Post-concussion syndrome and brain injury

Speech and language therapist, Katy James is head of the brain injury community team at The Children's Trust.

She has had first-hand experience of working with young people who have problems after sustaining a concussion.

The members of my team and the brain injury specialists that I work with have recently been having some interesting discussions about all things concussion related – in particular post-concussion syndrome (a collection of symptoms that some people develop after they have had concussion) and chronic traumatic encephalopathy (CTE – a progressive degenerative disease being identified in athletes with a history of multiple concussions)."

Hidden disability

Last year we assessed a young boy with post-concussion syndrome following a blow to the head in a school rugby match. He was experiencing significant difficulties including fatigue, sleep, pain, concentration and communication. It was impacting on his participation at school and home life. He fell very neatly into the 'hidden disability' group where the young person looks fine but is struggling with everyday tasks.

Head Games

Concussion is hitting the sports headlines too, such as in football, rugby, hockey, and horse riding. CTE is a term that we have started to hear more and more about from neurologists with an interest in such sports related head injury. At the United Kingdom Acquired Brain Injury Forum conference last year we watched a screening of 'Head Games', a revealing research based documentary about the "concussion crisis" in sports. If you get a chance, do watch this. It features Chris Nowinski, a former NFL player, (pictured right) and focuses on the effects of repeated concussions as well as the effect of repeated concussions sustained during sports in adolescence. » Former WWE wrestler, Chris Nowinksi calls for brain injury awareness.

Children and girls more susceptible to concussions

As they don't have fully myelinated brains, meaning their connections don't have the coating and insulation of adult brains, children and young people are more susceptible to concussions. In addition, they have disproportionately weak necks compared to adults, and large, heavy heads. This sets them up for brain injuries that are more serious than those sustained at a later age from the same amount of force. Whilst 80% of children and young people with concussion recover within 7-10 days, 20% have longer lasting symptoms and 5-10% of these develop post-concussion syndrome. Post-concussion syndrome can take a year to recover from with a small number 'never recovering'. Findings have also shown that girls appear more susceptible to concussions and post-concussion symptoms than boys and are often slower to recover. (Cantu, 2009). Work is being done in the sports world to reduce the occurrence of repeated head injuries, with national guidelines including a sports concussion assessment tool. But at a local level with our work in the community, our brain injury community team and brain injury specialists play an important role in raising awareness for all things concussion related such as: • Providing education to schools on risks, concussion factors and signs
• Advocating for safety of those children returning to sports/high risk activity
• Raising awareness about the impact of repeated head injuries. NHS advice on concussion.
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