Pediatric Neurology and Neurosurgery

Pediatrics

Head Trauma and Concussions

Best Pediatric neurology & neurosurgery program in New York, according to U.S. News & World Report

If your child has experienced head trauma, from mild to severe it's important that he or she receive a full evaluation by an experienced team of specialists to ensure a proper recovery. At NewYork-Presbyterian, our pediatric concussion experts thoroughly assess your child to determine if a concussion has occurred, evaluate his or her cognitive function, and customize a roadmap to recovery with the goal of a full return to normal activities.

 

About Our Program

At the NewYork-Presbyterian/Weill Cornell Concussion and Brain Injury Clinic and the NewYork-Presbyterian/Columbia University Concussion Clinic, we offer comprehensive evaluations, treatment of symptoms, and monitoring of children to ensure that they heal completely before returning to their normal activities. We also provide consultations to local high schools, colleges, and professional teams to assess the level of concussions and advise athletes about appropriate recovery times.

Multidisciplinary Team Approach

At our Concussion Clinics, multidisciplinary teams of pediatric neurologists, pediatric neurosurgeons, neuropsychologists, sports medicine specialists, neuro-ophthalmologists, physiatrists, and physical therapists assess and monitor your child's symptoms and function. We will match your child to most appropriate experts based on his or her age and symptoms.

Expertise in Post-Concussive Syndrome

While most children recover fully from a concussion after resting and refraining from activities for a recommended period, some continue to experience lingering symptoms such as headaches and/or dizziness for several weeks or even months after the injury. Our teams include specialists in such post-concussion syndrome. In addition to providing cognitive rehabilitation for these patients, our doctors are conducting research to identify factors that may raise a child's risk of developing post-concussion syndrome, such as a history of migraines. They're also studying how eye tracking, brain imaging with MRI, and tests of neurocognitive performance can predict the risk of post-concussion syndrome.

What is a Concussion

A concussion is a mild traumatic brain injury that may be sustained from a blow to the head after a fall, an accident or during contact sports. While viewed by some athletes as something they can "play through," concussions are serious injuries that need to be treated appropriately. If someone who has a concussion sustains a second concussion before healing from the first concussion, additional brain injury may occur.

Symptoms

Symptoms of a concussion may not occur immediately after injury, instead perhaps taking several days or even weeks to become evident. Although losing consciousness is a common sign of a concussion, it is possible to have a concussion without being completely knocked out.

Possible symptoms include:

  • Vertigo or balance problems
  • Visual disturbances, such as blurred vision or diplopia
  • Cognitive problems (difficulty concentrating or remembering new information)
  • Headaches
  • Increased need for sleep
  • Irritability
  • Nausea/vomiting
  • Fatigue

Children who have the following symptoms should be taken immediately to the emergency room:

  • Refusing to eat or crying excessively
  • Persistent, worsening headache
  • Continued vomiting or nausea
  • Seizure
  • Loss of consciousness
  • Amnesia regarding the event that caused the head injury
  • Worsening state of confusion
  • Slurred speech

How we Diagnose Concussion

At New York-Presbyterian's Concussion Clinics, children are fully evaluated with a complete physical and neurological examination. Patients may also undergo computerized neurocognitive testing, extended neuropsychological testing, and MRI scanning utilizing new imaging techniques to identify not just structural abnormalities of the brain, but also functional abnormalities. This testing can be performed to determine the severity of a concussion as well as to monitor a patient's recovery.

Our Approach to Care

A Prompt Evaluation

ConcussionYour child should be evaluated as soon as possible after a suspected concussion and try to schedule appointments expediently. We'll perform a physical exam and assess your child's cognitive function through tests of attention, memory, vision, reaction time, and other mental abilities. In some cases, we perform neuroimaging such as MRI. If a patient suffers aa sports-related injury, our doctors, who are team physicians for several sports teams, will apply their expertise and data they have collected regarding sports-related head injuries to devise the best plan of action for the patient.

A Roadmap to Recovery

Allowing your child to fully recover from a concussion is essential for preventing other complications down the road. We'll customize a recovery schedule for your child, using a series of cognitive, balance and neurophysiological tests, with the goal of a full return to regular levels of schoolwork and sports when your child has fully recovered.

Holistic and Comprehensive Care

At New York-Presbyterian, we recognize that every patient with a head trauma or concussion has a unique combination of symptoms, circumstances and needs. We take a holistic approach to care that considers the entire patient, including his or her physical, emotional and social factors. We partner with patients and their parents in shared decision-making, empowering them with knowledge, support, and the most effective treatment options to address their symptoms and hep them to return to their regular activities.

A Family-Centered Environment

You know your child better than anyone. As parents, you are vital members of our team. We'll rely on you and your child to let us know if your child is experiencing sleep problems or headaches, is having trouble concentrating in school, or seems anxious, irritable, or out of sorts. That kind of information is helpful to us in assessing your child's recovery from a concussion.

How We Treat Concussion

For most patients with a concussion, surgery is not needed. Patients are instructed instead to rest—physically and mentally—until fully recovered. The key to recovering fully after a concussion is preventing additional injury to the head. An additional hit to the head, particularly before the brain has recovered, can cause further damage.

