Study: Concussions Not Taken Seriously

A mild traumatic brain injury is often called a concussion. But parents take an injury that's called a concussion less seriously, a new study suggests. Many parents think a concussion affects the head but not the brain.

The study looked at hospital records of 341 children with traumatic brain injury. About one-third were diagnosed with a concussion. Others were told they had a traumatic brain injury. Children diagnosed with a concussion were 11⁄2 times as likely as others to leave the hospital early. They were 21⁄2 times as likely to return to school early. These trends persisted even if a child diagnosed with a concussion had a moderate or severe injury.

The study appeared January 18 in the journal Pediatrics.

What Is the Doctor's Reaction?

Trauma to the head happens a lot. Children tumble down stairs, fall off bicycles, get hit by cars, and bang their heads playing sports. This is never good for anyone, but especially for children.

The labels "concussion" and "mild traumatic brain injury" are often used to describe the same kind of head injury. This is confusing because:

• People often believe a concussion is less serious than a mild traumatic brain injury.


• People do not even think a concussion is any kind of injury to the brain.

A study just published in the journal Pediatrics looked at how the name given to a child's head injury seems to help decide how it is treated.

Researchers looked at the hospital records of more than 400 children who were treated in an emergency room for a head injury. All of the children were admitted to the hospital. The study also looked at what happened after they left the hospital.

Children diagnosed with a concussion were more likely to:

• Be discharged from the hospital earlier


• Go about their normal activities sooner


• Return to school sooner

Concussions were not thought to be mild traumatic brain injuries. The term concussion seemed less alarming. It apparently made parents feel more at ease. Their children seemed to recover quickly and well. This occurred most often when the child had a normal computed tomography (CT) scan of the head. A normal scan showed no damage to the brain.

This study highlights that everyone does not understand what a concussion means in the same way. There is no clear definition of a concussion.

We need to be more cautious in treating and caring for head injuries. Closer follow-up and focused care should help improve outcomes.

What Changes Can I Make Now?

All concussions are some form of brain injury. Parents should remember that:

• Children with a wide range of brain injuries -- from mild to severe -- are diagnosed with concussions.
  
• Concussions in children are still serious, even if no harm is evident.


• It is often hard to assess how severe a mild traumatic brain injury is in children.


• The age of the child is important, as the brain is still developing.


• There is still a lot we don't know about brain injury in children.

It is risky for kids to return too quickly to sports or environments where they could hurt their head again.

We know it is very dangerous for a child (or an adult) to get a head injury more than once. This is a bigger problem if a second blow to the head occurs too soon after the first impact.

Protect your children's heads! They should always:

• Wear seat belts in cars


• Use helmets when playing fast-paced or impact sports, such as football, hockey or skiing

You might not see your child fall or get hit. You may not find a bruise or bump on the child's head. You should still look out for the symptoms of any impact to the head. They can include:

• Loss of consciousness


• Vomiting


• Confusion about simple things such as time or place


• Abnormal behavior or mental status


• Headaches


• Dizziness

If your child was diagnosed with a concussion, he or she does have a mild brain injury. Always monitor your child's symptoms and behavior closely right after any head injury.

Pay close attention to symptoms that get worse instead of better. Doing this can help the doctor to determine if your child really has a serious brain injury.

Fortunately, many bumps to the head do turn out to be mild. You will want to check in with your child's doctor to be sure. Make certain that the doctor answers all of your questions about how to care for your child at home.

What Can I Expect Looking to the Future?

This study shows us why we need to use more specific language to talk about medical conditions. The terms we use affect how we:

• Think about a problem


• Treat the problem


• Get the outcomes we hope for

Brain injury is a hot topic of research. We are learning more and more about the effect of mild traumatic brain injury in children of all ages.

Studies will help us to learn more about how best to identify brain injury and the extent of any damage to the head.

In addition, studies will continue to seek out the best decision-making tools to help treat head trauma in children. These rules inform a doctor's decision making, but do not replace it.