Common head injury not taken seriously

Despite growing public interest in concussions because of serious hockey injuries or skiing deaths, a researcher from McMaster University has found that we may not be taking the common head injury seriously enough.

In a study to be published in the February issue of the journal Pediatrics, Carol DeMatteo, an associate clinical professor in the School of Rehabilitation Science, found that children who receive the concussion label spend fewer days in hospital and return to school sooner than their counterparts with head injuries not diagnosed as concussion.

"Even children with quite serious injuries can be labelled as having a concussion," said DeMatteo, an occupational therapist and associate member of the CanChild Centre for Childhood Disability Research at McMaster. "Concussion seems to be less alarming than 'mild brain injury' so it may be used to convey an injury that should have a good outcome, does not have structural brain damage and symptoms that will pass."

But despite the benign terminology, a concussion is actually a mild traumatic brain injury which could have serious repercussions.

DeMatteo and her research team at McMaster University, funded by the Ontario Neurotrauma Foundation (ONF) and the Canadian Institutes of Health Research (CIHR), analyzed medical records for 434 children who were admitted over two years to the McMaster Children's Hospital in Hamilton with the diagnosis of acquired brain injury. Of the 341 children with traumatic brain injury, 300 children had a severity score recorded and, of that group, 32 per cent received a concussion diagnosis.

The researchers found that despite the severity of the injury, children with the concussion label stayed fewer days in hospital. The concussion label was also a strong predictor of earlier discharge from hospital. Children labeled with a concussion spent fewer days away from school; they were also more than twice as likely to return to school sooner following hospital discharge.

"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," DeMatteo said.

"These children may be sent back to school or allowed to return to activity sooner, and maybe before they should. This puts them at greater risk for a second injury, poor school performance and wondering what is wrong with them."

DeMatteo said using the term "mild traumatic brain injury" instead of "concussion" will help people to better understand what they are dealing with so that they can make decisions accordingly. Particularly, as there are no universally accepted guidelines for using the concussion diagnosis in children, she said that using more specific descriptors of brain injury could lead to more consistent terminology use for both clinical and research purposes.