A concussion is the result of a traumatic brain injury that will impair the overall brain function, the effects are temporary, they can be severe depending on the case. When a child suffers from a head injury resulting in a concussion, they can develop complications or delayed healing times depending on their previous injury history and whether they had a preexisting concussion prior that didn’t get to heal. Suffering from a hit to the head while the preexisting concussion is healing can also lead to more-severe symptoms. Symptoms of a concussion can include states of depression, confusion or feeling as if in a fog, headache, blurry vision, trouble focusing, nausea/vomiting and irritability. Brain damage from a concussion can cause emotional symptoms that do not resolve on their own. If a child suffers from a concussion, they should rest from both physical and mental (cognitive) activities for 3-5 days or longer if instructed by a doctor.
It is estimated that every 1 in 5 youth experience a concussion at least once before the age of 18. Majority of youth that suffer from a concussion recover from symptoms within 1 month. There has been discussion that concussions may cause further altercations within the brain structure that leads to long-term consequences that can persist even though concussive symptoms subsided. When it comes to children that have suffered from a concussion going back to regular routine can be difficult, some kids may require classroom adjustments whether it’s a lighter course load or a shortened school day. Reading and exercising can lead to reoccurring symptoms such as a headache.
The present study conducted by Zivanovic et al., 2020 was to examine the long-term effects of a Childs concussion on the brain to measure the external shape and dimensions that were poorly portrayed. The researchers used a magnetic resonance imaging (MRI) to examine the cortical volume. Which measures the number of neurons and processes and cells in the brain and the thickness of the cortical which is the outer layer of tissue below the stem of your brain in youth after several years after suffering from a concussion. The study showed that a concussion was defined using following criteria which was consistent with the World Health Organization (WHO) to aid the outcome of mild traumatic brain injury and multiple large-scale pediatric studies. They measured post-concussion symptoms by using a Post-Concussion Symptom Inventory test (PCSI) that consisted of 26 items measuring somatic symptoms such as pain, weakness, or shortness of breath, to determine if it affects their overall function or a cause of distress, as well as cognitive, emotional, and sleep/fatigue symptoms along with it. Both patient and parent reports were completed and both patient and parents were to rate each symptom on a 7-point Likert-type scale. Cognitive performance was also measured using tests from the CNS vital signs (CNSVS) using a computerized neurocognitive battery to pinpoint: verbal memory, Stroop testing to determine if there is a delay in reaction time between congruent and incongruent motive as well as a shifting attention test.
The results of the study showed that there were no significant differences in cortical volume or thickness in youth with preexisting concussion history. An exploratory analysis between groups was conducted and the results concluded that there was still no difference in cortical volume and thickness between youth with a single concussion and those with multiple concussions. Youth with a preexisting history of concussions reported higher levels of symptoms post-concussion. Parents also states that the youth with history of concussion reported higher levels of post-concussion symptoms in their child. As for the self-report scales, there was no correlation found for either cortical volume or thickness using the PCSI scale or the parent-report domain scores. There was better reaction time reported in the CNSVS scores that associated with a thinner outer layer of the brain. Verbal memory scores were correlated with a thinner outer layer in the left middle frontal cortex and no significant correlation between cortical volume and any of the CNSVS domains or thickness and CNSVS cognitive flexibility.
As for long term effects of concussion injuries in youth is important for understanding the effects of this injury of the brain’s maturation. This study found that there were no differences in cortical volume and thickness on average of 2.5 years post-concussion in youth.
Zivanovic, N., Virani, S., Rajaram, A. A., Lebel, C., Yeates, K. O., & Brooks, B. L. (2021). Cortical Volume and Thickness in Youth Several Years After Concussion. Journal of Child Neurology, 36(3), 186–194. https://doi.org/10.1177/0883073820962930
