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Brain Injury Prevention this Spring/Summer

posted by SK Brain Injury    |   March 29, 2012 16:29

With Spring and Summer fast approaching, we are sharing some tips to keep you and your children safe.

PREVENTION is the only known cure for brain injury!

Brain Injury Association of Michigan President shares how to help protect children from harm by following these selected seasonal safety facts from the Brain Injury Association of America’s seasonal brochures:

Spring

  • Bicycle incidents are most likely to occur within five blocks of home. Teach by example. A bicycle helmet is a necessity not an accessory.
  • Baseball has the least amount of safety equipment required of any youth sport. Check that your child’s baseball helmet meets standards of the national Operating Committee on Standards for Athletic Equipment.
  • Falls are the most common cause of playground injuries. Check the surface under playground equipment. Avoid asphalt concrete, grass and soil surfaces. Look for surfaces with shredded mulch, pea gravel, crushed stone and other loose surfaces.
  • Two-thirds of all-terrain vehicle accidents have involved children under 16 years old. Model safe behavior by always wearing helmets with face protection and protective clothing.
  • Brain injuries occur when skaters fall and hit their heads on the pavement. Wear a helmet for protection against falls.
  • Brain injury is the leading cause of death among children hit by cars. Always stop at the curb or edge of the road; never run into the street.

Summer

  • Most children who survive drowning are found within two minutes of being under water; most who die are found after 10 minutes or longer. Always supervise your child around water.
  • Alcohol use is a leading factor in boating incidents and deaths. Stop your child from riding in a boat with anyone who has been drinking alcohol.
  • A bicyclist who is wearing a helmet is less likely to die, be seriously injured or become disabled if hit by a car. Buy a helmet that meets the safety standards of ANSI , Snell or ASTM. Tighten chin strap to keep helmets from slipping forward or backward. Only two fingers should fit under the chin strap Place the helmet directly over the forehead.
  • Screens are designed to keep out bugs, not to keep in children. Install child safety window guards

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Brain Injury Effects on Children: Larger than Experts First Thought

posted by SK Brain Injury    |   January 24, 2012 11:15

Young children who suffer a severe head blow may not overcome the traumatic brain injury (TBI) as well as previously believed, and interventions may be needed even years after, according to two new studies out of Australia.

For the first study, Australian researchers looked at 56 children, 40 of whom were injured between ages 2 and 7 and the other 16 who served as a control group. They found that a decade after each of the 40 suffered a TBI, evidence persisted of intellectual deficits. The study is published this week in the journal Pediatrics online and will be included in February's issue.

They looked at the intellectual, adaptive and executive abilities of the children, as well as their social/behavioral skills. Those with severe TBI tested lowest on IQ exams compared to a control group — as much as 18 to 26 points lower. They also found that regardless of how serious the injury was, recovery "seemed to plateau in the five- to 10-year range," the researchers said.

A release announcing the findings noted that "this is important because it counters the theory that children 'grow into the deficits' and suggests that even many years post-TBI, intervention may be necessary and helpful."

Most of the children in this study were injured by car accidents or a serious fall. They were tested at the time of their injury, then tested again three, six and 18 months after the injury, as well as again at five years and 10 years.

The findings apply to major brain trauma, not to cases of mild concussion or bumps on the head.

"Most of the deficits occurred in higher learning skills such as organization, planning and reasoning, because these are centered in the frontal regions of the brain, which are most often affected in head injuries," wrote Alice Park on a blog for Time magazine.

"These regions are also the ones that develop fastest early in life, so any injury that disrupts the normal trajectory of nerve growth can have long-lasting effects," said lead author Vicki Anderson, director of critical care and neuroscience research at Murdoch Children's Research Institute in Melbourne, Australia. Scientists have long talked about the brain's plasticity and its remarkable ability to reroute signals when something injures the brain. Some researchers believe that injuries to very young children are more apt to be overcome for that very reason than brain injuries in older children and adults. But Anderson noted that young children's brains are not fully developed and, after injury, development lags and may not catch up. "If you look at the trajectory of improvement over time, normal kids have one trajectory, while those with brain injuries have the same trajectory but start out at a much lower point," Anderson told Time.

The study did note a positive: Brain development after a traumatic brain injury does not appear to grind to a halt, as some had theorized.

