Concussions and the Longer-Term Effect on Children's Brains

 Andrew Mayer, PhD, and his team at the Mind Research Network and University of New Mexico recently analyzed the brains of children ages 10 to 17 that recently suffered mild traumatic brain injuries. Although this was a small study, comparing 15 concussion sufferers with 15 healthy participants, the results have some alarming implications for children post-concussion. Previous studies have demonstrated that concussions affect the brain’s white matter, which is responsible for transmitting information throughout different regions of the brain. In the children tested soon after sustaining a concussion, there was evidence of structural changes in white matter on top of the cognitive symptoms typically associated with concussions. Although the patients no longer reported symptoms in their follow up appointments about 3 months later, Mayer and his colleagues found that the changes in white matter remained.

As Mayer notes, “The magnitude of the white matter changes in children with mild traumatic brain injury was larger than what has been previously reported for adult patients…This suggests that developmental differences in the brain or the muscular-skeletal system may render pediatric patients more susceptible to injury.”  While a child may seem to have recovered from a concussion once symptoms subside, it is possible that their healing is not yet complete. This raises the important question of when it is actually safe for them to participate in activities that risk sustaining a second concussion. Extra care must be taken treating concussions in youth to prevent subsequent injuries that could harm their developing and “already vulnerable” brains.

Further research is needed to determine whether these changes in white matter in children are permanent or only part of an extended recovery process after a concussion. Hopefully these findings will serve as a catalyst for subsequent studies to help keep kids safe.

Follow the below links to read more on Medical Xpress or Health Day…

MedicalXpress: “Concussions Affect Children’s Brains Even after Symptoms Subside”

Health Day: “Brain Changes Continue after Child’s Concussion”

David Dobbs: "A New Focus on the 'Post' in Post-Traumatic Stress"

In David Dobbs's recent article published in the New York Times, he describes new research highlighting the pivotal role that a welcoming and positive environment can play in helping victims of traumatic events return to a normal life. As Dobbs elaborates, "The environment just after the event, particularly other people's responses, may be just as crucial as the event itself." Contrary to popular belief, a traumatic experience does not automatically resign a person to post-traumatic stress disorders.

In one study, George Washington University's Dr. Brandon Kohrt (seen lecturing in the above photo) observed 141 former child-soldiers from Nepal's 10 year civil war as they re-assimilated into their villages. All of the children had been torn from their families and experienced violence and other horrors of the war. The research demonstrated that "In villages where the children were stigmatized or ostracized, they suffered high, persistent levels of post-traumatic stress disorder. But in villages that readily and happy reintegrated them (usually via rituals or conventions specifically designed to do so), they experienced no more mental distress than did peers who had never gone to war."

While these findings don't promise an easy healing process for those that suffer traumatic events, they certainly give hope that the healing is possible.

See David Dobbs's article, "A New Focus on the 'Post' in Post-Traumatic Stress," here...

Preventing Injuries through Smart Budgets

Amidst the polarizing budget talks taking place in Washington, some of the most important issues are seemingly forgotten. Kate Carr, the President and CEO of Safe Kids Worldwide, recently wrote the Office of Management and Budget as a reminder of "...the vital role of the federal government in keeping kids safe." In her letter, Carr advocates for the adequate funding of 3 crucial agencies that help prevent childhood injuries: the Consumer Product Safety Commission (CPSC), the National Highway Traffic Safety Administration (NHTSA), and the National Center for Injury Prevention and Control (NCIPC).

With the proper resources, these agencies can continue to successfully protect children and fulfill their missions.

Specifically, the Consumer Product Safety Commission has been instrumental in preventing dangerous toys and children's products from crossing our borders. According to the U.S. Customs and Border Protection and the CPSC, in 2012 the agencies confiscated two million units of products, many of which were children’s toys with toxic amounts of lead.

Second, the National Highway Traffic Safety Administration has led the charge in reducing childhood injuries sustained in motor vehicle accidents. The agency has successfully discouraged distracted and drunk driving through statewide grant initiatives, promoted awareness about the proper use of child safety seats, and established a graduated driver license grant program to better train teenage drivers.

Finally, the National Center for Injury Prevention and Control "...is the only federal entity that focuses on injury and violence prevention in the home, recreational and other non-work settings." One of its main initiatives has been the National Action Plan for Child Injury Prevention which increases awareness about the problem of childhood injury and promotes solutions by uniting the efforts of various organizations under a common vision and strategy.

Clearly, these agencies stand out for their important work in raising awareness and preventing childhood injuries. To make sure that the importance of these organizations stays on politician’s minds this budget season, a simple letter such as Ms. Carr's can go a long way!

Click here to read Kate Carr's letter to Acting Director Jeffrey Zients of the Office of Management and Budget.

The "Heads Up, Don't Duck" Initiative for Safer Hockey

Through the “Heads Up, Don’t Duck” initiative, the Mayo Clinic aims to teach hockey players valuable techniques to play the game safer and prevent spinal cord injuries. Check out the below video to see the Clinic’s recommendations. Click here to read more about Heads Up, Don’t Duck on the Mayo Clinic’s website.

Update on Thursday, December 27, 2012 at 8:17AM by Minutes for Memories

Check out this related article arguing that rules against excessive aggression in hockey can lead to fewer injuries. Dr. Michael Cusimano, neurosurgeon and expert on sport-related brain injuries, advocates the widespread implementation of the Fair Play Program, which considers sportsmanship in league ranking and tournaments. According to Dr. Cusimano, “Given that brain injuries are so common and that they can have permanent effects, we need to introduce measures that we known have been shown to work to reduce the numbers of children and youth suffering these injuries in sport. Rule changes essentially alter the culture of a sport and clearly define acceptable behavior for players, coaches, parents, and officials.” 

Working to remove high-risk behaviors, such as hits to the head, board checks, and checks to the back, from the hockey culture can make the sport safer for the children that play.

See this article and more from Dr. Cusimano here on MedicalXpress.com: “Rules Limiting Aggression Should Reduce Hockey Injuries”

"Toxic Stress Derails Healthy Development"

This video by the Center on the Developing Child at Harvard University shows how "toxic stress" can inhibit a healthy, normal development in children. The term toxic stress refers to "...the strong, unrelieved activation of the body’s stress management system in the absence of protective adult support."

For children living with injuries, this video attests to the importance of having a solid network of support to help them conquer the obstacles they face and to make sure that toxic stress doesn't become one of them.

Also, click here to read more on the Center on Developing Children's website.