Pediatric Head Injuries in Summer Camps

Summer camps have a unique supervisory environment that may lead to increased head injury risk for children. The epidemiology of head injuries in camps is unclear. We partnered with CampDoc.com to review head injury reports from camp nurses in 2016 from 197 camps in 36 states. A total of 4290 (92%) reports were coded as definite head injuries, 47% (n = 2002) in female campers, with median camper age of 10 years. Head injury severity was coded as mild (94%, n = 4040), moderate (6%, n = 248), or severe (<1%, n = 2). Only 3% (n = 134) were medically evaluated, and 29% (n = 1221) were sports-related. Head injuries were categorized as definite (3%, n = 137) and probable (13%, n = 572) concussions, with 39% (n = 277) being sports-related and 61% (n = 83) of definite concussions incurred by female campers. Summer camps, while an important location of head injury risk, appear to be a safe environment for youth.

Download Full-text

The impact of posttraumatic seizures on 1-year neuropsychological and psychosocial outcome of head injury

Journal of the International Neuropsychological Society ◽

10.1017/s1355617700001661 ◽

1996 ◽

Vol 2 (6) ◽

pp. 494-504 ◽

Cited By ~ 17

Author(s):

Alan M. Haltiner ◽

Nancy R. Temkin ◽

H. Richard Winn ◽

Sureyya S. Dikmen

Keyword(s):

Head Injury ◽

Psychosocial Functioning ◽

Brain Injuries ◽

Injury Severity ◽

Head Injuries ◽

Psychosocial Outcome ◽

Traumatic Head Injury ◽

The Impact ◽

Head Injury Severity ◽

Posttraumatic Seizures

AbstractThis study examined the relationship of posttraumatic seizures and head injury severity to neuropsychological performance and psychosocial functioning in 210 adults who were prospectively followed and assessed 1 year after moderate to severe traumatic head injury. Eighteen percent (n = 38) of the patients experienced 1 or more late seizures (i.e., seizures occurring 8 or more days posttrauma) by the time of the 1-year followup. As expected, the head injured patients who experienced late posttraumatic seizures were those with the most severe head injuries, and they were significantly more impaired on the neuropsychological and psychosocial measures compared to those who remained seizure free. However, after the effects of head injury severity were controlled, there were no significant differences in neuropsychological and psychosocial outcome at 1 year as a function of having seizures. These findings suggest that worse outcomes in patients who develop posttraumatic seizures up to 1 year posttrauma largely reflect the effects of the brain injuries that cause seizures, rather than the effect of seizures. (JINS, 1996, 2, 494–504.)

Download Full-text

One year psychosocial outcome in head injury

Journal of the International Neuropsychological Society ◽

10.1017/s1355617700000126 ◽

1995 ◽

Vol 1 (1) ◽

pp. 67-77 ◽

Cited By ~ 136

Author(s):

Sureyya S. Dikmen ◽

Barbara L. Ross ◽

Joan E. Machamer ◽

Nancy R. Temkin

Keyword(s):

Head Injury ◽

Low Income ◽

Injury Severity ◽

Sickness Impact Profile ◽

Head Injuries ◽

Psychosocial Outcome ◽

Post Injury ◽

Head Injured ◽

One Year ◽

Head Injury Severity

AbstractPsychosocial outcome at one year post-injury was examined prospectively in 466 hospitalized head-injured subjects, 124 trauma controls, and 88 friend controls. The results indicate that head injury is associated with persistent psychosocial limitations. However, the presence and extent of limitations are related to the demographics of the population injured, to other system injuries sustained in the same accident, and particularly to the severity of the head injury. More severe head injuries are associated with limitations implying greater dependence on others including poorer Glasgow Outcome Scale (GOS) ratings, dependent living, unemployment, low income, and reliance on family and social subsidy systems. Head injury severity is more closely related to more objective indices of psychosocial outcome (e.g., employment) than to self-perceived psychosocial limitations, such as measured by the Sickness Impact Profile (SIP). (JINS, 1995, I, 67–77.)

Download Full-text

Functional Outcome After Pediatric Head Injury

PEDIATRICS ◽

10.1542/peds.94.4.425 ◽

1994 ◽

Vol 94 (4) ◽

pp. 425-432

Author(s):

Arlene I. Greenspan ◽

Ellen J. MacKenzie

Keyword(s):

Head Injury ◽

Social Services ◽

Behavioral Problems ◽

Injury Severity ◽

Functional Limitations ◽

Head Injuries ◽

Sociodemographic Factors ◽

Abbreviated Injury Scale ◽

Severe Injuries ◽

Head Injury Severity

Objectives. To examine the consequences of head injury and the medical, economic, and sociodemographic factors affecting functional status 1 year after injury. Methods. A follow-up was conducted on 95 children (aged 5 to 15) 1 year after they were hospitalized for head injury. Parents were interviewed by phone concerning their child's preinjury and current health status, and the family's economic and social resources during the 1 year postinjury. Inpatient medical records were reviewed to obtain information regarding the characteristics of the injury. Results. We found that study children were more likely than children from the general population to have limitations in physical health, behavioral problems, and to be enrolled in a special education program. These findings were true for all levels of head injury severity, although children with severe head injuries (Abbreviated Injury Scale 5) were more likely to demonstrate these functional limitations than were children with less severe injuries (Abbreviated Injury Scale 2, 3, 4). After controlling for head injury severity, we found that the poorer outcomes were associated with poverty, preinjury chronic health problems, and lower extremity injuries. Conclusions. The large proportion of children who demonstrated functional limitations underscores the importance of evaluating all children hospitalized with head injuries for functional limitations and providing rehabilitation and social services when needed.