The other study, also published in Pediatrics this week, found that socioeconomic status might be an even stronger predictor of intellectual development than simply having suffered a traumatic injury to the brain. They told CNN that lower socioeconomic status, high parental stress and low parental involvement affect a child's recovery after TBI and that might account for it.

Article from Deseret News

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Kids and Concussion

posted by SK Brain Injury    |   December 19, 2011 12:00

He may be the Mayor of Brantford but he's also a hockey dad and like a lot of other parents these days Chris Friel is disturbed by what he sees happening on the ice.

"The fun is being taken out of the game," Friel said. "There are kids who are getting hit and injured -some really badly -concussions are spiralling right out of control.

"These are the kinds of injuries that can really affect kids in the future."

He and others are so concerned they have formed a Dangerous Play in Sports task force to bring everyone involved with sports -governing bodies, referees, coaches, players and parents -together to help make playing both fun and safe. The task force is starting with hockey and includes representatives from local hockey associations.

"We want to put fun back into the game," Friel said. "There's a lot of the 'get'em, hitem, kill'em' out there right now and we want to get rid of that kind of attitude, take it out of the game.

"There's nothing wrong with a good clean hit but there is something wrong when the game becomes all about hitting."

Although the task force intends to look at all contact sports, it's starting with hockey because it's the sport that gets most of the attention when it comes to concussions. A lot of that attention is the result of hockey star Sidney Crosby being forced to stay on the sidelines for more than 10 months after suffering a concussion in January.

With Crosby unable to play, the NHL was missing its best player and his injury created widespread awareness of the devastating impact concussions can have on an individual. That awareness has become so pronounced parents, players, coaches and officials are taking steps to improve safety and cut

down on hits that could lead to concussions.

Just prior to the start of the season Hockey Canada approved a new head contact rule that reflects a zero tolerance approach to hits to the head, neck and face. Under the new rule, a minor penalty is to be assessed to a player who accidentally hits another player in the head, face or neck.

When the hit to the head is judged to be intentional, the offending player is to be assessed a double minor penalty or a major penalty and a game misconduct.

Locally, the Brantford Minor Hockey Association has implemented a concussion management program that includes baseline testing for representative teams this season. The goal of the program, which is operated in co-operation with the Clinical Medicine Research Group Ltd., is to ensure players who suffer concussions don't return to the ice too soon.

In addition to education and information about concussions, the program includes neuro-cognitive testing, proper medical management and research.

The program is in its first year and covers 12 teams from pee wee to midget and is being very well received by coaches, players and parents, said Todd Francis, the director of risk management for the Brantford Minor Hockey Association.

So far, about 12 players have been part of the program after suffering concussions.

Making sure kids who have concussions take enough time off to heal and don't return to the ice too soon is a big part of the program. But so is education and awareness for everyone involved including parents, trainers and coaches, Francis said.

"One of the things you have to remember is that minor hockey, like all of these sports, is driven by volunteers and one of the things we've done is provide them with pocketbook-sized card to help them recognize the signs of a concussion," Francis said. "We don't expect them or want them to be able to diagnose a concussion, that's not their job.

"But we want them to be able to recognize the symptoms so that a kid who gets hit hard and might have a problem doesn't go back on the ice until he or she is checked out. We want to give them the best information possible so they can make good, informed decisions."

The card includes the signs and symptoms of a concussion as well as a way of testing memory function and a player's balance.

Under the program, players who have suffered a concussion are examined by specialists who help determine the severity of the injury and develop a treatment plan.

The program is also an opportunity to collect data and keep track of players.

Association officials plan to review the program at the end of the season and are looking to expand it to all travel teams with the idea of encompassing all teams under the association's banner including house league.

He couldn't say for sure how many other associations across the province have a similar program. However, a lot of associations either have or are looking at introducing something similar because everyone involved in hockey is taking concussions far more seriously these days.

He believes its only a matter of time before such programs and policies become mandatory for all minor sports associations.

Francis is a Brantford Alexander's Alumni who played for the team when they were an Ontario Hockey League Junior A team in the early 1980s. He was drafted 35th in the second round of the NHL entry draft in 1983 by the Montreal Canadiens and played for several teams including the Brantford Smoke of the Colonial Hockey League in the mid-1990s. His playing career included the Oshawa Generals, the Flint Generals, Saginaw Generals and the Jacksonville Bullets as well as the Brantford Smoke when they were part of the Colonial Hockey League.

In addition to being the director of risk management for the Brantford Minor Hockey Association, Francis is part of the Dangerous Play task force.

