Health & Wellness
By Dwain Hebda
Try as they might, parents just can’t childproof childhood. Kids are forever finding ways to injure themselves, be it learning to walk, falling off a bike or skateboard, colliding with a playmate or one of a million other scenarios. Getting banged up, it seems, just goes with the territory of being a kid.
But even as they come to accept this fact of their kids’ lives, many parents are also becoming increasingly aware of—and concerned about—the effect of all that head trauma on their youngster. And, according to medical statistics from the Centers for Disease Control and Prevention, this isn’t just idle worry.
The CDC reports that in 2014, nearly 3 million cases of traumatic brain injury resulted in trips to the emergency room, hospitalization, or in some cases, death. Of that total, 812,000 were children.
TBI is defined as an injury caused by a bump, blow or jolt to the head that disrupts normal brain functioning, with or without the presence of other injuries. Mild TBI, commonly known as a concussion, represents the vast majority of cases every year.
“A concussion most often occurs with some type of head trauma, which could be by contact, like running into another kid playing sports, or it could be falling,” said Dr. Lauren Gibson-Oliver, a third-year medical resident in family medicine at UAMS. “It also could be an acceleration or deceleration or a rotational injury like in a car accident, ATV accident, going really fast and suddenly stopping for any reason.”
Gibson-Oliver said concussions are sometimes hard to detect by the naked eye, because children don’t always display the same symptoms. Loss of consciousness or dilated pupils alone are generally poor indicators of whether or not a concussion has occurred, she said.
“You will sometimes see loss of consciousness, but it’s really important to know that there is not always a loss of consciousness,” Gibson-Oliver said. “In kids especially, some estimates are that only about 5 percent of kids actually lose consciousness with a concussion.”
“As far as dilated pupils, that’s hard to say because some medications can cause dilated pupils. Depending on the age of the child, if they were taking any other substances, that could also cause dilated pupils. I don’t think that’s really a reliable source for parents to look at.”
Parents are also often fooled by the nature of the concussive incident itself. A person doesn’t have to suffer a blow to the head to get a concussion; a blow to the body that causes a whiplash motion can also do the trick. Football and hockey are generally seen as a breeding ground for concussions—and rightfully so—but experts warn that soccer, lacrosse or any other sport where there’s a chance for collision, falling or being struck by a fast-moving ball presents a risk of TBI.
Most garden-variety concussions clear up after a couple of days with “brain rest,” that is, staying still in a dark room and not thinking about anything. This fact might lead some to wonder what the big deal is, if the injury will just reset itself on its own.
“One thing is, the symptoms could be prolonged a lot longer than they would have been if they did cognitive and physical rest,” Gibson-Oliver said. “The other thing would be something we call second impact syndrome. If a second concussion occurs pretty shortly after a first, second impact syndrome can result in some devastating neurological injuries. That can even cause death, coma, something you can’t really recover from.”
“Another thing a lot of parents have probably heard about is chronic traumatic encephalopathy, or CTE. It’s big in the news. Football players and other athletes who have a lot of impact, people who have suffered multiple concussions throughout their lives, later in life have permanent changes in mood, behavior, cognition and, in severe cases, dementia or Parkinson’s. So, it is really important to try to prevent second concussions.”
Concussions at a glance
Boys and girls are equally susceptible to concussions; however, boys tend to incur more of them because of their participation in high-contact sports such as football and hockey.
According to Dr. Lauren Gibson-Oliver, the No. 1 sign of concussion in kids is a headache, occurring about 90 percent of the time. Dizziness, unsteadiness, difficulty concentrating and confusion or disorientation are all major red flags.
Minor symptoms in children, occurring in less than 30 percent of cases, include vision changes, sensitivity to light, nausea, drowsiness, amnesia or irritability.
Insist your children wear a properly fitted and certified helmet when riding a bike, skateboard, scooter or roller skating. Look for CPSC and ASTM certifications.
In the wake of a bump, bruise or whiplash, seek medical attention. Even if you don’t see the actual collision with another person or the ground, if your child is dizzy, disoriented or acting confused, play it safe with a trip to the emergency department.
If the injury occurred during sports, the child should immediately be removed from the game or practice and not allowed to participate further until being cleared by a physician.