‘Long concussion’ plagues 1 in 4 kids after even a mild head injury — Israeli study

Prevalence of post-concussion aftershock hampers recovery, say researchers, hoping study will lead to better understanding and treatment of health complaints after brain trauma

Nathan Jeffay is The Times of Israel's health and science correspondent

Illustrative image: A child with a head injury (iStock via Getty Images)
Illustrative image: A child with a head injury (iStock via Getty Images)

Children are undergoing unnecessary suffering after head injuries, because the knock-on effects of brain trauma aren’t understood, according to new Israeli research.

A team of scientists and physicians wrote in a peer-reviewed study published in Scientific Reports that post-concussive syndrome — a set of health aftershocks from concussion — is “prevalent and vastly under-diagnosed.”

After monitoring 200 children in the three years after a mild head injury, the team found that one in four suffered from chronic post-concussion syndrome.

Lead author Prof. Shai Efrati said it can be understood as a “long concussion” of sorts, akin to long COVID.

He explained that this means that children are diagnosed with forgetfulness, memory problems, sensitivity to light and noise, ADHD and even psychological problems.

Efrati said that more awareness of post-concussive syndrome would mean doctors who are approached with health complaints could more widely assess whether a previous head injury is relevant, and if so give more accurate diagnoses and better treatment.

“After head injury it’s common for children to complain of headaches, or difficulty concentrating at school, but it’s often diagnosed simply as migraines or treated with Ritalin,” Efrati told The Times of Israel.

“They often continue to suffer for many years from various disorders, instead of getting treatment for the real problem, which is the syndrome,” he said, adding that the research will boost awareness among doctors.

Illustrative image: a neurologist looks at brain scans (iStock via Getty Images)

Efrati conducted the research with collaboration from the Kaplan Medical Center and Shamir Medical Center.

One of Efrati’s collaborators, Prof. Eran Kotzer, emergency room director at the Shamir Medical Center, said that his field of medicine is tasked with determining whether the child suffers from a severe brain injury that requires immediate medical intervention.

But when there are no obvious signs of lasting damage, “the way most medical systems operate today, we miss long-term effects.”

Prof. Shai Efrati of Tel Aviv University (courtesy of Tel Aviv University)

It’s hard to spot from imaging how much lasting damage exists after a moderate or mild brain injury.

The damage is to the small blood vessels and neurons — and it is not detected on CAT scans of the head or on regular MRIs.

But Efrati said that while monitoring is challenging, assuming that children are fully recovered and treating them as such could be harming their long-term health.

“The fact that post-concussive syndrome is widespread suggests we should be more cautious with children after a head injury,” he said.

“Further harm to the head can damage their recovery, and just as you wouldn’t send a child who just recovered from a broken leg to play soccer, there is a need for children recovering from head injuries to act more cautiously,” he warned.

Efrait stressed that parents of children who are recovering from head injuries should consult with doctors to decide how to strike the right balance between freedom and caution.

Dr. Uri Bella, co-author and director of the pediatric emergency room at the Kaplan Medical Center, said the study is a wake-up call regarding the lasting effects of brain injuries.

“It should be understood that the consequences of brain injury during childhood continue throughout life,” she said. “Loss of any brain function can prevent the child from realizing his or her potential in education and in social life.”

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