The “Silent Injury”
In the last few years, concussions in young people have come to the forefront of medical studies. Concussions are unpredictable, hard-to-diagnose injuries that require vigilant treatment and care for a number of physical, cognitive, and emotional symptoms that do not always present immediately, which is why they’re often referred to as the “silent injury.” Thankfully, along with this added attention, new data is being compiled to help medical professionals better understand these injuries. Two recent studies published in Pediatrics address the severity and length of symptoms related to concussions, also known as mild traumatic brain injury (mTBI). Both of these studies are changing the way that these injuries are being interpreted and provide useful information about how they affect the health and wellness of young people.
Acute Concussion Symptom Severity and Delayed Symptom Resolution
The first study was conducted by a group of physicians and professors in Colorado from October of 2010 through March 2013 and was released in Pediatrics in June of this year. The study is entitled, “Acute Concussion Symptom Severity and Delayed Symptom Resolution,” the hypothesis of which was that the severity of acute concussion symptoms in youths could determine overall severity of the injury itself and the likelihood of Delayed Symptom Resolution (DSR), a definitive feature of Post-concussive Syndrome (PCS) that involves the presence of three or more symptoms 30 days after the injury that had not been previously observable. The hope for this area of research is that identifying an increased risk for DSR at the initial screening could help plot the most effective course of treatment from the earliest stages of recovery.
The study tracked 179 individuals ages 8 to 18 who had suffered a concussion less than six hours prior to being admitted to the Emergency Department (ED) and presented severe acute symptoms. Counter to the authors’ hypothesis, after following up with the patients one month after the initial screening, the study found that only 38 subjects (21%) met the criteria for DSR, which determined that initial symptom severity is not necessarily associated with DSR. This suggests that acute symptom reporting alone is not an accurate reflection of the physiological and psychological factors that ultimately lead to DSR.
Unfortunately, the findings of this study do little to clarify the potential long-term symptomatic responses to a youth concussion, regardless of the severity of the symptoms at presentation. However, this research does reinforce the need to continually monitor the patient after ED discharge, as the severity and longevity of concussion-related symptoms cannot be conclusively ascertained at the initial screening.
Duration and Course of Post-concussive Symptoms
“Duration and Course of Post-concussive Symptoms” was published in May of this year. The authors include a small contingent of medical doctors who worked in conjunction with Harvard Medical School to conduct their research. Their goal was to evaluate the length, range, and severity of symptoms in children during the weeks and months following the initial injury, and their findings represent the most comprehensive examination yet of pediatric concussion symptoms.
Children in this study who visited the ED presented with concussion symptoms commonly consisting of headaches, fatigue, and delayed cognition (taking longer than normal to think). However, for most of those injured, these initial symptoms abated within two weeks of suffering their mTBI: One month following the injury, nearly 25% of children were still dealing with headaches, 20% reported fatigue, and nearly 20% complained of delayed cognition. For most children, however, these initial symptoms were replaced with a number of others that developed in the weeks following the injury. These included irritability, general frustration, poor concentration, difficulty sleeping, and depression.
A more thorough understanding of how mTBI symptoms progress has a number of benefits for everyone involved. Patients will have a better understanding of the recovery timeframe and everything that goes along with it, which could potentially prevent additional stress related to their seemingly incoherent symptoms. Families and teachers can use this knowledge to better accommodate patients’ anticipated obstacles at home, on the athletic field, and in the academic sphere. Lastly, health care providers can more readily identify and understand symptoms that may otherwise have been viewed as atypical or even unrelated. This could reduce unnecessary testing and physician referrals, clarify post-concussive evaluations, and help to better inform patients and their families about an efficient treatment plan.
Each of these studies was carried out by professionals recognized for excellence in the field of childhood brain injury. They both incorporated ample study samples, exhaustive data compilation, and carefully considered interpretations of the findings. Still, despite this excellent work, the after-effects of concussions remain as unpredictable as ever. The first study found that initial symptom severity has no necessary causal component to overall length and severity of the mTBI, reminding all involved to remain cautious and vigilant during the recovery period. And while the second study did pin down a series of physical, emotional, and cognitive symptoms that are common to most children who have experienced a concussion, both at presentation and during the subsequent weeks following the injury, the fact that no two concussions are ever identical reinforces the need for follow-up treatment and regular monitoring.
If it is determined that your child has suffered a concussion, you can trust the expert staff at Crosley Law Firm to assist you in every way possible. Childhood concussion symptoms vary in length, severity, and presentation, but Crosley can direct you to the most experienced and respected medical resources nationwide to procure an accurate diagnosis and develop a tailor-made treatment plan for your child. They can also help you seek compensation if your child’s injury came as the result of another individual’s behavior or negligence. Learn more by visiting the Crosley Law Firm website at crosleylaw.com or by contacting them today at (877) 535-4529.
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