Despite increased public awareness of and knowledge about brain injuries, children and teens still make up a high number of traumatic brain injuries (TBIs), according to a recent report. Almost 300,000 emergency room visits a year over six years were linked to youth who suffered a brain injury in a sport or recreation activity. The Morbidity and Mortality Weekly Report, published by the US Centers for Disease Control and Prevention, also connects several sports to an increased risk of TBI.
Traumatic Brain Injuries Leveling Off, But Still High
According to the CDC, through the seven years included in their study approximately 2 million children under the age of 18 visited an emergency department due to a traumatic brain injury linked to sports or recreational activities. Though that figure leveled off in 2012 from previous years, such injuries still accounted for approximately 283,000 emergency department visits each year included in the study.
Among the activities that caused the highest rates of youth brain injuries were football, soccer, basketball, lacrosse, ice hockey and wrestling. Researchers noted that sports in which athlete collisions occur frequently tend to be linked to higher traumatic brain injury rates, accounting for twice as many such emergency department visits compared with non-contact sports and four times as many visits as recreation-related activities. Overall, contact sports made up 45 percent of TBI-related emergency department visits.
Though males still far outpaced females in TBI emergency department visits, the overall number for males decreased significantly during the study period, while the figure for females increased. In all, the levels of emergency department visits caused by a traumatic brain injury were highest in youths aged 10-14 and 15-17. Children under the age of 9 tended to visit emergency departments for brain injuries linked to playground activities.
Avoiding Youth Brain Injuries
The study’s authors note that there are opportunities to identify brain injuries in children, including preparticipation athletic examinations to identify those athletes who could be at an increased risk of TBI or require longer recovery, and take steps to prevent such injuries. Additionally, limiting player-to-player contact and reducing the risk of collisions will also prevent athlete TBIs. Researchers also note that studies regarding the role of officiating, policies, and athletic trainers in preventing TBIs in sports could also help.
Experts believe children are at a particularly high risk of TBIs and long-term consequences because their nervous systems are developing and their cranial bones are thin. Traumatic brain injuries in youth can cause permanent damage, including physical and cognitive impairments.
As a result of concerns about youth brain injuries, the CDC issued guidelines in 2018 to diagnose and manage mild traumatic brain injuries in children. When it released its guidelines, the CDC noted that mild traumatic brain injuries, or concussions, were a “rapidly growing public health concern because epidemiologic data indicate a marked increase in the number of emergency department visits for [mild traumatic brain injuries] over the past decade.” The CDC also stated that there were no evidence-based clinical guidelines to help with diagnosing and managing youth mTBIs.
According to the CDC, more than 800,000 children obtain treatment annually for a traumatic brain injury (including mild and severe brain injuries). Among the CDC’s recommendations are using age-appropriate symptom scales when diagnosing concussions, assessing for risk factors that could indicate a prolonged recovery, and providing patients and caregivers with customized instructions on returning to activities.
An editorial that accompanied the CDC’s guidelines noted that pediatric mild traumatic brain injuries are “a major public health problem.”
Athlete Brain Injuries Gain Attention
Though youth athlete brain injuries are the CDC’s focus, brain injuries linked to adult athletes have been in the news in recent years thanks to high-profile lawsuits. The NFL, NHL and NCAA have all faced and settled lawsuits filed by athletes who say the organizations knew or should have known about the risks to players but failed to warn or protect them from brain injuries.
The increased focus on athlete injuries is likely one factor in the recent decline in youth football participation. According to the National Federation of High School Associations’ athletic participation survey, as cited by Forbes, football participation has been on the decline for almost 10 years. That decline may have been slowed thanks to the federation’s work in reducing the risk of injury in football, including rules that prevent an athlete from returning to play if officials believe that athlete suffered a concussion.
With increased awareness and information, the hope is that the extent of youth concussions will decrease and fewer children will suffer long-term effects of traumatic brain injuries.