Most Prominent Concussion Symptoms in Children
Headache is the most frequently reported symptom of concussion in children, followed by dizziness, fatigue, and difficulty with concentration. 1, 2
Primary Concussion Symptoms by Category
Concussion symptoms in children fall into four main categories:
Physical Symptoms
- Headache (most common overall symptom) 1
- Dizziness
- Nausea/vomiting
- Balance problems
- Fatigue
- Light sensitivity
- Noise sensitivity
- Visual problems
Cognitive Symptoms
- Difficulty concentrating
- Memory problems
- Feeling "foggy" or "slow"
- Confusion
- Amnesia (retrograde or anterograde)
Emotional Symptoms
- Irritability
- Sadness
- Nervousness
- Emotional lability
Sleep Disturbances
- Trouble falling asleep
- Excessive sleep
- Loss of sleep
- Drowsiness
Symptom Timeline and Duration
The presentation and duration of concussion symptoms follow a typical pattern:
- Physical symptoms (particularly headache) predominate immediately after injury 3
- Emotional symptoms tend to develop later in the recovery period 3
- Cognitive symptoms may persist throughout recovery 3
Symptoms with the longest median duration include:
- Irritability (16 days)
- Sleep disturbance (16 days)
- Frustration (14 days)
- Poor concentration (14 days) 3
Symptoms that typically resolve more quickly include:
- Nausea
- Depression
- Dizziness
- Double vision 3
Important Clinical Considerations
Loss of Consciousness
- Occurs in less than 10% of concussions 1
- If present for more than 30 seconds, may indicate more significant injury 1
Amnesia
- Can be retrograde (before event) or anterograde (after event)
- Important indicator of potentially more serious injury 1
- Should be evaluated by asking about details before and after injury 1
Mental Fogginess
- May predict slower recovery from concussion 1
Persistent Symptoms
- One month after injury, approximately:
- 25% of children still experience headache
20% suffer from fatigue
- 20% report taking longer to think 3
Special Considerations for Children
- Children and adolescents typically have longer recovery times than adults 2
- School performance may be significantly affected 1
- Younger patients require more conservative management 2
Warning Signs Requiring Immediate Medical Attention
- Worsening headache
- Repeated vomiting
- Increasing confusion
- Seizures
- Visual changes
- Swelling or deformities of the scalp 2
Key Differences in Children vs. Adults
- Recovery course is typically longer in children than in college/professional athletes 1
- Children are at higher risk for second-impact syndrome (all reported cases are in athletes younger than 20 years) 1
- Catastrophic football head injuries are 3 times more likely in high school athletes than college athletes 1
Understanding these symptom patterns helps clinicians properly diagnose concussions in children and provide appropriate guidance for recovery and return to normal activities.