Concussions: What you should know

By Karen Weintraub Globe Correspondent January 14, 2013

When is it safe to go back to sports?

Every concussion is different, so there’s no standard timeline for resuming pre-concussion activities. Doctors generally say that physical activity should begin slowly, first with walking and then slow jogging. If no symptoms — like dizziness or headache — recur, the person can resume more active sports. After an initial rest period, doctors say activity is probably good for the brain. But a subsequent concussion can be more dangerous and require a longer recovery.

What about schoolwork?

Many local schools have begun requiring students to take computerized assessments, such as the IMPACT test, to provide a baseline of the student’s normal mental performance. After an injury, the test is readministered and results are compared. After a concussion, it may take a while for students to resume their full course load. Doctors usually suggest students drop the subjects that can be most easily picked up after a break.

Why is a concussion often worse in children than adults?

Children through adolescence are thought to face more danger because their brains are still developing. Through adolescence, brain cells are adding insulation, called myelination, which helps transmit signals and strengthens brain connections. The brain is more vulnerable to damage before it is fully myelinated. The heads of younger children are large relative to their bodies and their necks not as strong, which causes more movement upon impact, potentially causing more injury to the brain.

What are the symptoms of a concussion?

Concussions can lead to four major categories of symptoms: Cognitive symptoms, which might include trouble with memory, attention, or learning; sleep problems, including too much, too little, or trouble falling asleep; head pain, including migraines and sensitivity to light and noise; and emotional symptoms such as irritability, lack of impulse control, severe anxiety, depression, or suicidal thoughts. Those who already have migraines or depression, anxiety, or ADHD, often take longer to recover.

SOURCES: Robert Cantu, Boston University; William P. Meehan and Alex McLean Taylor, Boston Children’s Hospital

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