The task force has the potential to do a lot for hockey and other sports but its important for people to understand what the task force is trying to accomplish, he said.

"There had been some discussion leading up to this and I think there was some apprehension amongst some groups as to what the task force was going to do," Francis said. "I think it's important people realize that we're not trying to change the rules of the game, that's the job of the governing bodies.

"What we want to do is bring everyone together to see what we can do to make playing sports a better experience for everyone involved especially the kids."

By way of example, the task force might be able to help improve communication between all of the groups involved in minor hockey especially between the coaches and hockey referees.

"One of the issues we need to address is the recruitment and retention of referees," Francis said. "Retention is a huge problem because some people start out refereeing but soon give it up because they get tired of the abuse and lack of respect."

In hockey, and he suspects a lot of other sports, a lot of people involved in a game get too caught up in specific calls that were made or missed by an official. Instead of having huge arguments about specific incidents, the idea of the task force is to look at the big picture and see what can be done to improve the game locally.

"Ultimately, we're all responsible for the product that gets put on the ice and we all want it to be the best product possible," Francis said.

And yes, he acknowledged, some of the work of the task force is to help market the community which already bills itself as the Tournament Capital of Ontario.

"We want people to come into our community, play in tournaments and when they go home we want them to leave with the feeling that they've had a good experience," Francis said.

Brad Cotton is a hockey dad, the trainer for his 12-year-old Michael's competitive team and a member of the Dangerous Play Task Force.

"We want our kids to be competitive but we also want them to be safe," Cotton said. "I think we have to remember that these kids have to have a life outside of hockey.

"The vast majority of them will have to be able to function in school or in a workplace outside of hockey. Even those who do make it to the NHL have to be able to function once their career is over."

To do that they need to be able to use their brains and society is just now starting to understand the damage caused by concussions, he said.

"These kids represent our future but what kind of a future will we have if they are brain damaged as a result of too many concussions," he said. "I worry about my son when he's on the ice, that's why I became a trainer.

"I want to do what I can to help keep him safe."

Carol DeMatteo was pleased to hear about the steps being taken by city and Brantford Minor Hockey Association officials with respect to keeping kids safe.

She is an associate professor at the School of Rehabilitation Science at McMaster University and runs the acquired brain injury follow-up clinic at McMaster Children's Hospital.

More sports leagues and associations need to follow the example set by Brantford just as parents and coaches need to pay closer attention when a child is hit in the head.

"People really need to pay attention when a child hits his or her head," DeMatteo said. "They need to take it seriously and not let their child go back to doing what he or she was doing because they're going to get another injury.

"I think it's also important to understand that we're learning more about the brain and we're learning more about how long it takes to recover."

People who have multiple brain injuries risk permanent damage, she said.

DeMatteo prefers to use the term 'brain injury' instead of concussion because that's what a concussion is, a brain injury. When people use 'concussion' to describe the injury it has a way of minimizing it and that has to change, she said.

Brain injuries can have a huge impact on a young person's life, she said.

"They're devastated because they're not able to go to school, they start feeling bad about themselves and their self-esteems suffers," she said. "We're starting to get a much better picture of how much these so-called 'little' concussions can affect their lives."

SOURCE

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Headaches Common in Brain-Injured Children

posted by SK Brain Injury    |   December 9, 2011 12:00

Kids who have a concussion or other traumatic brain injury are more likely to develop headaches for up to a year afterward than children who have had a bodily injury, according to a new study.

While not entirely surprising, the results point to a difficult long-term problem for kids and their parents because adequate treatments are lacking, researchers say.

"It's an issue because they may have problems with sleep, and the headaches can make it harder to concentrate," said lead author Dr. Heidi Blume at Seattle Children's Research Institute.
More than half a million children go to the hospital each year for brain injury.

Blume and her colleagues tracked more than 400 children who had come into the emergency room with a brain injury -- 402 kids had a mild injury and 60 kids had a moderate or severe injury.

Oftentimes the damage was caused by rough play in sports, falls and car accidents.

Blume's team compared these head-injury cases to kids who had come into the emergency room with an arm injury.

Parents and children kept a diary of any headaches the kids reported for a year.

After three months, 43 out of every 100 kids who experienced a mild brain injury complained of headaches.

Among kids with moderate or severe brain injuries, 37 out of every 100 complained of headaches.

In comparison, 26 out of every 100 kids who had an arm injury reported having headaches three months later.

