Get unlimited digital access to baltimoresun.com. $0.99 for 4 weeks.

Head-Injury Cases in Kids on the Rise

The loud crack of Thomas Evans' first concussion startled even those on the sidelines when the high- school freshman jumped up to bounce a soccer ball off his head. Instead, he found his teammate's skull with an ear-splitting whack.

Thomas doesn't remember falling to the ground, cradling his head and yelling to his teammates that his brain was dying. Nor can the 15-year-old recall his trip to the emergency room and an MRI scan with promising news: He didn't have permanent brain damage.

But a growing number of student athletes like Thomas are being rushed to the hospital with head injuries. In the past five years, emergency-room visits for head injuries spiked 43 percent nationwide, according to a new analysis by American Association of Neurological Surgeons of data from the U.S. Consumer Product Safety Commission.

Doctors believe the staggering increase in hospital visits reflects a growing awareness among parents and coaches that head injuries are serious conditions. Public awareness campaigns have spread the message in recent years, as have celebrity injuries.

"In the past, 'having your bell rung' or 'having a dinger' were kind of blown off," said Dr. Anthony LoGalbo, a clinical neuropsychologist who runs a concussion clinic at Florida Hospital. "Now people are paying attention more and getting worried about it and going to a doctor to get evaluated."

Risky sports

Some sports are more hazardous to the head than others.

Biking injuries are the biggest culprit — about 37,000 children younger than 14 go to the emergency room with head trauma each year, according to the AANS data. Football is another sport where head injuries abound. And skateboard and scooter accidents are on the rise.

New technology for detecting concussions is trickling down from professional sports to high school sports teams. Because small but serious brain damage is hard to detect on digital scans of the brain, neurosurgeons are beginning to rely on a new type of test: computerized quizzes that test memory skills just after an injury. The NFL, NHL and even NASCAR have used the software for the past decade to monitor athlete's mental ability.

The trick is to take these mental drills before a concussion happens. At the Sports Concussion Program at Florida Hospital, LoGalbo tries to catch athletes at local high schools before sports seasons kick in. When athletes take the mental skills test before an injury — with tasks like recalling lists of random words and matching shapes after they've been rotated — doctors have a score to compare against if the athlete comes back dazed and with possible memory loss. Both the Florida Hospital clinic and the Arnold Palmer Pediatric Sports Medicine Program partner with local high schools.

Thomas' Oviedo High School soccer team wasn't screened last year. He rejoined his club team a month after his first concussion. One day into soccer practice this spring, Thomas was hit in the face with a ball and suffered a second concussion.

Time and response

The brain is fragile in the minutes, hours, and days after a concussion. Even small changes in blood flow can kill brain cells in this vulnerable period. So after each concussion, doctors told Thomas to rest in bed for several days and, literally, try not to think.

For professional adult athletes, taking time off from the game might not be so problematic. For student athletes, though, it's another story, especially as their brains continue to develop.

Thomas, who lives in Winter Springs, grew antsy in the days after his first concussion — he wasn't allowed to read, study for an upcoming math exam, listen to music or text his girlfriend. Even watching TV would be too taxing for his brain.

Thomas' mother, Jeannine Evans, said the recovery time was difficult for her, as well.

"Adults don't realize how hard it is for a kid's brain to recover," she said.

Thomas, who lives in Winter Springs, grew antsy in the days after his first concussion — he wasn't allowed to read, study for an upcoming math exam, listen to music or text his girlfriend. Even watching TV would be too taxing for his brain.

Not every bonk on the head warrants a trip to the emergency room, explains Dr. Greg Olavarria, director of pediatric neuroscience at the Arnold Palmer Medical Center, but sporting events should have adults on the sideline who know the telltale signs of a concussion.

"A child who passes out or does a lot of vomiting after the injury, or has a profound amount of memory loss should go to the emergency room for an evaluation," said Olavarria.

The best way to protect the brain is to prevent follow-up concussions from happening in the first place. After his second concussion, LoGalbo told Thomas to sit out on games and practice at least until he could do push-ups, sit-ups, and intense stationary biking without getting a splitting headache. He'll be back on the field next week in Miami for his first game after sitting out for two months.

"If I get another concussion, I won't be able to play," said the 6-foot-1 teenager. "I want to keep playing in the future."

Judging when an athlete is ready to jump back on the field is usually a subjective call, says LoGalbo. But now, trainers have a tool based on numbers, not rules of thumb.

The beauty of tracking a player's upward scores on mental tests, says LoGalbo, "is knowing when they might be eligible to go back and play."

Is it a concussion?

Though not every bonk on the head needs an ER trip, these symptoms are cause for concern:


  • Persistent headache

  • Dizziness

  • Nausea and vomiting

  • Sensitivity to light and noise

  • Problems with memory or concentration

  • Blurred vision or double-vision

  • Feeling really fatigued or tired

Source: Dr. Anthony LoGalbo, clinical neuropsychologist at Florida Hospital

Copyright © 2015, The Baltimore Sun
Related Content
Comments
Loading