Children and youth are at greater risk of concussions and more serious head injury than the general population. Concussions are the most common form of head injury, yet it is believed that they are under-reported owing to both a lack of consensus in the minimum requirements of the definition of a concussion and the presence of misconceptions among the general public regarding concussions. Nonetheless, concussions reportedly account for 3 to 8 percent of all sports-related injuries among youth presenting to urban emergency departments in Canada, which is expected to increase as public awareness rises. Furthermore, studies using national injury reporting databases in the United States indicate that sports-related injuries are responsible for 46 to 58 percent of all concussions suffered by youth between the ages of 8 and 19. Comparable Canadian data are not available.
Concussions, also known as mild traumatic brain injury (mTBI), occur as a result of an impact to or forceful motion of the head or other part of the body, resulting in a jarring of the brain. This may lead to a brief alteration of mental status, which may include: confusion, loss of memory directly preceding the event, sensitivity to light, slurred speech and/or dizziness or emotional changes, and may or may not be accompanied by loss of consciousness or seizures.
Evidence exists that children and youth take longer than adults to recover following a concussion , and can permanently change the way a child or youth talks, walks, learns, works and interacts with others. Therefore, concussion management and appropriate return to activity is crucial, particularly in the paediatric and adolescent populations.
Active and timely rehabilitation is essential for concussion patients who remain symptomatic longer than a six week period. This may include physiotherapy, occupational therapy, educational support, neuropsychology and in some case neuropsychiatry. If an individual returns to activity too soon and a second concussion is sustained before recovering from the first, a condition known as second-impact syndrome (SIS) may occur: a swelling of the brain that can result in brain damage causing severe disability or even death. Furthermore, an individual is 3-times more likely to sustain a second concussion while in recovery from a concussion.
Although no information is currently available concerning the economic burden of concussion for children and youth, a study is currently being conducted at the Children’s Hospital of Eastern Ontario (CHEO). Assessing young athletes ages 12 to 17 while suffering from concussion for over three months regarding their quality of life, results using a standardized quality of life survey found similar findings as those for patients receiving chemotherapy treatments for cancer.
The purpose of this report is to provide details on the burden of concussion among children and youth in British Columbia (BC) as a supplement to the report The Burden of Concussion in British Columbia. This supplement will be used to facilitate discussion of the need for standardized concussion prevention, diagnosis and management in BC specific to children and youth.
Concussion as a health event is recognized to be under reported and inconsistently coded. Concussion may also be labelled as a minor traumatic brain injury (mTBI), or sometimes as a head injury (which may include other injuries not involving the brain).
For the purposes of this report, concussion is considered a subgroup of head injury. Mortality data are presented for head injury alone, as no data for concussion mortality are available. Hospitalization data are presented for both head injury and for concussion as a subgroup of head injury, and emergency department data are presented for concussion alone.