Just over 1 in 4 children who have been discharged from the emergency room after a mild head injury develop persistent post-concussion syndrome that lasts many years. The corresponding study was published in Nature.
Post-concussion syndrome stems from micro-damage to the small blood vessels and nerves, which may only appear several months after a head injury. Symptoms often overlap with those of ADHD, sleep disorders, migraines, and depression, meaning that patients are often misdiagnosed.
For the study, the researchers included 205 children who underwent a head injury and were released from the emergency room without medical intervention, alongside 205 controls who did not undergo a head injury. They tracked these children for six months to three years.
In doing so, they found that 25.3% of those who had a minor head injury went on to develop post-concussion syndrome, whereas the same was true for just 2.4% of controls.
As damage caused by small head injuries are undetectable by CAT scans or regular MRIs, diagnosis of post-concussion syndrome requires long-term monitoring alongside imaging and functional tests of the brain. The researchers say their findings show that different approaches should be considered when treating children with a history of minor head injury.
"The purpose of an emergency room diagnosis is to determine whether the child suffers from a severe brain injury that requires immediate medical intervention," said Prof. Eran Kotzer, Director of the Emergency Rooms at the Shamir Medical Center, and one of the study’s authors, "Unfortunately, the way most medical systems operate today, we miss long-term effects and do not continue to monitor those children who leave the emergency room without visible motor impairment."
"Treatment for a wide range of disorders will change if we know that the cause of the new problem is a brain injury," said Prof. Shai Efrati, Associate Professor at Tel Aviv University and another of the study’s authors, "Proper diagnosis of the cause is the first and most important step in providing appropriate treatment for the problem."
Sources: Nature, Science Daily