Concussion Clinic

September 27, 2016

Would you know if your child had suffered a concussion?

The Centers for Disease Control and Prevention estimates that 1.6 to 3.8 million concussions occur each year, and that 5-10 percent of athletes will experience a concussion during any given sport season.

Yet, many parents with active kids do not know the signs and symptoms of a concussion or when one could happen.

Kids often become involved in a wide variety of games, including soccer or lacrosse, two of the many contact sports that make them vulnerable to injuries and concussions.

Additionally, even when a child is involved in a recreational sport such as bicycle riding, skateboarding or rollerblading, he or she could be at risk for concussions.

"If your son or daughter has signs or symptoms of a concussion - including, but not limited to, an injury with a subsequent headache, feeling like he or she is in a fog, dizziness or confusion - the child should immediately be pulled from the sport and evaluated by a healthcare professional," says Matthew Fazekas, MD, a pediatric sports medicine specialist and a member of the team of physicians at the new Joe DiMaggio Children’s Hospital Concussion Clinic.

About the Concussion Clinic

In 2016, Joe DiMaggio Children’s Hospital opened the doors to its Concussion Clinic, led by a world-class team of physicians who are board certified in sports medicine, pediatric neurology, pediatric physical medicine and rehabilitation, and pediatric neuropsychology, as well as a team of certified vestibular therapists.

"The concussion clinic is set up as a one-stop shop where patients will go through a full neurological examination. They may undergo neurocognitive testing, and start a process of return-to-learning and return-to-sports, as directed by the physician," says Dr. Fazekas.

The clinic operates from four locations: Hollywood, Coral Springs, Boca Raton and Weston.

It is the multidisciplinary effort of many JDCH specialists who work together.

In addition to Dr. Fazekas, these include Diana Martínez, MD, medical director of the Division of Pediatric Neurology; Virmarie Quiñones-Pagán, MD, a pediatric rehabilitation specialist; and Christina M. Zafiris, MD, a pediatric neuropsychologist.

In this video, Matthew Fazekas discusses the typical symptoms of a concussion:

Concussion: Tips and Symptoms - U18 Sports Medicine - Joe DiMaggio Children's Hospital

The signs and symptoms of a concussion can be subtle and may not be immediately apparent. Symptoms can last for days, weeks or even longer.

Common symptoms after a concussive traumatic brain injury are headache, loss of memory (amnesia) and confusion. The amnesia, which may or may not follow a loss of consciousness, usually involves the loss of memory of the event that caused the concussion.

Signs and symptoms of a concussion may include:

Headache or a feeling of pressure in the head
Temporary loss of consciousness
Confusion or feeling as if in a fog
Amnesia surrounding the traumatic event
Dizziness or "seeing stars"
Ringing in the ears
Nausea
Vomiting
Slurred speech
Delayed response to questions
Appearing dazed
Fatigue
Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury, such as:

Concentration and memory complaints
Irritability and other personality changes
Sensitivity to light and noise
Sleep disturbances
Psychological adjustment problems and depression
Disorders of taste and smell
Symptoms in children

Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they may not be able to describe how they feel. Nonverbal clues of a concussion may include:

Appearing dazed
Listlessness and tiring easily
Irritability and crankiness
Loss of balance and unsteady walking
Crying excessively
Change in eating or sleeping patterns
Lack of interest in favorite toys
When to see a doctor

See a doctor within 1 to 2 days if:

You or your child experiences a head injury, even if emergency care isn't required
The American Academy of Pediatrics recommends that you call your child's doctor for advice if your child receives anything more than a light bump on the head.

If your child doesn't have signs of a serious head injury, and if your child remains alert, moves normally and responds to you, the injury is probably mild and usually doesn't need further testing. In this case, if your child wants to nap, it's OK to let him or her sleep. If worrisome signs develop later, seek emergency care.

Seek emergency care for an adult or child who experiences a head injury and symptoms such as:

Repeated vomiting
A loss of consciousness lasting longer than 30 seconds
A headache that gets worse over time
Changes in his or her behavior, such as irritability
Changes in physical coordination, such as stumbling or clumsiness
Confusion or disorientation, such as difficulty recognizing people or places
Slurred speech or other changes in speech
Other symptoms include:

Seizures
Vision or eye disturbances, such as pupils that are bigger than normal (dilated pupils) or pupils of unequal sizes
Lasting or recurrent dizziness
Obvious difficulty with mental function or physical coordination
Symptoms that worsen over time
Large head bumps or bruises on areas other than the forehead in children, especially in infants under 12 months of age
Athletes

No one should return to play or vigorous activity while signs or symptoms of a concussion are present.

Experts recommend that an athlete with a suspected concussion not return to play until he or she has been medically evaluated by a health care professional trained in evaluating and managing concussions. Children and adolescents should be evaluated by a health care professional trained in evaluating and managing pediatric concussions.

Experts also recommend that adult, child and adolescent athletes with a concussion not return to play on the same day as the