One in four children who sustain a minor head injury is liable to have chronic post-concussion symptoms for years afterwards, a new study has revealed.
The research highlights the frequency with which mild head injury in children is not diagnosed, with 25.3 per cent of children who have Persistent Post-concussion Syndrome (PPCS) mistakenly thought to instead have conditions including attention deficit disorders, sleep disorders or depression.
The failure to recognise the impact can then lead to ongoing issues for children, which can include memory problems, psychological issues, sensitivity to light and noise for years afterwards, the study finds.
Professor Shai Efrati, of Tel Aviv University – which led the research with Kaplan and Shamir Medical Centers – said: “PCCS 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.”
The study examined 200 children who went to hospital A&E with a head injury and who were released after the need for medical intervention was ruled out.
The researchers tracked the subjects for a period between six months and three years from their date of discharge, and found that about one in four children released had the chronic syndrome.
“It should be understood that the consequences of brain injury during childhood continue throughout life,” says Dr Uri Bella, director of the Pediatric Emergency Room at the Kaplan Medical Center.
“Loss of any brain function will prevent the child from realising his or her potential in education and in social life.”
Unlike damage to large arteries and noticeable damage to brain tissue, with a minor head injury, the damage is to the small blood vessels and neurons, and is not detected on CAT scans of the head or on regular MRIs.
Diagnosis of the syndrome requires long-term monitoring of the manifestation of symptoms as well as the use of imaging and functional tests of the brain.
According to the researchers, the alarming findings demonstrate that changes in the approach are needed to be monitoring and treating these children.
“The purpose of an emergency room diagnosis is to determine whether the child suffers from a severe brain injury that requires immediate medical intervention,” adds Professor Eran Kotzer, director of the Emergency Rooms at the Shamir Medical Center.
“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,” concludes Professor Efrati.
“Proper diagnosis of the cause is the first and most important step in providing appropriate treatment for the problem.”
