Published: March 11, 2022
If your child has experienced a concussion, whether it happened during a sporting event or another type of accident, seeing a neurologist is not always necessary. Most primary care providers are able to offer guidance for managing symptoms (such as headaches, trouble thinking or fatigue), provide a concussion treatment plan, monitor progress during follow-up visits, and, if necessary, make a referral to a neurologist or concussion specialist.
Most cases of a mild traumatic brain injury, such as a concussion, are treatable by the primary care provider without additional neurological expertise.
Most cases resolve within a week, and the primary care provider can look out for any warning signs that your child’s concussion may require specialized neurological care: delayed recovery, a history of multiple concussions, or the need for medical management of symptoms. For most concussions, treatment involves limiting physical and mental activities until you see an improvement in symptoms. Then, those activities should gradually return to normal by continuing to increase the duration and frequency of the activities, as long as there is no return of concussion symptoms. Sleep and exercise are very important for recovery, but activities need to be reduced if they provoke concussion symptoms.
Our primary care providers can help manage your child’s symptoms and treatments after a mild concussion. Find a pediatrician.
Call (502) 629-KIDS (5437), option 3.
In an emergency, the child should be taken to the emergency room. An ER doctor can make an initial concussion diagnosis. Otherwise, the very first appointment does not need to be scheduled with a neurologist or neurosurgeon, according to Ian S. Mutchnick, M.D, M.S., pediatric neurosurgeon with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine.
“As long as the pediatrician is familiar with the tenets [of concussion management], it is always appropriate to see the primary care provider for a concussion,” Dr. Mutchnick said.
Primary care providers can treat linear skull fractures, the most common type of skull fracture and which resembles a thin line, as long as an underlying brain injury is not detected during radiographic imaging or X-rays, according to Dr. Mutchnick. Any patient with a skull fracture that is depressed (sunken in from the trauma) or whose imaging detects an underlying brain injury should visit a pediatric neuroscience provider like those at Norton Children’s Neuroscience Institute.
Symptoms of a concussion include loss of consciousness, confusion, slow response time, clumsiness, memory loss, headache, nausea, vomiting, blurred or double vision, light or sound sensitivity, fatigue or mood changes.
More serious signs that require emergency medical attention include: a headache that gets worse and does not subside; any weakness or numbness; seizures; repeated vomiting; slurred speech; confusion or agitation, including inability to recognize people or places; severe drowsiness or loss of consciousness.