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When ‘Humpty Dumpty’ Falls Agan

According to Montreal researchers, children who report in with a head injury are twice as likely to do the same soon. This is in contrast //with children who sprain their ankle or wrist, instead.

Says Dr. Bonnie Swaine, one of the authors, of the study which was published in the journal Pediatrics: “They were almost twice as likely to have a subsequent head injury compared to the kids who had a sprained ankle or wrist."

The researchers followed children who sought medical help for injuries at two Montreal hospitals and examined data from the Canadian Hospital Injury Research and Prevention Program.

It was seen that within six months of seeking medical attention after an injury, 2.4 per cent of the children were reported to have a subsequent head injury. Among those who sought medical attention specifically for a head injury, 3.2 per cent had a second head injury. That number increased to 5.5 per cent at 12 months.

According to Swaine, doctors have for years seen kids coming back with repetitive head injuries. The study gives some evidence to back these anecdotal observations, she opined.

Swaine also said she hoped a pattern would emerge so there could be a focus on intervention or prevention strategies, but so far, the only predictor for repeat head injuries were "they were younger, they were boys and they've already had a head injury."

It was observed that many of the children sustained a total of three head injuries - the initial one, the one for which they sought attention during the study and then a subsequent injury in the six or twelve months following.

Says Swaine: "We think perhaps the phenomenon is very complex and kids may not regain their pre-injury status after a head injury.

"Some of our research has shown children with a mild head injury can have subtle co-ordination, balance or equilibrium problems and even slower reaction time than their buddies that haven't had a head injury."

Yet, she wonders: "Or it could be something we weren't able to measure in these children that puts them more at risk."

According to Swaine, many health care providers must insist on a gradual, progressive return to activity, and check that the child is symptom free for several days before embarking on any physical activity.

This includes no more headaches, no more dizziness, the child should be able to remember things and not have trouble concentrating. Once this is achieved then the child can embark on a gradual return, Swaine opines.
ANN/L
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