Epidemic of Under Diagnosed Pediatric Concussions
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Epidemic of Under Diagnosed Pediatric Concussions

Tuesday, November 28, 2017By Richard Alexander and Nina Shapirshteyn

A recent article out of Medpage Today highlights the epidemic of “grossly” under diagnosed pediatric concussions in emergency departments. With more research about traumatic brain injury (TBI) and Chronic Traumatic Encephalopathy (CTE) in football players emerging, parents of school-aged athletes are rightly concerned. In the recent investigative study involving the New Jersey Medical School’s Department of Emergency Medicine in Newark, findings were disturbing, to say the least. Essentially, concussions were “grossly” under diagnosed in children seen at a pediatric Level 1 trauma center emergency room department. The research also found that concussions were more likely to be under diagnosed in patients who presented with sports related injuries, rather than in car accidents.

Concussions Under Diagnosed in Child Patients

According to the article, more than 60 percent of children who showed signs of concussion at University Hospital’s emergency departments were not diagnosed as having one. Researchers have concluded that providers need to be better educated about recognizing the signs and symptoms of TBI, especially in the vulnerable developing brains of children. The research team used established criteria to look at the emergency department’s records to analyze what patients manifested signs and symptoms of a concussion and how often those patients were diagnosed.

Concussions and Youth Sports

Sports injuries are a huge concern for parents in California and across the nation. Not only is there concern for whether or not potential concussions and TBI are properly identified on the field, we now have to worry about whether or not children will be accurately diagnosed in an emergency room department setting. The study found that head injuries sustained during sporting events were under diagnosed more often than head injuries suffered during car accidents.

Improving Concussion Diagnosis in Emergency Rooms

Although this was a single-center study, researchers suspect findings will be similar elsewhere. TBI, concussions and other head injuries are known as “invisible” injuries for a reason. More often than not, a concussion or TBI won’t leave a visible scar behind, and that’s why it’s critically important for health care providers in emergency room departments to be vigilant, highly trained and educated to diagnose a concussion when they’re presented with a patient who is exhibiting the telltale signs and symptoms.

We strongly recommend that parents and care providers treat a closed head injury, even when re-assured that it is minimal, with appropriate rest, postponing sports and physical activities that are risky and to be observant. While there is no known remedy other than rest and providing time for a closed head injury to heal, children enjoy growth hormones that commonly provide sound recoveries. While recovery is underway, it is important to go proceed with caution and to follow up with teachers, pediatricians and pediatric neurologists. Expect the most common symptoms in recovery which are fatigue and difficulty sleeping and stay alert for changes in activities and behaviors.

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