Pediatric Concussion Center

A concussion is a traumatic brain injury caused by a direct or indirect blow to the head, face, neck or elsewhere in the body that triggers a series of biochemical changes in the neurons. This can manifest itself via numerous short and long term symptoms that may appear hours to days after the injury and can last for several weeks or months. 

Keep in mind that not all bumps to the head are concussions, and you should consult a doctor for an official diagnosis. A concussion is usually diagnosed based on the patient’s history and the symptoms experienced after the injury, the most common being:

• Physical (e.g., headaches, balance problems)
• Cognitive (e.g., attention deficits)
• Emotional (e.g., mood dysregulation)
• Sleep (e.g., difficulty falling or staying asleep, sleeping too much)

The dedicated specialists at Cohen Children’s Pediatric Concussion Center have vast experience in the diagnosis and treatment of a full range of post-concussive symptoms. We use a multidisciplinary approach to care for children with all severities of traumatic brain injury and tailor treatment plans that meet each child’s unique needs. In addition to world-class pediatric neurologists, our comprehensive team includes members who specialize in the following areas:

• Headache
• Sleep medicine
• Emergency room/urgent care
• Neuropsychology/neurocognitive testing
• Vestibular and balance rehabilitation
• Physical therapy
• Return to school/play protocol management

Our approach to recovery is a three-step process: rest/return to activity, return to school and return to play.

Rest/return to activity

After a concussion, a brief period of rest during the acute phase (24 to 48 hours) is recommended before gradually returning to activity. There are two main components to rest:

• Mental rest: Avoidance of any activity that exacerbates the patient's symptoms. This relates to school, homework, extracurricular activities, reading/writing and phone/tablet/screen time. 
• Physical rest: Avoidance of sports, gym and aggressive play that may lead to another head injury. 

Return to school 

Returning to school full time should be a gradual process, as symptoms may worsen upon return. The patient should be closely evaluated to make sure they can tolerate returning.

Return to play 

The patient should not participate in gym class or sports until they have been symptom-free for at least 24 hours and have returned to school full time. At that time, your child should be re-evaluated by their pediatrician or pediatric neurologist to obtain clearance to return to play.

Our Pediatric Concussion Center experts are continuously advancing the field through research. Currently, our research focuses on improving the management of concussion patients in both the inpatient and outpatient settings. We are also collecting data about symptom burden in regard to the four main domains (physical, cognitive, emotional and sleep). This information will allow us to better predict patient recovery and help us better determine when medical treatment is appropriate. (Currently there is no imaging test that can show a concussion. Imaging is only needed if the patient’s condition continues to worsen, the condition lingers for a prolonged period of time, and/or there is a suspicion of a structural abnormality or a bleed.)

Our team members take part in a multitude of lectures in schools, community centers and concussion conventions throughout the year. Our goal is to increase awareness of concussions, their management and how to prevent them. We believe that the treatment of a concussion begins before the concussion occurs; in other words, management of co-morbid conditions such as migraine headaches, sleep disturbances, mood disturbances, dizziness and concentration deficits prior to the concussion will speed up the recovery.