What parents need to know about concussions and traumatic brain injury

Each year, pediatric brain injury leads to more than half a million emergency department visits and approximately 60,000 hospitalizations in the United States (National Library of Medicine). Whether it happens during sports, play, or everyday activities, it’s important for parents and caregivers to understand common causes, warning signs and when to seek medical care.

What is a brain injury?

A brain injury may also be called a head injury or traumatic brain injury (TBI), depending on how severe it is. They range from mild bumps or bruises (called contusions) to more serious injuries such as concussions, skull fractures, internal bleeding, or brain damage. Pediatric TBIs most often happen due to sports, recreational activities, falls, being accidentally hit in the head and motor vehicle crashes. These head injuries can affect the scalp, skull, brain or the blood vessels and tissues within the head. The good news: about 75% of TBIs are mild and not life-threatening (CDC).

Head injury signs and symptoms to watch for

Symptoms of a brain injury can look different from child to child. They may appear right away or develop over hours or days, and they often depend on how severe the injury is. Trust your instincts. If something doesn’t seem right, it’s okay to seek care.

Possible Symptoms of a Mild Head Injury

• Headache or pressure in the head
• Bump, bruise, or swelling on the head or face
• Dizziness or balance problems
• Nausea (with or without vomiting)
• Sensitivity to light or noise
• Feeling tired, sluggish, or “not quite themselves”
• Trouble paying attention or concentrating
• Confusion or slower thinking
• Irritability, sadness, or mood changes
• Blurred or double vision
• Changes in sleep (sleeping more or less than usual)

Possible Symptoms of a More Serious Brain Injury

These symptoms require immediate medical evaluation. They may include any of the symptoms above, plus:

• Trouble staying awake or difficulty waking up
• Loss of consciousness, even briefly
• A severe or worsening headache
• Repeated vomiting
• Slurred speech
• Trouble walking or clumsiness
• Weakness, numbness, or tingling, especially on one side of the body
• Seizures
• Memory problems or trouble recognizing people or places
• Blood or clear fluid draining from the nose or ears
• Pale, clammy, or sweaty skin
• Large or deep cuts to the scalp
• Loss of awareness of surroundings or coma

When to seek medical care

If your child falls or hits their head and shows any signs of a concussion or brain injury, they should stop the activity immediately and be evaluated by a medical professional. Early diagnosis and evaluation matter.

Go to the Emergency Department immediately for evaluation after a momentary loss of consciousness, bleeding from the head, or other signs of fracture, with no breathing issues. Call 911 if they have a seizure, difficulty breathing, sustained loss of consciousness or any signs of neck injury. When in doubt, especially for young children or high-impact injuries, choosing emergency care is the safest option.

How to prevent brain injuries

While not all injuries can be prevented, simple steps can lower risk: Dr. Laurie Ackerman, pediatric neurosurgeon with Riley Children’s, shares some top safety tips to avoid or reduce the risk of brain injury, including:

• Buckling up every car ride with the right car seat or booster
• Wearing properly fitted helmets for biking, scooters, and sports
• Making homes and playgrounds safer for kids
• Never shaking a baby and knowing how to cope when feeling overwhelmed

Knowing what to watch for and when to seek care makes a real difference after a head injury.

Specialized care for brain injuries at Riley Children’s Health

From common to complex, children can safely receive expert, age-appropriate care at Riley Children’s Health, where teams specialize in diagnosing and treating all kinds of pediatric brain injuries. Care is provided by a coordinated team that may include Emergency Medicine, Physical Medicine & Rehabilitation and Neurosurgery for more serious injuries.

“When a child comes to the emergency department with a head injury, our first priority is a careful evaluation. Due to the scope and size of Riley, we can quickly involve pediatric specialists and imaging when needed, so families know their child is getting the best care right away,” says Dr. Cory Showalter, division chief of pediatric emergency medicine.

Care doesn’t stop after the emergency visit. Riley Children’s offers multidisciplinary support tailored to your child’s recovery. Our Physical Medicine & Rehabilitation specialists help manage symptoms, support healing, and guide a safe return to school, sports, and daily activities. For more serious injuries—such as dented skull fractures or small areas of bleeding around the brain—our Neurosurgery experts provide highly specialized pediatric care.

Not all brain injuries or brain bleeds will require surgery, but all benefit from pediatric expertise and close monitoring. If your child needs emergency care, visit one of our three Riley Children’s emergency medicine locations.