How To Tell If Your Child Has Suffered a Head Injury

WNBC—NEW YORK CITY—April 9, 2007   

A recent study found that kids who suffer from a head injury are twice as likely to suffer a second head injury within six months as compared to other kids. The study raises the question of how much time kids need to spend on the sidelines after a bump on the head and suggest that the commonly practiced four weeks might not be long enough. To talk more about this study and head injuries in children, we are joined by Jordan Metzl, M.D., who is a sports medicine specialist at Hospital for Special Surgery in New York City.

Reporter: So the question is, the study finds that children who sustain a head injury are twice as likely to have another head injury in six months, but why is that?

Dr. Metzl: We know from our adult patients that there is something called a concussive predisposition, which is someone’s likelihood to have a second concussion if they’ve had a first. We knew this was true in adults and now we know it’s true in kids as well. We’re still not sure why, but we know it occurs probably because of how their brain is built and what they are being exposed to.

Reporter: So we might not know exactly why, but we know that it’s happening. Usually children are told to sit out activities for four weeks after they sustain a head injury. Now, this study is shedding new light on the notion that perhaps this should be a longer period of time. What’s your opinion on that?

Dr. Metzl: We used to think concussions were not very serious at all, and as sports medicine has evolved as a field we’ve learned so much about concussions, and we are appreciating how serious these injuries really are. With kids you need to be so very careful—if they’ve had a concussion, you make sure they are totally asymptomatic. There are some really problematic things that can happen if somebody has had a concussion.

Reporter: I think we throw that term ‘concussion’ around a lot, and it can be a lot of things. What exactly is a concussion and when do you have to be concerned about it?

Dr. Metzl: A concussion is basically a bruise to the brain, and there is a whole grade of concussions, from very mild concussions to very severe concussions. Most people think you have to lose consciousness to have a concussion, but that is not true. The mild ones do not involve loss of consciousness and are very common in kids.

Reporter: So as a parent, what would some symptoms be that would make you say, “I have a concern, and perhaps I should have my kid sit out or see a doctor?”

Dr. Metzl: That’s the crux of this. How do you recognize, as a parent or a coach, if the kid has had a concussion? Sometimes they’ll complain. If it’s a more serious one they’ll black out, but often they’ll come in complaining of post-concussive symptoms. There is a whole list of these post-concussive symptoms. The first are headaches. If kids have had headaches, it can be a real problem. Sometimes it’s dizziness. Also, sometimes if children have difficulty concentrating in school and that is different from their normal behavior, that is a cause for concern. There are a few others, such as a problem with vision and also something called tinnitus, which is a ringing in the ear. Any of these symptoms can be suggestive that they’ve had a concussion before, so as a parent or a coach you have to be really careful to make sure they’re not complaining of these symptoms.

Reporter: Something that parents are concerned about—hitting a soccer ball with the head—is this a bad idea?

Dr. Metzl: I get that question all the time. It’s really not a bad idea at all. It’s really very safe. As long as they hit the ball properly it doesn’t pose a problem whatsoever.

Reporter: So the bottom line is call your doctor, and the child probably should sit out longer than a four-week period after a head injury.

Dr. Metzl: If it’s a serious injury, be careful with it.

To view the full interview, visit WNBC.com.