Heads Up! New Program Improves Diagnosis and Management of Concussion in Kids

Kids these days. They bonk their heads. Often. More than 2.4 million U.S. children each year suffer sports-related traumatic brain injuries, according to the Centers for Disease Control and Prevention. While a majority of these are ‘mild’ concussions that cause relatively brief effects, severe injuries may cause prolonged or severe symptoms and may require long-term treatment or assistance.

More Than Just a Bump on the Head?

What makes a bump on the head a concussion? Acting like a cushion, the spinal fluid normally keeps the brain from banging into the skull. But when the head is hit too hard, the brain can suddenly crash into the skull and temporarily stop functioning normally. That’s a concussion.

Symptoms of concussion may appear mild, but can lead to lifelong problems that impair a person physically, psychologically and cognitively, particularly if the brain is not allowed to heal. Two concussions within a short period of time create even greater risk. Some patients may have symptoms that persist over time, which is known as post-concussive syndrome.

After a head injury, it is imperative that children rest until they are fully recovered, says Sue Kirelik, MD, Medical Director of Pediatric Emergency Services and Pediatric Department Chair at Sky Ridge Medical Center. This includes mental rest as well as physical. “After a concussion, you do not want to increase blood flow to the brain from physical or mental activity,” she says. “Metabolic demand on the brain can cause dizziness, nausea and other symptoms, so rest is the only treatment.”

Research shows that kids who rest after a concussion recover significantly more quickly than those who do not. Most children recover in about a week, but some require a lot longer — so that could mean a child must stay home for a matter of days or weeks, or in rare cases, even months.

The ImPACT™ Test Program at Sky Ridge Offers Parents a New Tool

While children may not want to admit that they are experiencing symptoms after a head injury, objective testing now provides a way to clearly measure whether or not they are back to normal.

The Pediatric Emergency Department at Sky Ridge now uses the leading-edge ImPACTTM Test Program (Immediate Postconcussion Assessment and Cognitive Testing) to diagnose concussion and determine how well a child is recovering. Testing involves a computer-based assessment of neurocognitive parameters such as reaction speed, mental processing, memory and other brain functions.

Because head injuries are frequently under-recognized and under-treated, Sky Ridge pediatricians now work hand in hand with local schools to ensure optimal treatment of their students. “Before the start of the athletic season, all athletes in the Douglas County School District undergo a baseline ImPACT test,” says Dr. Kirelik. “If they injure their head, they are retested and compared with their base- line. This helps identify who has had a concussion and how they’re recovering.”

Sky Ridge also developed a protocol to communicate with school nurses and primary care physicians in order to ensure that children are carefully observed in school and at home, and that they abstain from activity as long as needed.

“Since most parents don’t know they should tell the school about a head injury, it helps if we tell the school up front. This is a unique and far more effective approach,” Dr. Kirelik says.