Sports-Related Brain Injuries Landing More Kids in ERs

By Carolyn Quinsey, M.D.

A small study from Cincinnati Children's Hospital is likely to get the attention of doctors and may panic some parents, given recent worry over head injuries sustained in sports such as football, soccer and cheerleading.

In the new study, published today in the journal Pediatrics, researchers found a 92 percent increase in pediatric visits to their hospital emergency room for sports-related traumatic brain injury from 2002 to 2011.

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But the overall severity of these cases appears to be decreasing. Despite the increase in cases, the "injury severity scores" were lower and the number of kids admitted to the hospital for additional care remained the same, a finding that study author Dr. Holly Hanson said indicates a higher level of concern among parents and coaches when it comes to sports-related head injury. But she added that in most cases, the worry is warranted.

"In general, the children have had a real injury, and the family is responding appropriately," said Hanson, a pediatric emergency room fellow at Cincinnati Children's.

The U.S. Centers for Disease Control and Prevention estimates there are more than a half a million ER visits annually for traumatic brain injury in children, and sports-related head injury is a significant contributor to these visits.

The most common sport causing a traumatic brain injury was football, which will come as little surprise to the public given the NFL's recent settlement with former players. Dr. Robert Cantu, a neurosurgeon and sports-related head injury expert, said the results provide hard evidence for what has been seen anecdotally.

"On athletic fields at all levels with professionals on the sideline, the recognition of concussion is going up," said Cantu, who in the past has consulted with the NFL, NBA and NHL. The reason for this increased awareness? Media coverage of head injury, which, he said, "empowers parents with the information to participate in their child's illness."

Research continues on factors as different as the physics of sports-related impacts, athlete risk factors, long-term effects, and return-to-play timelines. Of growing interest: brain imaging and visual evidence of brain damage attributed to sports injury. Soon, Cantu said, doctors may be able to better understand exactly how these injuries occur.

"We are on the cusp of seeing concussion real time on imaging," he said.

But the real hope is that researchers will one day be able to find ways that these injuries can be prevented in the first place.

Doctor's Take

There are a few important tips that parents should take to heart when it comes to sports-related concussions, according to the CDC:

  • Remove the child from play right away;
  • Go to the emergency room if the child has experienced a loss of consciousness, decrease in alertness, seizure, persistent vomiting, change in behavior, worsening headache or any worsening change that raises concern;
  • See your pediatrician if there are any lingering symptoms from the injury, which may include headache, emotional changes, difficulty sleeping, other thinking or behavior changes, or any change that has raised concern;
  • Do not allow your child to return to play until a physician advises it. Usually, return to play occurs only after all symptoms have resolved.

Doctors, patients and coaches should work together to increase detection of sport-related head injury so that worse injuries are avoided. The ultimate goal and focus of research must be prevention of sports-related brain injury in the first place. This means taking the most vulnerable children out of high-risk play, changing techniques and practice patterns to avoid dangerous impacts, and maximizing safety equipment.

While children can't be bubble wrapped, with a few important steps, sports-related brain injury can be less frequent, and the focus can return to the fun and exercise of the game.