Download Full-text

Miller was (mostly) right: Head injury severity inversely related to simulation

Legal and Criminological Psychology ◽

10.1348/135532505x49828 ◽

2006 ◽

Vol 11 (1) ◽

pp. 131-145 ◽

Cited By ~ 18

Author(s):

Manfred F. Greiffenstein ◽

W. John Baker

Keyword(s):

Head Injury ◽

Injury Severity ◽

Head Injury Severity

Download Full-text

Inappropriate Discharge Instructions for Youth Athletes Hospitalized for Concussion

PEDIATRICS ◽

10.1542/peds.95.2.216 ◽

1995 ◽

Vol 95 (2) ◽

pp. 216-218

Author(s):

Frank J. Genuardi ◽

William D. King

Keyword(s):

Head Injury ◽

Injury Severity ◽

Head Injuries ◽

Closed Head Injury ◽

Medical Society ◽

Discharge Instructions ◽

Youth Athletes ◽

Closed Head Injuries ◽

Closed Head ◽

Grade 3

Objective. To evaluate the medical care, especially the discharge instructions regarding return to participation, received by youth athletes hospitalized for a closed head injury. Methods. We examined the records of all patients admitted over a 5-year period (1987 through 1991) to The Children's Hospital of Alabama for a sports-related closed head injury. Descriptive information was recorded and discharge instructions reviewed. Injury severity was graded according to guidelines current during the study period, as well as those outlined most recently by the Colorado Medical Society, which have been endorsed by a number of organizations including the American Academy of Pediatrics. Discharge instructions recorded for each patient were then compared with those recommended in the guidelines. Results. We identified 33 patients with sports-related closed head injuries. Grade 1 concussions (least severe) occurred in 8 patients (24.2%), grade 2 in 10 (30.3%), and grade 3 (most severe) in 15 (45.4%). Overall, discharge instructions were appropriate for only 10 patients (30.3%), including all with grade 1 concussions, but only 2 with a grade 2 (20.0%) and none with a grade 3 concussion. Conclusion. All who care for youth athletes must become familiar with the guidelines for management of concussion to provide appropriate care and counseling and to avoid a tragic outcome.

Download Full-text

The impact of blood ethanol concentration on the classification of head injury severity in traumatic brain injury

Brain Injury ◽

10.3109/02699052.2015.1075154 ◽

2015 ◽

Vol 29 (13-14) ◽

pp. 1648-1653 ◽

Cited By ~ 7

Author(s):

Pål Rønning ◽

Per Ole Gunstad ◽

Nils-Oddvar Skaga ◽

Iver Arne Langmoen ◽

Knut Stavem ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Injury Severity ◽

Ethanol Concentration ◽

Blood Ethanol Concentration ◽

The Impact ◽

Head Injury Severity

Download Full-text

Traumatic brain injury—the effects of patient age on treatment intensity and mortality

BMC Neurology ◽

10.1186/s12883-020-01943-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ola Skaansar ◽

Cathrine Tverdal ◽

Pål Andre Rønning ◽

Karoline Skogen ◽

Tor Brommeland ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Injury Severity ◽

Age Groups ◽

Composite Score ◽

Increased Risk ◽

Management Intensity ◽

Treatment Bias ◽

Head Injury Severity

Abstract Background Ageing is associated with worse treatment outcome after traumatic brain injury (TBI). This association may lead to a self-fulfilling prophecy that affects treatment efficacy. The aim of the current study was to evaluate the role of treatment bias in patient outcomes by studying the intensity of diagnostic procedures, treatment, and overall 30-day mortality in different age groups of patients with TBI. Methods Included in this study was consecutively admitted patients with TBI, aged ≥ 15 years, with a cerebral CT showing intracranial signs of trauma, during the time-period between 2015–2018. Data were extracted from our prospective quality control registry for admitted TBI patients. As a measure of management intensity in different age groups, we made a composite score, where placement of intracranial pressure monitor, ventilator treatment, and evacuation of intracranial mass lesion each gave one point. Uni- and multivariate survival analyses were performed using logistic multinomial regression. Results A total of 1,571 patients with TBI fulfilled the inclusion criteria. The median age was 58 years (range 15–98), 70% were men, and 39% were ≥ 65 years. Head injury severity was mild in 706 patients (45%), moderate in 437 (28%), and severe in 428 (27%). Increasing age was associated with less management intensity, as measured using the composite score, irrespective of head injury severity. Multivariate analyses showed that the following parameters had a significant association with an increased risk of death within 30 days of trauma: increasing age, severe comorbidities, severe TBI, Rotterdam CT-score ≥ 3, and low management intensity. Conclusion The present study indicates that the management intensity of hospitalised patients with TBI decreased with advanced age and that low management intensity was associated with an increased risk of 30-day mortality. This suggests that the high mortality among elderly TBI patients may have an element of treatment bias and could in the future be limited with a more aggressive management regime.

Download Full-text