Head Injuries and Concussion: When to Seek Care

An independent educational resource prepared by Mark M. Simonian, MD, FAAP

Sources checked: August 2, 2026     |     Medical review complete

This page is for general education only and does not replace individualized medical advice. This resource does not establish a doctor-patient relationship. For questions about your own child, contact your child's current healthcare professional.

Magnolia Pediatrics, Valley Children's Healthcare

2497 E. Herndon Avenue, Suite 101, Clovis, CA 93611     |     559-538-3070

Most childhood head bumps are minor, but a serious brain or neck injury can initially look less severe. The child's alertness, behavior, movement, vomiting, headache, vision, and change over time matter more than the size of a scalp lump alone.

Urgent Warning Signs — Check This First

When in doubt about a life-threatening head or neck injury, call 911.

CALL 911 NOW

  • The child is unconscious now, cannot be awakened, is not breathing normally, or becomes limp or unresponsive

  • A seizure occurs after the injury

  • New slurred speech, inability to recognize people or places, marked confusion, weakness or numbness, inability to walk normally, or rapidly worsening coordination

  • A possible neck or spine injury with severe neck pain, weakness, numbness, or inability to move normally; keep the child still and do not move the neck unless needed for immediate safety

  • Severe bleeding that will not stop with firm direct pressure, or you believe the child is in immediate danger

GET EMERGENCY MEDICAL CARE NOW

  • Any loss of consciousness, even if brief, especially when followed by headache, vomiting, confusion, unusual behavior, or difficulty remembering the event

  • Repeated vomiting, a headache that is severe or getting worse, increasing drowsiness, or difficulty staying awake

  • One pupil larger than the other, double vision, new weakness or numbness, slurred speech, marked clumsiness, or persistent dizziness

  • Blood or clear watery fluid from the nose or ear, bruising around the eyes or behind an ear, an obvious dent in the skull, or a deep or gaping scalp wound

  • A high-force event such as a motor-vehicle crash, being struck by a vehicle, a fall from a substantial height, or a hard high-speed object striking the head

  • A child with a bleeding disorder, a medicine that increases bleeding risk, a ventricular shunt, or another condition that raises the risk from head injury develops any concerning symptom

  • The child was injured intentionally or the history raises concern for possible abuse

CONTACT YOUR CHILD'S HEALTHCARE PROFESSIONAL TODAY

  • The child has possible concussion symptoms: headache, nausea, dizziness, balance trouble, sensitivity to light or noise, blurred vision, slowed thinking, memory or concentration problems, or feeling 'not right'

  • An infant or toddler has more than a light bump, or afterward has unusual crying, cannot be consoled, refuses feeds, is less playful, seems unsteady, or behaves differently

  • Vomiting occurs once, headache or dizziness persists, the child is unusually irritable or sleepy, or symptoms appear hours after the injury

  • A scalp cut may need closure, bleeding continues after about 10 minutes of firm pressure, or swelling or tenderness is large or worsening

  • The child has had a previous concussion, migraine, learning difficulty, mood disorder, or another factor that may affect recovery

  • You are uncertain whether the injury was only a light bump or whether the child can be safely observed at home

Sources and medical review

First Steps After a Head Injury

  • Stop the activity. If a concussion is possible during sports or recreation, remove the child immediately and do not allow same-day return.

  • Check breathing, alertness, neck pain, movement of the arms and legs, speech, balance, pupils, and whether the child remembers what happened.

  • If a neck injury is possible, keep the child still. Do not twist or bend the neck to examine it.

  • For ordinary scalp bleeding, use a clean cloth or gauze and firm direct pressure. Do not press on an obvious skull depression or embedded object.

  • For a scalp bump, place a cold pack wrapped in cloth over the area for about 20 minutes. Do not place ice directly on the skin.

  • Record the time and cause of the injury and any loss of consciousness, vomiting, confusion, seizure, or behavior change. Symptoms can appear or become more noticeable over hours or days.

Possible Concussion

A concussion is a mild traumatic brain injury caused by a bump, blow, or jolt to the head—or by a hit to the body that makes the head and brain move rapidly. Loss of consciousness is not required. A child who seems dazed, confused, unusually emotional, unsteady, slow to answer, forgetful, or simply 'not right' may have a concussion.

