There are over 1 million concussions in the United States every year, and each one is different. Most concussions resolve within 2 to 4 weeks; however, if they are not properly managed, a concussion can persist for much longer. Approximately half of individuals with a single mTBI (mild concussion) demonstrate long-term cognitive impairment and while most individuals are unaware of the potential risks, properly managing concussions from the beginning can prevent future persistent post concussion syndrome.

At Carolina NeuroServices, we are experts at helping both children and adults manage physical and mental activity to prevent concussions from persisting. We utilize comprehensive neuropsychological testing to help provide appropriate treatment plans for persistent concussions. We also provide cognitive rehabilitation to improve attention, processing speed, and working memory functioning in concussed patients. We further provide psychosocial support in individual and group therapies for patients who have trouble with adjustment issues.. As the official team neuropsychologist of the Charlotte Checkers, Dr. Ewert is familiar with the most up to date protocols for return to play after concussion.

Concussion Signs & Symptoms

  • Headache or a feeling of pressure in the head
  • Temporary loss of consciousness
  • Confusion or feeling as if in a fog
  • Amnesia surrounding the traumatic event
  • Dizziness or “seeing stars”
  • Ringing in the ears
  • Nausea
  • Vomiting
  • Slurred speech
  • Delayed response to questions
  • Appearing dazed
  • Fatigue


There is nothing more important than keeping our children healthy and safe. Wear your helmets, protect your head and see a doctor if you have any type of head impact and/or injury.
But do you know how to you recognize, respond to, and minimize the risk of concussion or other serious brain injuries? Is the old method of keeping our kids awake for several hours enough? Are there long- term consequences to only one concussion?

A concussion is a type of traumatic brain injury—or TBI— caused by a blow to the head that causes the brain to move quickly back and forth inside the skull. This fast movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging the brain cells. A jarring blow to the head and hitting the ground are both common causes among children. Concussions are closely associated with football and hockey, but kids can receive concussions playing any high-impact sport, including soccer, basketball, and volleyball. Cheerleading, gymnastics, skateboarding, and even riding a bike can also cause them.
How can you tell if your child/teen has had a concussion?

Children and teens who show or report one or more of the signs and symptoms listed below—or simply say they just “don’t feel right” after a blow to the head—may have a concussion or other serious brain injury. Contrary to popular belief, a child can have a concussion without ever becoming unconscious. Symptoms that may appear hours, or even days, later include difficulty concentrating, sensitivity to light, irritability, difficulty sleeping, and depression. And, it may be surprising to know that studies now show that girls are more susceptible to concussions than boys.
Signs Observed by Parents

• Appears dazed or stunned
• Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent
• Moves clumsily
• Answers questions slowly
• Loses consciousness (even briefly)
• Shows mood, behavior, or personality changes
• Can’t recall events prior to or aftera hit or fall

Symptoms Reported by Children and Teens

• Headache or “pressure” in head
• Nausea or vomiting
• Balance problems or dizziness, or double or blurry vision
• Bothered by light or noise
• Feeling sluggish, hazy, foggy, or groggy
• Confusion, or concentration or experienced in evaluating for concussion.

What are other more serious signs to look out for?
In rare cases, a dangerous collection of blood (hematoma) may form on the brain after a tbi. These can include:

  • One pupil larger than the other
  • Drowsiness or inability to wake up
  • A headache that gets worse and does not go away
  • Slurred speech, weakness, numbness, or decreased coordination
  • Repeated vomiting or nausea, convulsions or seizures (shaking or twitching)
  • Unusual behavior, increased confusion, restlessness, or agitation
  • Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously
    Head injuries should never be taken lightly.

Children and teens often continue to play while having concussion symptoms or who return to play too soon—while the brain is still healing—have a greater chance of getting another concussion. A repeat concussion that occurs while the brain is still healing from the first injury can be very serious and have prolonged effects.


It is essential that all student athletes have baseline testing performed prior to the beginning of the sports season. Then, after a concussed student has resolved, repeat testing can be  performed to see if the student has returned to baseline. This testing cannot be done over the computer! At our clinic, we follow NHL guidelines for return to play. Most importantly, we help manage academic accomodations and provide education and support during the recovery process.
At Carolina Neuroservices – The Head Injury Center, we pride ourselves on providing the top therapeutic assessments and training programs.  As parents ourselves, we understand the emotional, mental and physical strains you endure knowing that our child(ren) have been hurt. We want to ensure you, that we take every measure to help your child on the road to recovery quicker and with commitment to long-term success. Contact us today to schedule an evaluation.
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