Child Emergency Room Visits for Brain Injuries Doubled in 10 Years

Physicians speculate the public may be becoming more aware of the dangers of traumatic brain injuries.

A new study shows the number of children who visited emergency rooms for sports-related brain injuries has nearly doubled in the last 10 years.
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The number of children visiting emergency rooms for sports-related traumatic brain injuries, such as concussions, has nearly doubled in the last 10 years, according to a new study from physicians at the Cincinnati Children's Hospital Medical Center.

Between 2002 and 2011, the number of children making trips to emergency rooms for brain injuries increased by 92 percent. During the same time, the number of those admitted to the hospital for further observation or treatment also increased by about 10 percent.

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Holly Hanson, an emergency medicine fellow at Cincinnati Children's, and two other physicians studied more than 3,800 children and teens who came to the center with such injuries. Their findings were published online in the journal Pediatrics on Monday.

Hanson says the increase in emergency room visits for sports-related brain injuries may stem in part from a greater awareness of the dangers of traumatic brain injuries.

"I suspect that community – emergency department physicians, parents, coaches, trainers – are doing a better job at identifying and seeking medical attention early for concussions," Hanson says.

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Hanson and her colleagues found that football, soccer and basketball were the sports in which children were most-likely to experience injuries, with football accounting for 30 percent of the emergency room visits. The sports that contributed to the greatest number of hospital admissions were football, skateboarding and rollerblading, and baseball and softball, Hansen says.

The Centers for Disease Control and Prevention has called traumatic brain injury an "invisible epidemic," because unlike other injuries, such as broken bones, the symptoms are not always immediately identifiable. According to the CDC, almost 500,000 emergency room visits for traumatic brain injuries each year are made by children under the age of 14. And each year, emergency rooms nationwide treat nearly 175,000 sports-related traumatic brain injuries among children under the age of 19.

Though the number of visits and admittances for sports-related brain injuries increased, the average level of severity of the injuries decreased, a fact that Hanson attributes to increased awareness. Hanson says physicians may be more inclined to admit patients for further observation or treatment because studies have encouraged them to avoid head imaging, such as CT scans, which can use high amounts of radiation.

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"Because of that we may decide to keep them in the hospital and watch them a little longer," Hanson says. "So it's a more conservative approach."

Additionally, Hanson says physicians today may be doing a better job of recognizing the signs and symptoms of traumatic brain injuries – such as concussions, skull fractures, brain bleeding and brain contusions – than they were 10 years ago.

"A less-severe injury is triggering us to say, 'Hey this kid may still need to come in and be watched,' whereas 10 years ago we may not have even recognized that those were the signs and symptoms of a concussion," Hanson says. "So the injury itself may not be quite as severe but we feel additional supervision or additional treatment might be good."

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