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Long term consequences of mild head injury in children are underdiagnosed, causing prolonged suffering.

A new study by Tel Aviv University, Kaplan Medical Center and Shamir Medical Center (Assaf Harofeh) found that one in four children (25.3%) who have been discharged from the emergency room after a mild head injury are misdiagnosed and continue to suffer from persistent post-concussion syndrome for many years. The syndrome includes chronic symptoms such as memory loss, psychological issues and sensitivity to light and noise, which can be misdiagnosed as symptoms of ADHD, depression or sleeping disorders. The misdiagnosis results in the children receiving treatment that is not suited to their condition, which causes them prolonged suffering.

The study was led by Prof. Shai Efrati of the Sagol Center for Hyperbaric Medicine and Research at Tel Aviv University and Shamir Medical Center (Assaf Harofeh), Dr. Uri Bella and Dr. Eli Fried of Kaplan Medical Center, and Prof. Eran Kotzer of Shamir Medical Center. The results of the study were published in the journal Scientific Reports.

The researchers examined 200 children who suffered from a head injury and who were released from the emergency room after the need for medical intervention was ruled out. They tracked the subjects for a period between six months and three years, and found that about one in four children released from the emergency room suffered from the chronic syndrome.

Long-Term Monitoring Needed

According to the researchers, the alarming findings demonstrate that changes in the approach are needed to be monitoring and treating these children. 

„Persistent post-concussion syndrome is a chronic syndrome that results from micro damage to the small blood vessels and nerves, which may appear several months after the head injury. As a result, it often gets misdiagnosed as attention deficit disorders, sleep disorders, depression, and so on,” explains Prof. Shai Efrati. 

„The purpose of an emergency room diagnosis is to determine whether the child suffers from a severe brain injury that requires immediate medical intervention,“ adds Prof. Eran Kotzer, Director of the Emergency Rooms at the Shamir Medical Center.  „Unfortunately, the way most medical systems operate today, we miss long-term effects and do not continue to monitor those children who leave the emergency room without visible motor impairment.“

„Treatment for a wide range of disorders will change if we know that the cause of the new problem is a brain injury,“ concludes Prof. Efrati. „Proper diagnosis of the cause is the first and most important step in providing appropriate treatment for the problem.“

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