A child’s brain needs even more protection against injury

Thirteen-year-old Anna slips from the uneven bars, slamming the mat headfirst. Dizzy and nauseous, she doesn’t tell her coach for fear he’ll pull her from practice or, worse, the upcoming competition.

She resumes practice, unaware she has suffered a concussion.

She falls again. This time the impact causes permanent brain damage. Within seconds, her dream to perform gymnastics, go to college and become a veterinarian shatters.

Though most concussions are reversible, some can cause life-changing injuries if not allowed to fully heal. Those of us entrusted with the health and well being of children – and even young athletes themselves – need to take this injury seriously. Young, developing brains are more sensitive to the effects of concussions, placing them at greater risk of long-term brain damage. Fortunately, certain actions can help prevent or minimize this damage.

But first, let’s look at what happens when a direct or an indirect blow triggers a concussion. Damage to brain tissue causes temporary chemical and metabolic changes within the brain cells, making it more difficult for cells to function and communicate. If a cell loses too much energy during this process, the cell dies and cannot be replaced. If a second injury follows before the brain recovers, and while it is highly vulnerable, a stroke or other life-threatening injury can occur.

After the first concussion, children should immediately stop participating in activities that put them at risk of another head injury. Participating makes a second injury more likely since the child will have slower reaction time, decreased balance and coordination due to the first concussion.

I tell patients, “You’re not the same person you were before your concussion, but you will be if you protect your brain and allow it to fully recover.”

Reducing mental and social activities for one to two weeks, or until concussion symptoms resolve, protects the brain and helps healing.

National attention on the link between multiple concussions and long-term brain damage in professional athletes has underscored the need to protect children and adolescents from a similar fate.

At Valley Children’s, I see a significant decline in a child’s functioning following only a few minor concussions within a year or two. Each additional concussion seems to cause greater injury, longer recovery and more permanent difficulties. After two or more concussions, I advise parents to seriously consider removing their child from activities with high risk of head injury.

Children frequently return to an activity before full recovery. They might be concerned about letting the team down or disappointing their parents or themselves. Rather than being cautious, the coach or teacher might tell the child to “shake it off” and get back in the game.

The result shows up in our emergency rooms. Sports-related concussions account for more than half of all ER visits by children ages 8 to 13, according to the National Athletic Trainers Association. Many other activities, from skateboarding and bicycle riding to cheerleading, also can cause this injury.

Emergency medical attention is needed if the child experiences vomiting, loss of consciousness, seizure or other major symptoms. If even milder symptoms persist more than two weeks, the child should see a pediatric specialist for evaluation.

Athletic and recreational activities provide physical, emotional, mental and social benefits that far outweigh the risk of serious injury – but we need to use common sense. The cumulative effect of concussions over a lifetime, and the sensitivity of a child’s maturing brain to injury should be considered when deciding how young a child begins playing sports – particularly contact sports like football.

Society tends to define success only by winning rather than continuous improvement. The win-at-all-costs attitude pressures kids to keep playing, even after a head injury – but at what price? Each time a child continues to play soon after a concussion, they risk severe complications. For each successive concussion, children are trading precious brain cells for touchdowns, goals, trophies or glory.

We have a responsibility to ensure our kids reach their full potential. To do that, we must protect their brains.

This story was originally published August 23, 2017 at 6:17 PM with the headline "A child’s brain needs even more protection against injury."