Israeli study finds that one in four children with mild traumatic brain injury (mTBI) suffer from persistent post-concussive symptoms
In a large multi-center retrospective matched cohort study, Israeli scientists recently found that one in four children (25.3%) who have been discharged from the emergency room after a mild head injury suffered from persistent post- concussive symptoms.
Among the chronic symptoms seen in these children were forgetfulness, memory problems, sensitivity to light and noise, ADHD and even psychological problems. Sadly, many of these children had been misdiagnosed as suffering from unrelated ADHD, sleep disorders, depression, etc. This misdiagnosis, the researchers noted, leads to treatment that is not suited to the problem, thus causing the children prolonged suffering.
Prof. Efrati of Tel Aviv University, one of the authors of the study states that:
“Persistent post-concussion syndrome is a chronic syndrome that results from micro damage to the small blood vessels and nerves, which may appear several months after the head injury, and therefore is often misdiagnosed as attention deficit disorders, sleep disorders, depression, etc. There are cases where children report headaches and are diagnosed as suffering from migraines or, for example, children who report difficulty concentrating and the doctor prescribes Ritalin. Unfortunately, these children continue to suffer for many years from various disorders and, instead of treating the real problem, which is the syndrome, they receive treatments that usually do not solve the problem.”
“It should be understood that the consequences of brain injury during childhood continue throughout life,” adds Dr. Uri Bella, Director of the Pediatric Emergency Room at the Kaplan Medical Center, one of the other authors of the study. “Loss of any brain function will prevent the child from realizing his or her potential in education and in social life.”
Children who had pre-existing neurological, neurosurgical or psychiatric problems were excluded from the study. The study also excluded children who were hospitalized for more than 48 hours, suffered multi-trauma injuries, or had a positive CT scan.
In comparing the prevalence of post-concussive symptoms between 6 and 60 months post-injury, the authors found no decline in symptoms, suggesting that the 25% of children with persistent symptoms “are expected to have a chronic unremitting syndrome.”
A surprising finding in the study was that loss of consciousness was found to be related to a lower, not higher rate of persistent post concussive symptoms.
This study highlights the importance of carefully following children in the months following concussion, recognizing symptoms that arise, and providing appropriate treatment.