DEAR DOCTOR K: Last week my 14-year-old daughter fell while skateboarding. She hit the back of her head and was dazed and had blurry vision for a few seconds. But she felt fine once she sat down and rested a bit. Now the left side of her head hurts, but otherwise she feels normal. Should she see a doctor?
DEAR READER: Yes, she should. In a child, particularly, it is often hard to know when trauma to the head may have caused a brain injury. That's why you should never ignore a head injury, no matter how small it seems.
It may sound like I'm overreacting. After all, children bump their heads all the time. And in most cases, this results in nothing more than minor bumps, bruises or cuts in the scalp.
But sometimes head trauma can cause more serious injuries, like a concussion. The skull -- the bony globe that surrounds and protects the brain -- is hard. But the brain is as soft as Jell-O. A head injury can cause the soft brain to forcefully bang against the hard skull. When that happens, the hard bony shell that was built to protect the brain injures the brain instead.
Concussions in children are serious. A concussion can cause:
-- Neck pain
-- Nausea or vomiting
-- Dizziness or vertigo
-- Hearing loss
-- Blurred or double vision
-- Irritability, anxiety or change in personality
-- Loss of memory
-- Difficulty concentrating or slowing of reaction time
-- Brief loss of consciousness
Symptoms often happen right away, and go away within minutes to hours. But sometimes children have symptoms that last for several days, weeks or even months.
The most important thing to do after suffering a concussion is to avoid situations that could cause another head injury. That's why it's important to take a break from physical and even mental activity. If your daughter has a concussion, her doctor might recommend that you:
-- Adjust your child's schedule and schoolwork.
-- Excuse your child from gym class, recess and sports.
The pediatrician will let you know when it's OK for her to return to normal activities.
In addition, watch your child closely. Sometimes the injury that caused a concussion can cause bleeding into the brain. Tell the pediatrician if symptoms get worse, come back, last too long, or if your child's behavior changes. These are clues that something is not right.
Finally, in the future, insist that your daughter wear a helmet for skateboarding, biking or any other riding activity. Nothing is more important in protecting her from a brain injury. Some brain injuries last a lifetime. Some, even, are fatal. Helmets save brains, and lives.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.