Blume said headaches can have a big impact on kids' lives, affecting their performance in school and forcing them to drop out of sports, band or other activities that could potentially trigger headaches.

It's unclear why the children with mild brain injury were more likely to have headaches than those who suffered more severe damage.

"That is a conundrum that we don't fully understand, but it's been noted before" in research on adults, said Karen Barlow at Alberta Children's Hospital in Calgary, Canada.

"There might be something about the moderate and severe traumatic brain injuries that interfere with the mechanisms of sensing pain," Barlow speculated, "but we haven't gotten to the bottom of that."

The researchers did not determine whether kids who suffered a brain injury were also more likely to have had headaches before the injury than the kids who had an arm injury.

They did find that the risk for having headaches after a head injury was especially pronounced among girls.

Girls who had a mild brain injury were more than twice as likely to have headaches as girls who had an arm injury, whereas boys had nearly similar rates of headaches regardless of the type of injury.

"I'm not surprised about this because it's what I see in clinic," Blume told Reuters Health.

The study, published in the journal Pediatrics, did not determine why there was a difference between the sexes.

Girls might be more likely to report headaches, Blume said, "but I don't think it can all be chalked up to a difference in reporting. I think there's something else going on."

Women and girls are more likely to suffer migraines than men and boys, which could be due to hormone levels, and perhaps hormones might also play a role with headaches after brain injury too.

The greater chance of having headaches among girls could also reflect changes in the way boys' and girls' brains develop, Blume said.

The challenge for any child suffering headaches after a brain injury is that there are few ways to treat them.

"Right now we have no studies to guide the treatment of post-traumatic headaches in children," said Barlow, who was not involved in the new study.

Rest and hydration are usually offered, but Barlow said there's only anecdotal evidence backing them up.

Fortunately, it appears that 12 months after a brain injury, the headaches seem to go back to the levels seen among kids who have had an arm injury.

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Rates of Head Injury in Children is Dropping, Death rates Stay the Same

posted by SK Brain Injury    |   November 7, 2011 11:28

The number of children hospitalized for head injuries has decreased in recent years, a new study finds.

However, the rate of death from such injuries has remained about the same, even though doctors are using aggressive treatments to try to save these kids, the study found.

Newborns and African American children were at particularly high risk of dying after a head injury, the researchers said. To prevent such injuries, future research should try to determine why this is, and whether other groups are also at increased risk.

"The more we expose these high risk groups, the more we expose the vulnerable age groups and race disparities," the better able we are to tackle and prevent these injuries, said study researcher Dr. Justin Lee, a surgical resident at Baystate Children's Hospital in Springfield, Mass.

The study was presented Oct. 17 at the American Academy of Pediatrics meeting in Boston.

Head injuries in kids

Lee and colleagues used a database to identify cases of U.S. children who were hospitalized for traumatic brain injuries (TBI) between 2005 and 2008.

Examples of injuries included severe concussions, and injuries that cause bleeding inside the brain, Lee said.

The researchers found 175,261 pediatric traumatic brain injuries. Over the study period, the number of yearly injuries decreased from 50,088 to 36,884. This decrease is likely due to increased awareness about head injuries, and the use of helmets while bicycling, Lee said.

Source

However, the mortality rate remained at 3.5 percent for all three years.

The four main causes of injury were being hit by a car, being in a car that was in an accident, falling and biking accidents.

Some patients required aggressive operations, including removing part of their skull (a craniotomy), or placing a hollow bolt in their brain to monitor pressure in the skull, Lee said.

Newborns were 2.8 times more likely, and African American children were 1.4 times more likely, to die of their brain injury than other children.

It's possible lower access to health care may explain the increased risk of mortality in African American children, Lee said.

Prevention

By the time children require aggressive treatments for head injuries, they are already at a high risk of dying, Lee said.

"It's not that the procedures weren’t good enough to rescue them," Lee said. "It’s the mere fact that they even required those procedures, put them at a high risk of death," he said.

The findings suggest the key to reducing deaths from head injuries may lie not in better treatments, but in preventing these injuries in kids who are likely to suffer from them.

"It's not necessarily what we do inside the hospital," Lee said. "It's what happens pre-hospital. That is what's really going to determine the morality."

The new study has not yet been published in a scientific journal.

Pass it on: The number of head injuries in children is decreasing, but the rate of deaths from these injuries has not changed.

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