There was a time when most people didn’t consider hitting your head as that big of a deal, unless you were bleeding, of course.

Today, people realize there’s more problems to a bump on the head than a goose egg.

Not only does the medical community know more about the effects of a concussion, but also coaches, parents and the community have learned a great deal more about the signs, symptoms and treatments.

“It’s kind of an invisible injury,” said Colin Ellis, a physical therapist with Lehigh Valley Health Network Outpatient Neurologic Rehabilitation, about concussions compared to injuries like a sprained ankle, for instance. “A concussed patient often looks rather unscathed.”

What happens to your brain after you hit your head

A concussion is any sudden or repeated impact to the head that causes the brain to move back and forth quickly. This can cause chemical changes in the brain, some of which can be permanent, said Dr. Duy Tran, a pediatrician in emergency medicine at LVHN.

Ellis and Tran spoke at an online information session titled “Because They’re Kids: Fall Sports and Concussions.” Tran spoke about how to prevent and identify concussions, and Ellis spoke about rehabilitation treatments.

“It kind of frustrates me when I still see coaches say ‘oh it’s nothing, shake it off, go back in,’?” Tran said. “If you notice that your child or athlete suffers one of these head injuries, don’t be hesitant to ask to have them removed from the field so they can stop playing.”

Tran said concussions are responsible for more than 500,000 emergency room visits each year, and 18,000 hospitalizations. About 80% to 90% of brain injuries are mild with fewer than 10% of children actually losing consciousness.

Still, head injuries do cause about 1,500 deaths in children every year.

A concussion can range in severity from mild or severe mild to severe.

What to look for after a hit

Some symptoms of a mild concussion, also called a mild traumatic brain injury, include:

• The inability to remember events prior to or after the hit on the head;

• Appearing dazed or stunned;

• Answering questions slowly;

• Forgetting instructions or getting confused;

• Moving around clumsily;

• Experiencing double vision;

• Losing consciousness, even briefly, and;

• Showing changes in mood, behavior or personality.

A person may say he or she feels nauseated, has a headache or feels pressure in the head. He may say he is bothered by light or noise, feels foggy, sluggish, dizzy, confused or just doesn’t feel right.

Serious symptoms of traumatic brain injury include:

• Loss of consciousness;

• Drowsiness or unable to wake up;

• Repeated vomiting or nausea, convulsions or seizures;

• One pupil in the eye is larger than the other;

• Slurred speech, weakness, numbness or decreased coordination;

• Unusual behavior, increased confusion, restlessness or agitation, and;

• A headache that gets worse and does not go away.

“These are all really significant or serious signs that the kid may have suffered more than just a mild concussion,” Tran said. “These definitely need to be evaluated by an expert.”

A serious concussion can have lifelong effects. It can increase a person’s risk of anxiety and depression as he or she gets older, and it can cause problems with memory, word finding and dementia, Tran said.

Concussions are also the cause of a brain injury known as chronic traumatic encephalopathy, which is caused by multiple hits to the head that go untreated.

“The brain is like any other body part. If you abuse it enough, it will just break,” Tran said.

Preventing head injuries

There are some ways to help prevent head injuries.

Tran suggested limiting tackle football to children in middle school and older. Younger children don’t know the proper techniques to avoid injury and often lead with the head when tackling. This can cause injuries. Younger children also have weaker necks.

Tran thinks there should be zero tolerance for head contact in sports. This includes a ban on body checking in ice hockey, and heading the ball in soccer, at least until children are older and have stronger necks.

Parents can also be proactive in preventing concussions. Tran suggested:

• Placing gates at the top of stairs to prevent falls;

• Making sure that helmets are properly fitted before riding a bike, skateboarding, etc.;

• Go to playgrounds that have soft surfaces, and;

• Make sure children are sitting in appropriate-sized car seats and booster seats, because head injuries can occur in vehicle crashes.

Tran said he knows most kids want to go right back to playing their sport after a concussion. He said he tells them, “Would you rather be out for a game or rather be out for a season? Or better yet, would you rather not even be able to play this sport anymore? Kids are stubborn, but that’s why we’re the adults, and when that happens, we need to be the adults and make those decisions and say, ‘Look I’m trying to protect you, but also if you want to have a future in this sport then it’s probably best to sit out.’?”