The study highlights oversight in the investigation of childhood brain injuries

The study highlights oversight in the investigation of childhood brain injuries

Nearly a quarter of U.S. children with symptoms of a brain injury or concussion are not screened for the condition, with younger children particularly likely to be missed, a new national study shows.

The peer-reviewed US research published in the journalbrain injury,also shows that children with symptoms or a diagnosis of a brain injury or concussion were more likely to have symptoms of depression than other adolescents. They also had a harder time making friends.

Routine checks would help ensure such children receive the care they need, says lead researcher Priyanka Ramulu, who became interested in the topic after suffering a concussion in a car accident at age 15.

She conducted the research while in high school in Maryland and is now studying neuroscience at Duke University.

Head injuries from sports, car accidents, falls, and other types of blows to the head can be more serious in children than adults because their brains are still developing.

Previous work has shown that symptoms such as fatigue, headaches and difficulties with memory and concentration can last for years, disrupt schooling and increase the risk of self-harm and suicide in young people.

However, most of this research has been conducted on adults or children treated in clinics, and there has been a lack of information about the effects of concussions and brain injuries on youth in the general population.”

Priyanka Ramulu, senior researcher

To address this problem, Ms. Ramulu, together with Dr. Varshini Varadaraj from Johns Hopkins University in Baltimore and Dr. Samir Belagaje of Emory University in Atlanta collected data from 4,269 children ages 5 to 17 whose parents (or another responsible adult) participated in the 2020 National Health Interview Survey (NHIS), a nationally representative study.

Parents were asked whether the child had ever had symptoms of a brain injury or concussion as a result of a blow or blow to the head. Possible symptoms listed were: loss of consciousness or unconsciousness; being dazed or leaving a gap in memory; Headache, vomiting, blurred vision, or changes in mood or behavior.

They were also asked whether the child had ever been evaluated for a concussion or brain injury and whether this led to a diagnosis of concussion.

About 8.7% of children had symptoms of a concussion or brain injury and 5.3% had a formal diagnosis.

Extrapolating the results to all U.S. children ages 5 to 17 suggests that 4.6 million children had symptoms and 2.6 million received a diagnosis in 2020.

Additionally, about 23% of children with symptoms were not screened for a concussion or brain injury (representing about one million nationwide), with younger children more likely to not be screened.

The survey also included questions about the child's current psychological and social well-being.

Those who experienced symptoms or a diagnosis of a concussion or brain injury had a 60% higher risk of depression symptoms and twice the risk of anxiety than those without symptoms or a diagnosis.

They were also more likely to have taken medication to improve their ability to concentrate (70% more likely), mental health, behavior or emotions, and to have sought counseling more often (50% more likely).

“We found that just over a quarter (26%) of those with anxiety or depression symptoms received therapy or medication,” says Ms Ramulu. “If mental health problems are undertreated, this could increase the risk of self-harm and suicide.”

Children with symptoms and/or a diagnosis of a concussion or brain injury also had a harder time making friends (57% more likely).

Although the study failed to prove a causal link, the results suggest that concussions increase the risk of psychological, social and behavioral difficulties in children, the researchers say.

Limitations of the study include the lack of information about when the head trauma occurred and how severe the brain injury was. In addition, it was not clear whether the psychological problems were specific to head trauma or whether they occurred after other injuries and illnesses.

The authors conclude that there is an urgent need to screen all children for concussions and brain injuries after a blow to the head.

“Routine assessment of children who have suffered a blow to the head is crucial if children are to receive the treatments and care they need, be it medication, psychological counseling or help making friends,” explains Ms Ramulu.

“Identifying a concussion or brain injury is also an important step in preventing a second head trauma, which can be more serious and take longer to recover from.”

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