A concussion is a brain injury resulting from a blow to the head. Not the kind of injury you can see on a CT scan or MRI — there’s no broken bones and no squashed or visibly damaged brain. But nonetheless, the brain is damaged. Symptoms tell you immediately after a concussion that the brain has been affected. Sometimes, a person is knocked out cold, but a concussion can occur without unconsciousness. Milder symptoms can include disorientation, confusion, and problems with memory and balance. With time and rest, these symptoms will usually improve, especially after a first concussion.

But sometimes concussions can cause real, lasting brain damage. After a concussion, athletes (both professional and student) can suffer from poor attention, headaches, memory problems, and depression — symptoms that may or may not get better with time. Unfortunately, young athletes may be more at-risk than the pros. Young brains are still developing, and are more likely to be injured. There’s also some genetic variability — some people are more resilient than others to the effects of concussions. Repeated concussions can be dangerous to anyone, and a “second hit” after a concussion that hasn’t completely healed can be deadly.

As I tell the teenagers: “Protect your brain. You may need to use it later.”

What can parents and coaches do to help keep their kids safe?

• Provide good training so young athletes know how to play safely. Support coaches who teach student athletes well, and take potential brain injuries seriously.
• Make sure that athletes have good protective equipment, including helmets and mouth guards. These don’t prevent all (or even most) concussions, but using them consistently and correctly is still important.
• School systems should have mandatory, science-based concussion management systems, developed in accordance with national guidelines.
• Officials and referees need to call fouls, and discontinue play when it’s dangerous. Players who put themselves or others at risk should be sent off the field without hesitation.
• Coaches on the sidelines need to look for even subtle signs of concussion in their players, and pull them out of the game if there are any signs at all. When in doubt, players should sit out.
• Players themselves need to know that they should never tough it out — any “dinger” needs to be reported, even if that means they’ll be pulled from the game. Brains are far more important than scores.
• If your child does have a concussion, be sure to follow the guidance of his physician. A gradual return to sports should not begin until all signs and symptoms of concussion have resolved. And if symptoms occur with activity, you must back off again.
• If your child has had more than one concussion, or a concussion with prolonged symptoms, consider working with a neurologist to ensure that there’s no lasting damage.

Roy Benaroch is a pediatrician who blogs at The Pediatric Insider. He is also the author of Solving Health and Behavioral Problems from Birth through Preschool: A Parent’s Guide and A Guide to Getting the Best Health Care for Your Child.