Rothman Concussion Network


For Parents & Athletes

Monday, April 17th, 2017
Adolescents and teens can experience delayed symptoms hours or even days after an initial impact. Knowing the signs and symptoms of concussion ahead of time can increase awarness for parents and their children.
For Parents & Athletes

What is a concussion?

A concussion is a type of brain injury - also called a traumatic brain injury, or TBI - that occurs as a result of an impact to the head or body.

When such an impact occurs, as from a blow, a jolt, or a fall, the sudden movement can cause the brain to bounce around or twist inside the skull, which can lead to chemical changes in the brain and sometimes stretch and damage brain cells.


Common signs and symptoms of a concussion:

Some experts believe that adolescents and teens can experience delayed symptoms hours or even days after an initial impact. Knowing the signs and symptoms (both reported and observed) ahead of time can increase awareness of concussions for parents and their children. For a comprehensive list of concussion symptoms, visit our signs and symptoms page.

Signs and Symptoms Observed by Parents or Guardians Symptoms Reported by Your Child or Teen
Appears dazed or stunned Difficulty thinking clearly Numbness or tingling
Is confused about events Difficulty concentrating or remembering Does not "feel right"
Answers questions slowly Feeling more slowed down Irritable
Repeats questions Feeling sluggish, hazy, foggy, or groggy Sad
Can't recall events prior to the hit, bump, or fall Headache or "pressure" in head More emotional than usual
Can't recall events after the hit, bump, or fall Nausea or vomiting Nervous
Loses consciousness (even briefly) Balance problems or dizziness Drowsy
Shows behavior or personality changes Fatigue or feeling tired Sleeps less than usual
Forgets class schedule Blurry or double vision Sleeps more than usual
Forgets assignments Sensitivity to light or noise Has trouble falling asleep


In some rare cases, a more serious injury such as brain swelling or a brain bleed can occur as a result of an impact to the head. * If you think you or your child has suffered a head injury, and you observe any danger signs, or you feel something is not quite right, or you do not feel comfortable, go to the Emergency Room right away.

Danger Signs
One pupil larger than the other
Drowsiness or inability to wake up
A headache that gets worse and does not go away
Slurred speech, weakness, numbness, or decreased coordination
Repeated vomiting or nausea, convulsions or seizures (shaking or twitching)
Unusual behavior, increased confusion, restlessness, or agitation
Loses consciousness (even briefly)


Did you know?

  • While headache is the most common symptom of a concussion, you do not need to have a headache to be diagnosed with a concussion.[1]

  • Less than 10% of concussions will result in loss of consciousness.[2]

  • Athletes who have had a concussion are at an increased risk for having another.[3]

  • Athletes with multiple concussions have been found to have lower scores on tests of verbal memory and reaction time. [4]

  • Adolescents sometimes don't experience symptoms of concussions until hours or days after their injury, so always keep an eye out for contact hits to the head, chest, or body. [5,6]

  • It is suspected that more than 50% of concussions go undiagnosed. [7]

  • Getting a second concussion before a previous concussion has healed can result in Second Impact Syndrome, a potentially life-threatening complication that can cause brain swelling, permanent brain damage and even death. [8,9]

  • In the past, "Rest is Best" was the hallmark treatment for sports concussions. Current research however now supports introducing a gradual increase of activity to the recovery plan when managed closely by a concussion specialist. [10]

  • Baseline concussion testing can sometimes help athletes return to play more quickly, (and safely). Baseline testing gives specialists information about the athlete's brain prior to an injury, and is helpful in crafting the best treatment plan following a concussion. Baseline testing can refer to many different measures used by specialists, including assessments of cognitive function, balance, and vision. [11]


Reduce your chance of injury by following these guidelines:

  • Always give your full attention, whether it's in a game or in practice.

  • Listen to your coaches and follow their instructions.

  • Make sure you know all of the signs and symptoms of concussion before participating in sports, and be sure to report anything that does not feel "right," especially after a hard hit, fall, or blow to the head.

  • Don't minimize concussions among your friends and teammates. Support each other if you think a friend is hurt. Don't be afraid to tell a coach on your teammate's behalf about an injury.

