Is it a concussion?

Which is more serious: a concussion or a mild brain injury?

Actually, it’s a trick question. When children suffer from a concussion-whether they fall from their bikes or get hit in a soccer game-they always endure some degree of trauma to the brain.

But a study from Canada, published in the journal Pediatrics, found that both parents and physicians are confused by the term concussion. The result may mean children aren’t healing properly from brain injuries.

Researchers followed 400 children who went to the hospital after a head injury. Families were less likely to consider a concussion a brain injury, and physicians even considered concussion as a separate category from brain injury.

Kids who were given the diagnosis of concussion were sent back to regular activities earlier than those who were diagnosed as having a brain injury.

The findings worry Dr. Holly Benjamin, a sports medicine specialist at the University of Chicago. She says people don’t realize the severity of concussion symptoms can range dramatically, from a few hours of nausea and headache to weeks of amnesia and cognitive problems.

“We have a long way to go in terms of education to help people to understand concussion is a traumatic injury,” she says. “We need to understand that kids take a long time to recover and they need careful follow up to avoid permanent risk of damage.”

Benjamin has treated student athletes who experience permanent personality changes. One student, she remembers, dropped from an A to a C average and lost his scholarship because of a concussion.

Rest is essential for the brain to heal, Benjamin says. Even if a child feels better at home, her symptoms may return if she tries to take a test or rejoin sports practice.

The younger the child, the longer the recovery time. Youth under 18 need at least one week of rest; some may require three weeks, Benjamin says. Once a child suffers a concussion, he is four times more at risk of having another one.

Parents should keep a watchful eye on their child, looking for subtle signs like slowed reaction time or trouble remembering things. Physicians should always clear a child before they get back to regular activities.

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