kids’ korner By A. David Rothner, MD Tips for Parents and Children Dr. Goldstein and her daughter, Haley, offer these tips for children and parents of children who are involved in sports: TAKE RESPONSIBILITY FOR EDUCATION. Make sure you, your coaches and your school administrators understand the risks for concussion, recurrent concussions, return-to-play guidelines, and evaluation and treatment options. BE AWARE OF PREDISPOSING FACTORS. Adolescents who have a previous history of headache or a strong family history of headache seem to have more problems with headaches after concussion. Post-Concussion Headache in Sports F OR HALEY MANKIN of Newtown Square, Penn., cheerleading was life. She had migraine and New Daily Persistent Headache that appeared at age 13, but that didn’t stop her from participating in activities and going to school. That is, until a cheerleading competition at age 15. Mankin was at the bottom of a human pyramid when it collapsed; she was hit in the head three times, resulting in a concussion. She doesn’t remember the moments that followed, although her friends tell her she seemed confused. “We weren’t that panicked,” says her mother, Lisa Goldstein, MD, a child psychiatrist. “We’d seen other kids with concussions. We thought she’d be back to her normal self quickly. It wasn’t until we started to realize she wasn’t recovering like other kids that the gravity of the situation began to set in.” Six weeks after the concussion, Haley’s migraines increased from her usual two times a month to three times a week. Ten weeks after the trauma, she was hospitalized for nine days with intractable daily migraine and vomiting. Now 17, Haley continues to experience daily headaches and has been diagnosed with post-concussion headache in the form of chronic migraine. She is home-schooled and typically unable to complete more than three non-consecutive hours of schoolwork a day or go to noisy or busy places like the grocery store, movie theater or mall. Up to 3.8 million recreation- and spo \[]Yۘ\[ۜ\[X[H[H[]Y]\Xܙ[H[\܈\X\H[][[ۋ[[Y[\H[ZYHۘ\[ۜ\H\\X\Y[XZ]H\XX]HX]\H[[\[[^H\X[Hܙ[^Yܝ]\\[ZY\ˈHYۘ\[ۜ\\[[\[X]YH\[و[]]X[\Y\Xܙ[\X\X\Y[H\L\YHوH\[YX]XˈYH[Y\\]HHY\]Hوۘ\[ۋ]\X\\Y\[HX[\XYX\[[X[\X^HH[YK]\\[]HHY\[X\وۘ\[ۜYH\X\][ۈ[[ܙHܝ[[Xܝ [Y[K[ K]YXۘ\[ۈXYX\ۘ\[ۈ][[ۈ[[[&\ܝ\\[X[][Y\XX[[[XH\H[][HYX]HX\H^\Y[HXۘ\[ۈXYX\]\YZX]Y[X\H][\]\[[ۈ[H[YKSTSPQPTQTUSPBZYܘZ[KۚXZ[HXYXH܈HX[][ۋH[XYHYXYX\܈H[Z[H\ܞHوXYX\[܈H][XH\H[ܙHZ[H^\Y[HYHܛHو[\YH[ܙH]\H[\]H\ܞHوXYXKXܙ[H[\][ۘ[\YX][ۈوXYXH\ܙ\]][X]XXYX\][][][^\وH][X]X][]\[XYXHXX[\YܙYH]YXYX\\][][]\[YZوHۘ\[ۋHXYX\[[HۜY\Y]][X]XXYX\ˈۘHXYۛY8%[\[HXHHܛY\ܞH [Y[H]Y]و[\\HYHH]\X[^[x%HX]Y[]\\YۙY\YۈHXYX\HوXYXH]H[\^\Y[[˂SSPBHSUPPTSRHPSӋ[^HYZ]]Hۘ\[ۈHH\[ZY\Z[HH\ۘ\[ۈx&YYHYY[][HXY[Y\XY[YܙH]^\8'H\۸&][[[[ۙHX]\HHY&][^H[HܜH܈XZHYH]Z]Y\XY[˸'H]8&\[\ܝ[܈[[Hۙ\X]\H^H[\\[ܜ[Y\H\HX\[ۘ\[ۜˈVHSRTPˈ8'ۛ]][]]\][X[K8'H[^H^\ˈ8'[[[H[[]XZH[H\H[[^\[HHYH[H]K'H[^HX\Y^HZ]\\[]Y[؛[]\HYKXH^\\[Y\YH\\^\˂ܝ\[]Yۘ\[ۈ\[[\][ۈ[H[[ۚ[وHZ[]\YHHH]]x&\XY ܈H]ܘH[Z]YHXY K[[\\[\\\H[][L^\Xܙ[H\[YX]Xˈ]Y][Y\XYX\H[[[ۈ[\Hوۘ\[ۋ[[\܈[ˈXۘ\[ۈXYXH KH\Hو][X]XXYXK\HXۙ\HXYXH]][\H\[وHۘ\[ۋHXYX\[\[[X[Hܛ\Έ[[ۋ]\HXYXK\\XX\ٝ[X]Y[\۸&]X\H܈X[HY\\ˈ^\]H\Hوݙ\]KX[\YYX][ۜ Y[Y\\H[ܙH[XHHYZK^\]HX[\[Z[[XZH][ܙHYX[܈[[[Z\\[XX]H\XX[Y]X\X][ۜ[[HYY܈[[][X]Y[[\ݙHXYXHXX[\Y\HY\]X]HY\Y\]X]HY][ۋYX][ۘ[\ܝ[[[[ˈ^\\H\X[Y[YY\XX[[[\[HY\H^\\H]\K[ܙX\[ݙ\[YK]X^H[H[\ܝ[Y\H]Y\[K[YZ[[[X]]Y\][^X\]B[\\ˈ]][Z[][HY[[\H[و[YX][ۘ[[[܈[[YHH[8&\Y[H[[[[[ۘ[[[܈[[[HܚYZ\Y[[X]Z\Z[[Y\YY\[K][X[KX]Y[[[\Hۈ]ۋ[Y]\][ۈX^H\]HY\[[[[YH܈]\H]Y[HXZܚ]Hو[]YX[][\ݙH][H\HوYZوH][XK[^HX[[\\[HX[\ܝ[ۈوY\[H\\ˈ܈]Y[]\\[]\][[ܙH[\ܝ[YH[^\[HX]Y[[8'\x&\[^\H[[H]Y[[܈H^X]Y[\H܈܋\\X\[]܈Y\\H\[K8'HZ[^\و[^K8']H]\]H\H]x&[]]\'H[]\H]H][[[X[][[XY\B[XܚXHXY\O\]˚XYX\˛ܙ[X8'XYHHY[X\'H]HYوHYHYKH[[H][ۘ[XYXH[][ۋ[H[XZ]HHXܚ\[ۈXY\K˚XYX\˛ܙ][ۘ[XYXH[][ۂB