Traumatic brain injuries in kids: What problems lurk in the future?
Doctors are beginning to get answers to the question that every parent whose child has had a traumatic brain injury (TBI) wants to know: What will my child be like 10 years from now?
In a study presented over the weekend at the annual meeting of the Association of Academic Physiatrists in Las Vegas, researchers from Cincinnati Children's Hospital Medical Center shared research on the long-term effects of TBI -- an average of seven years after injury.
A TBI is any injury to the head that interferes with the normal functioning of the brain. This can be a violent blow or bump, which can result in a sudden jolt, or a penetrating injury that pierces the skull and the brain tissue. TBIs can range from mild (commonly known as a concussion) to severe, potentially resulting in unconsciousness or memory loss.
Patients with mild to moderate brain injuries are two times more likely to have developed attention problems, and those with severe injuries are five times more likely to develop secondary ADHD.
These researchers are also finding that the family environment influences the development of these attention problems.
- Parenting and the home environment exert a powerful influence on recovery. Children with severe TBI in optimal environments may show few effects of their injuries while children with milder injuries from disadvantaged or chaotic homes often demonstrate persistent problems.
- Early family response may be particularly important for long-term outcomes, suggesting that working to promote effective parenting may be an important early intervention.
- Certain skills that can affect social functioning, such as speed of information processing, inhibition, and reasoning, show greater long-term effects.
- Many children do very well long-term after brain injury and most do not have across the board deficits.
More than 630,000 children and teenagers in the United States are treated in emergency rooms for TBI each year. But predictors of recovery following TBI, particularly the roles of genes and environment, are unclear. These environmental factors include family functioning, parenting practices, home environment, and socioeconomic status.
Using neuroimaging and other technologies, scientists are also learning more about brain structure and connectivity related to persistent symptoms after TBI.
In a not-yet-published Cincinnati Children's study, for example, researchers investigated the structural connectivity of brain networks following aerobic training.
The recovery of structural connectivity they discovered suggests that aerobic training may lead to improvement in symptoms.
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