injury and symptoms. Patients might work with specialists in speech-language pathology, physical therapy and occupational therapy. They also might undergo evaluations with psychologists and neuropsychologists, if needed. Clinical social workers and psychologists can work with schools to plan any necessary accommodations.


Our Services for Concussion and Related Neurotrauma

Gillette’s Neurotrauma Clinic provides specialty evaluations and outpatient follow-up care for children and teens who experience concussions and related neurotrauma. We also offer evaluations and treatments specially designed for infants and toddlers.

Patients who experience concussions may work with specialists in:

Our services also include administering ImPACT for children 12 and older.

When children 15 and under experience a severe brain injury, Gillette provides pediatric intensive care (critical care) and comprehensive inpatient rehabilitation care in addition to the services above.


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