This week the The Center for Disease Control (CDC) released a detailed report to Congress describing the effects of traumatic brain injury (TBI) on children. This blog has been committed to providing the latest news on a very hot topic. The public is paying attention, and Congress wanted answers.
The news is not good. Children experience a disproportionate amount of head injuries, and automobile accidents and falls are major contributors. In 2013, children (age 0-14) accounted for 640,800 emergency room visits for TBI. That means over 500,000 children with head injuries made it to an emergency room and we all know that the number remaining at home and never examined was much larger.
This is a huge problem. 30-60% of these kids with mild TBI still had symptoms one month after injury. Children with head injuries have similar symptoms and findings as adults. They complain of headaches, blurred vision, dizziness, fatigue just like adults. But children are not little adults, they have a much more difficult time explaining how they feel, or can’t explain anything. The result is they are often missed or ignored. Adults who strike their heads in automobile accidents are aware something has gone wrong.
Children tucked away in the backseat are just terrified and crying. If there are not outward signs of bleeding or bruising, even their parents in the front seat have no clue about what’s happening. The result is like most problems with kids- they are unnoticed. Even very diligent and thoughtful parents and pediatricians just find it a difficult problem.
The brains of children are still developing, growing rapidly and are very vulnerable to disruption. Adults with concussions can suffer permanent damage, but if the normal growth of the brain is hampered, life-long handicaps become real and permanent. The brains of young children are simply more sensitive, and even well-constructed car seats cannot protect them from head trauma and whiplash.
I have personally examined children after automobile accidents, or falls, with vision problems. The parents frequently state their kids rub their eyes a lot- the children have tearing, they have trouble reading, or in participating while in school. Reading is critical- this is the main reason why these children need to see the eye doctor. This is the most scary statistic in the report: 14% of students with mild TBI need educational support services 12 months after the initial injury- they are falling behind. And once you fall behind in school, the future is not encouraging.
The CDC report emphasizes that more must be done to rescue these children. Where do I come into play as an ophthalmologist? I need to examine these children’s eyes and see if glasses will help. I need to see if the eyes are moving normally and I need to check to detect other signs of mild traumatic brain injury. Otherwise, kids become socially isolated, depressed, and fall further behind in school. I examine children of all income brackets- the economically disadvantaged are seen in my office.
Congress has received the report on our children with TBI this week, and the conclusion is obvious: Much work needs to be done.
