football player
Cumberland Times-News, Steve Bittner/AP
Brandon Reed, an eighth-grader and quarterback for the Bishop Walsh Middle School football
team, shows the inside of a high-tech helmet Thursday, Sept. 3, 2009, that players are using
at the Cumberland, Md., school.

Concussion or Brain Injury? Both Are Serious

January 19, 2010 04:20 PM
by Colleen Brondou
A new study found that whether a child is diagnosed with a concussion or a brain injury makes a big difference in how serious the injury is perceived to be.

Concussion vs. Brain Injury

Even though “concussion” and “traumatic brain injury” generally mean the same thing, what term is applied to a child’s injury influences how seriously the injury is treated, Melissa Healy reports for Booster Shots, a Los Angeles Times blog.

The study, published in the journal Pediatrics, examined almost 270 children that were admitted to a hospital in Ontario, Canada, after a head injury. One-third of the kids were diagnosed with a concussion and the rest were labeled with some variation of traumatic brain injury (TBI). Those diagnosed with a concussion were 1 and a half times as likely to be discharged from the hospital in the days following their injuries as compared with those diagnosed with “mild TBI,” Healy writes, “even though there was significant overlap between the two groups in terms of the severity of their head injuries.” The kids diagnosed with concussions were also 2 and a half times more likely to return to school early.

“Our study suggests that if a child is given a diagnosis of a concussion, the family is less likely to consider it an actual injury to the brain,” Carol DeMatteo, an occupational therapist and childhood disability researcher at McMaster University, and the study’s lead author, said in a news release. “These children may be sent back to school or allowed to return to activity sooner, and maybe sooner than they should. This puts them at greater risk for a second injury, poor school performance, and wondering what is wrong with them.”

Background: Concussions take the spotlight

Over the last several years, there has been more focus on concussions—particular in children. Research has found that young brains don’t recover from concussion as quickly as previously thought. According to Mike Wilson, writing for The Oregonian, the headache and disorientation commonly associated with a concussion may disappear in as little as 15 minutes. But even 36 hours later, “75 percent of those with concussions still have problems with memory and cognition,” Wilson writes.

Making the problem worse, too many kids with concussions go back to the playing field too soon. In 2009, Time magazine reported on a study of athletes at 100 U.S. high schools. The study found that from 2005 to 2008, 41 percent of athletes with concussions returned to the field too soon, putting that a greater risk of second-impact syndrome.

“Concussion produces an energy crisis in the brain,” David Hovda, director of the Brain Injury Research Center at UCLA’s David Geffen School of Medicine, told Time. “A second concussion will cause such an energy demand that it will overwhelm the survival capability of the brain.”

Concussions in Girls

Most people think of high school football players when they think of concussion risk. But according to a 2007 New York Times article, even though football has the most concussions, girls competing in high school sports such as basketball and soccer are more susceptible to concussions than boys are in the same sports. In addition, girls with concussions also consistently take longer to recover from them.

“Generally speaking, the medical profession does not do a very good job in recognizing that female athletes sustain concussions at an equal or even higher rate as males,” Dr. Robert Cantu of Brigham and Women’s Hospital in Boston, told The New York Times. “It’s flying under the radar. And as a result, looking for concussions in women is not pursued with the same diligence, and it’s setting girls up for a worse result.”

Analysis: Changing attitudes about concussion

Even though the public may be getting more informed about the seriousness of concussion injuries, changing attitudes on the playing field may take more time. As Sean Gregory points out for Time magazine, sometimes, competitive coaches may push their players back on the field too soon. Other times, players themselves don’t fully report their head injuries, “with team spirit giving them too much of a warrior mentality,” Gregory writes.

“It’s really hard to break that sort of culture,” Dr. Mick Koester, who practices at the Slocum Center for Orthopedics & Sports Medicine in Eugene, Ore, told The Oregonian. “The only way to break that is with education.”

“We hear from the old guard that says we’ve always had concussions and we’ve always sent them back in,” Koester said. “The problem is, it’s a different sport now. These kids are playing 11 months out of the year. They’re bigger, stronger and faster. We recognize (the dangers) a lot more.”

Related Topic: Post-concussion syndrome

Long after a concussion is supposed to have healed, memory and emotional problems can persist. Researchers are finding that a condition called post-concussion syndrome (PCS) can affect between 30 and 80 percent of people that get concussions each year. PCS can last for months and impact memory, balance and concentration.

Reference: Concussion

WebMD presents a complete overview of concussions, explaining what they are, what causes them, symptoms, and how they are diagnosed and treated.

Centers for Disease Control and Prevention has more specific information for concussion and high school sports. Find information for athletes, coaches and parents.

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