You say concussion, I say brain injury. Let's call the whole thing serious
The terms concussion and mild traumatic brain injury pretty much mean the same thing. But which term a parent hears from the doctor makes a big difference in the seriousness with which the injury is treated, a new study finds.
Injured kids whose parents hear the word "concussion" spend less time in the hospital, go back to school and other activities earlier, and run greater risks to their cognitive health than do kids whose parents are told their child has sustained a "brain injury."
The study, published today in the journal Pediatrics, tracked 268 kids admitted to a hospital in Ontario, Canada after a head trauma. Doctors there gave a third of them a diagnosis of "concussion," while the rest got some variant of traumatic brain injury -- sometimes shortened to TBI. In the days following their injuries, those with a diagnosis of concussion were 1 1/2 times as likely to be discharged from the hospital as those with a "mild TBI" diagnosis -- even though there was significant overlap between the two groups in terms of the severity of their head injuries. There was a 2 1/2 times greater likelihood that the kids diagnosed with "concussion" would go back to school early as well.
"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," said the study's lead author, Carol DeMatteo, an occupational therapist and childhood disability researcher at McMaster University, in a news release accompanying the article. "These children may be sent back to school or allowed to return to activity sooner, and maybe sooner than they should. This puts them at greater risk for a second injury, poor school performance, and wondering what is wrong with them."
Physicians' alertness to a concussion's potentially lingering effects -- including hearing loss, dizziness, memory problems, headaches, depression -- is growing, the result of the U.S. military's burgeoning experience with personnel in Iraq and Afghanistan who are showing signs of brain trauma. As described in a recent article in The Times, the challenge of caring for troops with brain injuries sustained in battle has brought new money and attention to the study of brain injury and its aftermath.
The world of professional sports, which has had years of experience with concussions, has much to contribute to the effort. But organizations such as the National Football League have shown reluctance to acknowledge what is increasingly clear to medical researchers: that patients with repeated concussions, especially those who go back to strenuous activity before their brain has healed, run a high risk of negative effects long after sustaining a bump to the head.
-- Melissa Healy