Concussion should be termed brain injury: study

Concussions in children should be renamed "mild traumatic brain injuries," to better convey their seriousness, some Canadian researchers say.

Children diagnosed with a concussion were released from hospital sooner and returned to school faster than those diagnosed with a traumatic brain injury, regardless of the severity of the injury, occupational therapist Carol DeMatteo of McMaster University in Hamilton, and her colleagues report in Monday's issue of the journal Pediatrics. 

"When we would try to recruit the children and their families, we kept hearing families say to us, 'No, it's OK, my child doesn't have a brain injury, he only has a concussion,'" DeMatteo recalled. She wondered how common the perception was, and whether it made a difference to treatment and recovery.

To find out, the researchers analyzed data on 434 children who were admitted with acquired brain injury to McMaster Children's Hospital over a period of two years. Of 341 who were found to have traumatic brain injury, 32 per cent received the diagnosis of concussion.

But 24 per cent of children who had moderate or severe scores on tests of neurological function were labelled as having a concussion, the team found.

'I still believe that a lot of people think concussion means a hit to the head and it doesn't involve the brain.' — Carol DeMatteo

Children diagnosed with concussion were also 1.5 times more likely to be released from hospital earlier than those who did not. They were also 2.4 times more likely to return to school just a few days after the injury.

DeMatteo, a clinical professor in the school of rehabilitation science at McMaster, said she wants parents to have good information before deciding whether children should return to school or activity, since doing so too soon puts them at greater risk for a second injury and poor school performance.

"After our study, I'm of the belief that if you use the word 'brain,' that people pay attention a little bit more. I still believe that a lot of people think concussion means a hit to the head and it doesn't involve the brain."

Usefulness of new term debated

DeMatteo believes children should see a doctor if they are showing signs of a concussion, such as fatigue, headache, memory problems, disturbed sleep or mood changes.

Previous research suggests that children who suffer a concussion or mild brain injury are twice as likely to have another within the year.

Dr. Anne-Marie Guerguerian, a critical care physician at Toronto's Hospital for Sick Children, found the study interesting, but disagreed with the idea of purging the concussion diagnosis from practice. Mild traumatic brain injury isn't a better option, because it isn't useful in describing the injury for families, Guerguerian said.

Concussion expert Dr. Karen Johnston, a neurosurgeon and director of the Sports Concussion Clinic at Toronto Rehabilitation Institute, was also not in favour of junking the term concussion. Johnson helped develop an international consensus statement on concussion in sport that includes a common definition and recommendations on managing the injury.