Concussion Program

Pediatric Concussions

Facts about Concussions

  • Mild brain injury or concussion is one of the most common injuries following a trauma
  • Leading causes of concussion include motor vehicle crashes, sports and recreational injuries, falls, and being struck on the head
  • Failure to properly diagnose and treat a concussion can lead to life-long physical, cognitive, and psychological effects
  • Concussions are difficult to diagnose and treat
  • Proper management is key to safe return to sports, school, work and other activities

Concussion Signs and Symptoms

Symptoms of concussion usually fall into four categories and can be mild to severe:

  • Thinking/ Remembering (Cognitive): difficulty thinking clearly; feeling slowed down; difficulty concentrating; difficulty remembering new information
  • Physical: headache; nausea or vomiting (early on); sensitivity to noise or light; feeling tired, having no energy; fuzzy or blurry vision; dizziness; balance problems
  • Emotional/Mood (Behavioral): irritability; sadness; feeling overly emotional; nervousness and anxiety
  • Sleep:  sleeping more than usual; sleeping less than usual; trouble falling asleep

Diagnosis, Evaluation and Treatment

Concussion clinic experts are experienced in the management of concussion in children and athletes of all ages.  Careful assessment and documentation of event history and symptoms are obtained to ensure proper diagnosis and treatment.

Specialists with the concussion team work closely with the injured patients and their families, school nurses, administrators, coaches, trainers, employers and referring physicians, to ensure a return to full activity as quickly and safely as possible .

  • Diagnosis – Concussion is any trauma induced alteration in mental status that may or may not include a loss of consciousness. Careful assessment and documentation of event history and symptoms are obtained to ensure proper diagnosis and treatment.
  • Imaging through CT and MRI may be used to rule out more serious injuries, but are not sensitive to the effects of concussion.
  • ImPACT Testing - the computer-based neuro-cognitive test provides information about the severity of the injury and the impact on functions such as memory, reaction time, visual motor skills and brain processing speed.
  • Consultative Services and therapies in the departments of Neurology, Neurosurgery, Neural and Behavioral Sciences, Orthopaedics and Rehabilitation (including sports medicine), Pediatrics, and Surgery (including trauma services) are also readily available for consultative services, if required.

The Team

Our Penn State Hershey Concussion Program provides comprehensive care to patients recovering from concussion and brain injury. A multidisciplinary team of adult and pediatric providers specializing in sports medicine, rehabilitation, neurosurgery, neuropsychology, neurology and trauma are available to assist patients with varying levels of concussion.  Speech therapy, physical therapy, occupational therapy, and educational support services are also readily available for evaluation and treatment. 


To schedule an appointment with one of our providers, call 717-531-6824

Penn State Children's Hospital, Concussion Program
500 University Drive, MC H075
Hershey, PA 17033
Fax: 717-531-3784


  • Harry P. Bramley, D.O.Medical Director, Concussion Program graduated from the Philadelphia College of Osteopathic Medicine (GME) in 1995 and completed an internship at Geisinger Medical Center in 1996.  His residency followed at Penn State Milton S. Hershey Medical Center in Pediatrics. Dr. Bramley is a board certified pediatrician who presently serves as a rehabilitation specialist and medical director of the Penn State Hershey Concussion Program for pediatrics.  Prior to his arrival at Penn State Hershey, Dr. Bramley spent six years as a pediatric trauma consultant. He is a former collegiate athlete who recognizes the benefits of youth athletics and is active with local youth athletic programs as a coach, official and board member.
  • Matthew Silvis, M.D., Medical Director, Primary Care Sports Medicine graduated from the Pennsylvania State University College of Medicine in 2002. He completed a family medicine residency at Wake Forest University in Winston-Salem, NC. After residency, Dr. Silvis practiced wilderness medicine in rural Wyoming before returning to Wake Forest where he completed a fellowship in primary care sports medicine. Dr. Silvis is currently an associate professor in the departments of Family and Community Medicine, Orthopaedics, Rehabilitation and medical director of primary care sports medicine. He serves as a team physician for the Hershey Bears Hockey Club and Hershey High School.
  • Jessica Butts, M.D.
  • Cayce Onks, D.O., M.S.
  • James Rory J. Tucker, M.D.

Tips for recovery

"Relative Rest" is very important after a concussion because it helps the brain to heal. Ignoring your symptoms and trying to "tough it out" often makes symptoms worse. Healing takes time, so be patient. Only when your symptoms have reduced significantly, in consultation with your doctor, should you slowly and gradually return to your daily activities, such as work or school. If your symptoms come back or you notice new symptoms as you become more active, this is a sign that you are pushing yourself too hard. Stop these activities and take more time to rest and recover. 

As the days go by, you can expect to gradually feel better.

Tips to help you get better:

  • Get plenty of sleep at night, and rest during the day.
  • Avoid activities that are physically demanding (e.g., sports, working-out)  or require a lot of concentration (e.g., sustained computer use, video games).
  • Ask your doctor when you can begin to safely return to your usual activities.

Returning to Regular Activity

During the recovery phase for concussion, there is increased risk for further injury. The recovery phase must include being symptom free at rest, symptom free with regular activities (such as school and work), and symptom free with high-risk activities (such as sports, working, and driving).

See the links below for more information about concussion available on the web.

Post concussive syndrome

When symptoms persist:

Click below to see the brain animation of a concussion:

Parents have an essential role in their child's recovery from a concussion. Parents are able to monitor their child best for symptoms and report changes to healthcare providers as necessary. See the links below for more details.

There are many resources available regarding concussion for healthcare providers on the web.

Click below to see the brain animation of a concussion: