School has begun and with it the advent of of school sports. From daily practices to weekly games, child athletes are at some degree of risk for head trauma. Family Savvy is pleased to have guest contributor Dr. Robert Pearlman share his perspective on this issue. He has over 25 years of practice in the field of neurology, is the father of five children, and is married to Dr. Jo Herzog.
Dr. Robert Pearlman
Head injury is one of the most common problems in clinical practice. It can vary from a trivial “bump on the head” to permanent devastating neurological injury or death. Most individuals will experience head trauma at some time during their lives. Fortunately, the brain is well protected by the skull and a thin layer of spinal fluid that cushions the brain from any jarring motion.
Head trauma is common during falls, motor vehicle accidents, playing sports, and a host of other physical activities. If the trauma is mild, the person may not loose consciousness. The sequelae of such an injury may be only a brief headache. However, as the severity of the impact increases, the person can suffer loss of consciousness, or in severe cases, coma may be the result. The latter injury can often result in permanent neurological injury such as weakness, confusion, amnesia and seizures. Those suffering this type of injury are often hospitalized for many weeks and can spend a longer period of time in a rehabilitation center. Most people after a severe head injury will be unable to resume their prior employment or other activities.
Most families will have one or more children who decide to play a sport while in school. Sports such a football or those that have body contact are much more likely to produce head injuries. It is not uncommon that during practice or a game for one or more players to suffer from head trauma. Fortunately, the injury in most cases is insignificant, but this is not always the case. Repeated small traumatic events can cause lasting brain injury.
In my practice, I have seen many athletes after head trauma. If the injury is mild, the athlete may be restricted from playing his or her sport for a period of time. In the office setting, an MRI scan of the head may be needed to dispel any chance of bleeding or swelling not recognizable by clinical exam. In an emergency setting, scanning of the brain should be mandatory.
I have on many occasions advised anxious parents and their child athlete on the danger of repetitive head trauma. Subtle brain injury may occur even with mild trauma that over a lifetime can become cumulative. Even college and professional athletes have to be cognizant of the risks that repetitive head injury can cause. If this means that the child can no longer participate in a certain sport, then this may be the wisest decision to preserve vital long term brain functioning.
Not every head injured person requires neurological evaluation, but the threshold to have such a person evaluated should be low because even mild head trauma can produce significant neurological impairment.