  • Parents: Get to know your coaches. What are their qualifications? What is their background? Have they had concussion training? Experienced coaches will teach proper technique for your child's sport.

  • Parents: Ensure proper fit and wear for all equipment, including cleats, and be sure all equipment is under warranty.

  • Parents: If your school has a licensed athletic trainer, get to know them. Keep the lines of communication open. If your child does sustain a concussion, they will play a role in the treatment plan and will work as your child's advocate.


Athletic safety equipment:

While NO athletic safety equipment has been proven to prevent concussions, helmets can prevent skull fracture, orbital fracture, eye injuries, and lost teeth. If you, your school, or your sporting organization is thinking about mandating a new piece of equipment for the prevention of concussion, remember some questions to keep in mind:

  • Is there peer-reviewed, independent research to support claims pertaining to concussion prevention with this equipment?

  • Could this equipment alter my athlete's sense of safety during contact play?

  • Will it affect my child's form or technique in any way? Could it alter their mechanics or muscle memory?

  • Will my athlete be required to wear this equipment during both practice and games? If not, could this encourage conflicting habits?

  • Will my athlete still be wearing this equipment when they progress to another level of competition, such as high school or college?

  • Will this device (such as an insert) invalidate a warranty on a currently used piece of equipment (such as a helmet)?

  • Are there guidelines on proper fit for this equipment? Does this product have a warranty? Does my school or organization have guidelines to mandate checking for proper fit?

Remember, one of the best ways to avoid injury is to know proper technique and form for your sport, and to stay alert. If you suspect a concussion, always remove yourself (or your child) from play and get evaluated by a healthcare provider trained in the treatment and management of concussions.



  1. Kushner D (1998). "Mild Traumatic brain injury: Toward understanding manifestations and treatment". Archives of Internal Medicine. 158 (15): 1617-1624.

  2. From American Academy of Pediatrics, Clinical Report, "Sport-Related Concussion in Children and Adolescents", Pediatrics, Mark E. Halstead, MD, Kevin D. Walter, MD, The Council on Sports Medicine and Fitness, Vol. 126 No. 3, September 1, 2010.

  3. Moser RS, Iverson GL, Echemendia RJ, Lovell MR, Schatz P, Webbe FM, et al. (2007). "Neuropsychological evaluation in the diagnosis and management of sports-related concussion". Archives of Clinical Neuropsychology. 22 (8): 909-16.

  4. Covassin T, Stearne D, Elbin R. Concussion History and Postconcussion Neurocognitive Performance and Symptoms in Collegiate Athletes. Journal of Athletic Training. 2008;43(2):119-124.

  5. Field M, Collins M, Lovell M, Maroon J. Does age play a role in recovery from sports-related concussion? A comparison of high school and collegiate athletes. J of Pediatrics 2003;142:546:553.

  6. Giza C, Hovda D. The neurometabolic cascade of concussion. J Ath Tr. 2001;36(3):228-325. Posted July 9, 2012

  7. McCrea M, Hammeke T, Olsen G, et. al.  Unreported concussion in high school football players: implications for prevention.  Clin J. Sport Med 2004;14:13-17

  8. Bey T, Ostick B. Second Impact Syndrome. Western Journal of Emergency Medicine. 2009;10(1):6-10.


  10. Semple, B. D. (2016), Challenging the dogma that 'rest is best' after concussion (Commentary on Mychasiuk et al.). Eur J Neurosci, 44: 2405-2406. doi:10.1111/ejn.13346

  11. Guskiewicz KM, Bruce SL, Cantu RC, et al. National Athletic Trainers' Association Position Statement: Management of Sport-Related Concussion. Journal of Athletic Training. 2004;39(3):280-297.

For Your Brain The Best Minds

For Your Brain The Best Minds

Thank you for visiting the former Jefferson Comprehensive Concussion Center website. We are now proudly owned and operated by the Rothman Institute Concussion Network. Please take a moment to explore our new website. If you would like to contact Jefferson, please call 1-800-JEFF-NOW. To schedule an appointment with the Rothman Concussion Network, call 267-463-2300 or visit our Make an Appointment Page.