In the rare instance that an intracranial hematoma (blood clot) occurs, surgical intervention is needed. Surgery involves temporarily removing a section of skull bone, a procedure called a craniotomy, and evacuating the buildup of blood.

Recovery and Evaluations

Concussion cannot be seen on MRI scans, CT scans, or other neuroimaging, therfore, our Concussion Programs focus on neuropsychological evaluations to assess the presence and extent of any damage and develop safe return-to-school, and return-to-play recommendations for children.

We work closely with schools to evaluate children who have sustained concussion to be sure their return to their schoolwork is does not aggravate the symptoms of a concussion. We work with adults, especially athletes, to make return-to-play recommendations that guard against repeat concussion and further injuries.

Post-Concussion Syndrome (PCS)

Most concussions and other mild traumatic brain injuries resolve without treatment within a few weeks, and long-term effects are very rare. Some children, however, continue to experience physical, cognitive, and emotional symptoms after six weeks, including:

  • Headache
  • Dizziness
  • Difficulty concentrating or completing tasks
  • Irritability
  • The sense that you “just don’t feel like yourself”

These patients may have post-concussion syndrome (PCS) or persistent post-concussive symptoms, which can make daily life and going to school more difficult. Over time, and especially with treatment, these symptoms will get better.

Why Choose Us

Nationally Ranked in Pediatric Neurology and Neurosurgery

U.S. News & World Report has ranked New York-Presbyterian among the top pediatric neurology and neurosurgery programs in the country, reflecting our reputation and excellent outcomes, the expertise of our pediatric neurology care teams, our high volume of cases, and other data related to patient care.

Expertise in Post-Concussive Syndrome (PCS)

While most children recover fully from a concussion after resting and refraining from activities for a recommended period of time, some continue to experience lingering symptoms such as headaches and/or dizziness for several weeks or even months after the injury. Our teams include specialists in such post-concussion syndrome. In addition to providing cognitive rehabilitation for these patients, our doctors are conducting research to identify factors that may raise a child's risk of developing post-concussion syndrome, such as a history of migraines. They're also studying how eye tracking, brain imaging with MRI, and tests of neurocognitive performance can predict the risk of post-concussion syndrome.

Multidisciplinary Care from a World-Class Team

NewYork-Presbyterian’s pediatric neurologists and neurosurgeons are internationally recognized for the diagnosis and treatment of a wide range of neurological diseases and disorders in children.  Their knowledge and clinical expertise across the entire spectrum of pediatric disorders of the brain and spine, coupled with a multidisciplinary team approach, enables them to develop expertise in very rare conditions such as gene therapy, prenatal surgery, movement disorders, cerebrovascular diseases, spasticity, and craniovertebral junction (CVJ) abnormalities.

As physicians affiliated with dedicated children’s hospitals, they collaborate with pediatric specialists in every field of medicine and surgery as needed, including child neuroradiologists, anesthesiologists, neuropathology, nurses, child life advocates and social workers specially trained to work with children.

World-Class Brain & Spine Centers

NewYork-Presbyterian’s world-class brain and spine centers, located at NewYork-Presbyterian/Weill Cornell and NewYork-Presbyterian/Columbia, offer the most advanced, comprehensive pediatric neurosurgical care to children of all ages for a wide range of pediatric brain and spine conditions, using innovative treatments and a multidisciplinary, collaborative approach.

Access to Pediatric Specialists

NewYork-Presbyterian has more top pediatric specialists than any other hospital in New York according to Castle Connolly.  Your child's healthcare team has access to all of the various pediatric medical and surgical subspecialists who practice at NewYork-Presbyterian, ensuring that all of your child's medical needs can be addressed.

Dedicated Pediatric Intensive Care Units

At NewYork-Presbyterian Komansky Children's Hospital and NewYork-Presbyterian Morgan Stanley Children’s Hospital, our Pediatric Intensive Care Units are dedicated to young patients in immediate need of intensive neurologic care, either due to trauma or disease or following complex neurosurgery. We treat children with any type of brain injury or illness, including traumatic brain or spinal injuries, status epilepticus, stroke, encephalitis, meningitis, and coma.

24/7 Patient Transfers

NYP STAT, a full-time transport system, is available to bring children to the Pediatric ICU from our network hospitals, other hospitals within the Tri-State area, and beyond. Physicians who wish to transfer a sick child from another hospital to NewYork-Presbyterian Hospital should call 1-800-NYP-STAT (1-800-697-7828), to reach the Transfer Center. They'll be greeted by a critical care nurse, who will put them in touch with an accepting physician, ensure a clean ready bed, and facilitate transportation arrangements if needed.

Seamless Access to Resources and Support Services

At New York-Presbyterian, patients and families have seamless access to our vast resources, including on-staff neuropsychologists who offer testing and treatments for emotional and cognitive issues that may occur after a brain trauma or concussion.  We also have a Parent-to-Parent program that can connect you personally with a parent whose child has been treated for the condition your child has.

Contact us

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Additional offices are located in Queens, Brooklyn, and Westchester.