Concussions

A concussion is a type of mild traumatic brain injury (mTBI) caused by a blow, jolt, or impact to the head, leading to temporary brain dysfunction. In children, concussions can be particularly serious due to their developing brains and vulnerability to long-term cognitive, behavioral, and emotional consequences if left untreated. In Bangladesh, children frequently sustain concussions from falls, road traffic accidents, school sports injuries, bicycle crashes, or playground incidents. Unfortunately, awareness about concussion remains limited, and many children are misdiagnosed or untreated. Dr. Md. Nafaur Rahman, one of the leading pediatric neurosurgeons in Bangladesh, provides accurate diagnosis and expert management of pediatric concussions, ensuring safe recovery and preventing complications like Second Impact Syndrome or Post-Concussion Syndrome. What is a Concussion? A concussion occurs when a sudden force causes the brain to move rapidly back and forth inside the skull, resulting in disruption of normal brain function. This can affect memory, balance, behavior, and consciousness, even in the absence of visible injury or abnormal CT scan. Although classified as "mild" brain injury, concussions must be taken seriously, especially in growing children. Common Causes of Concussions in Children (Bangladesh Perspective) Falling from height (rooftops, stairs, bunk beds) Bicycle, rickshaw, or motorbike accidents Hit on head by object (books, ceiling fans, furniture) Sports injuries – football, cricket, running, school competitions Schoolyard fights or physical abuse Shaken Baby Syndrome in infants Signs and Symptoms of Pediatric Concussion Symptoms may appear immediately or hours to days later, and often vary by age. Common signs include: Immediate Symptoms: Loss of consciousness (even brief) Confusion, disorientation Dizziness or balance issues Headache or pressure in head Nausea or vomiting Visual disturbances (blurred or double vision) Memory loss surrounding the event Delayed or Subtle Symptoms: Irritability or emotional changes Excessive sleepiness or trouble sleeping Difficulty concentrating at school Increased sensitivity to light or noise Fatigue or slowed response Behavioral problems in younger children Parents in Bangladesh should be vigilant if their child complains of headache or behaves unusually after even a seemingly minor head injury. When to Seek Emergency Neurosurgical Care Immediate consultation with a pediatric neurosurgeon is advised if the child has: Prolonged loss of consciousness Seizures Repeated vomiting Severe headache worsening over time Slurred speech or unsteady gait Confusion that doesn’t resolve within hours History of previous concussion Suspected skull fracture or bleeding Diagnosis in Bangladesh Context Since concussions do not always show up on CT or MRI, diagnosis is clinical, based on symptoms, history, and neurological exam. Dr. Md. Nafaur Rahman uses standardized tools such as: Pediatric Glasgow Coma Scale (GCS) SCAT (Sport Concussion Assessment Tool) for older children Cognitive and balance assessments Neuroimaging (CT/MRI) if red flags are present Observation for 24–48 hours when necessary Management Approach by Dr. Md. Nafaur Rahman 1. Initial Care Rest and monitoring at home or hospital No screen time, physical activity, or school for initial days Pain control with paracetamol (not NSAIDs) Hydration, nutrition, and sleep optimization 2. Gradual Return-to-Learn and Play Dr. Nafaur follows international concussion protocols to guide the child back to daily activities: Stage 1: Complete cognitive and physical rest Stage 2: Light mental activity at home Stage 3: Partial school attendance with modification Stage 4: Full academics and light physical activity Stage 5: Return to sports with supervision 3. Rehabilitation Neurocognitive therapy if symptoms persist Speech and behavior therapy for post-concussive difficulties Psychological counseling for emotional symptoms Complications of Unmanaged Concussion Post-Concussion Syndrome (PCS) – symptoms lasting weeks or months Second Impact Syndrome – potentially fatal swelling after second injury Chronic Traumatic Encephalopathy (CTE) in repeated head trauma Academic and behavioral problems Developmental delays in young children Importance of Pediatric Neurosurgical Evaluation In Bangladesh, many concussions are managed by non-specialists, and parents often ignore minor head injuries. However, timely assessment by a qualified pediatric neurosurgeon ensures: Accurate diagnosis Monitoring for delayed complications Safe return to school and sports Prevention of long-term brain injury Why Choose Dr. Md. Nafaur Rahman? Highly experienced in managing pediatric head trauma and concussion Practices at National Institute of Neurosciences & Hospital (NINS) Provides structured care from diagnosis to rehabilitation Offers safe return-to-school and sports protocols Available for emergency and outpatient care at Bangladesh Paediatric Neurocare Centre Book an Appointment 📌 Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre 📞 For Serial / Emergency Contact: 📱 +8801912988182 | +8801607033535 🌐 Visit: www.neurosurgeonnafaur.com