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Docs say that children with concussions do not have to stay in the dark for days: shots



While children may need a day or two of complete rest after a concussion, they may feel more and more isolated and anxious, says Angela Lumba-Brown, a pediatric emergency physician who helped shape new guidelines.

Gregoire Sitter / EyeEm / Getty Images


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While children may need a day or two of complete rest after a concussion, they may feel more and more isolated and anxious, says Angela Lumba-Brown, a pediatric emergency physician who helped shape new guidelines.

Gregoire Sitter / EyeEm / Getty Images

A few weeks ago, eight-year-old Liam Ramsay-Leavitt from Martinez, California, swung on the climbing poles at school. "And then I just fell on the page," he says. "I was dizzy and I had a sore head."

It turned out he had a concussion.

The doctor said he had to leave school for a week – there was no homework (he had no it does not bother me too much), but also no reading, no break, no video games, no chess club, no activity. "I'd just say it's really boring," says Ramsay-Leavitt. "And disappointing."

"It was hard," confirms his mother Michelle Ramsay-Leavitt. After three days, I asked the doctor if he could go to school and just sit down. "

Your doctor followed what has been the norm for nearly a decade. Wisdom about treating childbearing: Keep children at home, store them in a dark room with no screens and minimal stimulation, and ban any kind of physical exertion.

But in the light of recent research, the American Academy of Pediatrics has been updated this month. This is a guideline for the treatment of mild brain trauma that urges physicians and parents to allow children to return to school earlier and allow them to To use electronics and to be physically active again after only a few days rest.

"This is for a child Who is primarily concerned with curiosity and new experiences that have so much more energy than their parents is almost a punishment when told that they have to stay in a dark room" says Dr. Angela Lumba-Brown. a pediatric emergency drug The physician and co-director of the Concussion and Brain Performance Center at Stanford University.

One or two days of complete rest might be necessary, but more children may feel isolated and anxious, Lumba-Brown notes. A recent study found that children who awoke for one to two days after a concussion had fewer symptoms and recovered faster than those who took a strict five-day break from school, work, and physical activity.

The AAP recommendations, Lumba-Brown, and their team developed guidelines issued by the Centers for Disease Control and Prevention in September to personalize the resumption of children's activity, matching the need for stimulation with the need for rest.

"Doctors, parents and teachers should work with the child to find a plan," says Lumba-Brown. "Maybe after two or three days rest, that means going back to school, but maybe only for half a day, or maybe not, maybe the patient will be able to do it all day without her headaches getting worse."

Students should receive a refund of homework and exams and do as little or as much as possible, the new leaders suggest. They also propose a similar, gradual approach to physical activity.

"We do not recommend that a child go directly into the body. Mark Halstead, pediatrician and assistant professor at the Washington University School of Medicine, St. Louis, Mo., who has written both the AAP and CDC guidelines. "But maybe they could do a brisk walk or light work on an exercise bike – things to get their heart rate going."

Aside from the resumption of physical activity, another major change in the guidelines suggests that children can get back on their bodies using phones and computers earlier. "One thing we have to take into account for children today is that they are socially connected through their electronic devices," says Halstead. In any case, there is no research suggesting that viewing screens after a concussion is inherently harmful – although staring at the TV or computer could aggravate the headache after a concussion.

For the Diagnosis of Concussion and the Recognition of Recovery Procedures The guidelines and new rates discourage CT scans or fMRIs except in severe cases where physicians suspect bleeding or skull fracture. This is due to the fact that brain concussion rarely occurs in these imaging examinations of the brain.

Instead, AAP and CDC instruct physicians to go over a checklist of symptoms in young patients asking them how tired, sleepy, or unbalanced they feel

The two organizations differ slightly in terminology. The AAP deals with "sports-related concussion," while the CDC guide focuses on "mild traumatic brain injury," or mTBIs. For most people, the two terms are interchangeable – although technically mTBIs are a subset of concussions that can describe more serious cases of head injury. "We try to use the term 'mild traumatic brain injury', especially because people tend to take it seriously," says Lumba-Brown. In fact, there is research that suggests that people underestimate the "concussion" compared to "brain injury."

But whatever you call it, in recent years it has become clear that "this type of injury is more common than we previously thought". Lumba-Brown says. An estimated 1.1 to 1.9 million children are treated each year in the United States for sports injuries or game-related head injuries, although the researchers believe that many more cases are not reported.

"The difficulty is that not every child with a concussion is about to get up and start stumbling," says Halstead. "You can not always see the symptoms, such as headaches or dizziness." Older children, especially those who take their sport seriously, can not tell adults that they do not feel well. "They may be more worried about how they come to the game or disappoint their teammates," he says. Therefore, adults need to be vigilant – especially ask the children how they feel and remember when they behave strangely.

At the same time, sport and play are an important part of childhood, he says. "We do not want to put children in a bubble just because we're scared."


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