Symptoms families may notice

  • Headache, pressure in the head, nausea, dizziness, balance problems, blurred or double vision, or sensitivity to light or noise

  • Feeling foggy, slowed down, tired, or low in energy; trouble concentrating, remembering, reading, or completing schoolwork

  • Irritability, sadness, anxiety, unusual emotional reactions, or a change in personality or behavior

  • Sleeping more or less than usual or having difficulty falling asleep

  • In infants and young children: increased crying, needing more comfort, feeding refusal, less interest in play, new clumsiness, or a change from usual behavior

A normal CT or MRI does not rule out a concussion, because concussion affects how the brain functions. Imaging is used selectively when clinicians are concerned about bleeding, a skull fracture, or another structural injury; it is not routinely required for every possible concussion.

Sources and medical review

Observation and Sleep

  • A responsible adult should stay with the child and observe closely during the first 24 hours. Continue watching for delayed or worsening symptoms over the next few days.

  • If the child has been appropriately assessed, has no danger signs, and is acting normally, sleep is generally allowed. Sleep supports recovery.

  • Do not automatically wake a sleeping child every few hours unless the evaluating healthcare professional specifically instructs you to do so. Follow any individualized discharge instructions.

  • ·Seek emergency help if the child becomes increasingly difficult to wake, has unusual breathing, vomits repeatedly, develops worsening headache, confusion, weakness, seizure, or another danger sign.

  • Offer fluids and simple foods as tolerated. Ask a healthcare professional before giving medicine after a head injury. Never give aspirin to a child or teenager unless it was specifically prescribed for another medical condition.

Sources and medical review

Recovery and Daily Activity

  • For a diagnosed concussion, use relative rest for the first 1 to 2 days: reduce activities that clearly worsen symptoms, but do not require complete isolation in a dark room.

  • After the first 1 to 2 days, gradually resume light physical and thinking activities that do not significantly worsen symptoms. Stop and step back if symptoms increase substantially.

  • Support regular sleep, hydration, and meals. Reduce bright screens, loud noise, reading, or busy environments temporarily when they clearly trigger symptoms.

  • Avoid driving, biking, climbing, rough play, amusement rides, and other activities that could cause another head injury until the child is medically ready.

  • Arrange follow-up if symptoms are worsening, interfere substantially with daily life, or are not resolving as expected. CDC guidance recommends reassessment or referral when symptoms have not resolved after about 2 to 4 weeks.

Sources and medical review

Returning to School

Most children with concussion can begin returning to school within 1 to 2 days, often before every symptom is gone. A prolonged complete absence can slow recovery. The child's healthcare professional and school should adjust the plan to symptoms.

  • Tell the teacher, school nurse, counselor, and coach about the injury and symptoms.

  • Possible temporary supports include shorter days, rest breaks, reduced homework, extra time, fewer tests, a quieter setting, and reduced exposure to bright light or noise.

  • Increase schoolwork gradually. If symptoms become substantially worse, reduce the workload and contact the healthcare professional.

  • Returning to class does not mean the child is ready for physical education, playground risk, practice, or contact sports.

Sources and medical review

Returning to Sports and High-Risk Activity

·        When concussion is suspected, remove the child from play immediately. No same-day return to practice, competition, physical education, or another activity with risk of head impact.

  • A healthcare professional should evaluate the child and give approval before beginning a return-to-sports progression.

  • The child should first be back to regular non-sports activities, including school. Return to sports then proceeds gradually through increasing activity levels under professional supervision.

  • Each step generally takes at least 24 hours. If symptoms return, stop, notify the healthcare professional, and resume only as directed from the previous symptom-free step.

  • Do not return to contact or collision risk until the child is symptom-free with exertion and has completed the medically supervised progression.

Sources and medical review

Preparing to Contact a Healthcare Professional

Have the following information ready when possible:

  • The child's age, medical conditions, medicines, allergies, bleeding risks, prior concussions, migraines, and learning or mood concerns

  • The exact time and mechanism: fall, collision, sports impact, object strike, motor-vehicle crash, or possible intentional injury

  • Whether there was loss of consciousness, memory loss, seizure, vomiting, headache, neck pain, dizziness, confusion, vision change, weakness, numbness, or unusual behavior

  • How symptoms have changed, what activities worsen them, and whether the child can walk, talk, drink, sleep, and interact normally

  • Any scalp wound or swelling and whether bleeding stopped with direct pressure

  • Any medicines already given, including the product, concentration, amount, and time

Do not delay emergency care to take photographs, record video, repeatedly wake the child, search for a symptom checklist, or wait for a callback when a danger sign is present.