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Physician Education Cards
Background
The Pediatric Committee has developed a Physician Education Information
Card that will be distributed to more than 3000 pediatricians and
family doctors in the Toronto region. This resource provides information
about diagnosing mild brain injury, secondary prevention and guidelines
for return to activity.
 Download Physician Education Card Now to save to your computer
or see the information below:
| Facts for Physicians
Mild Acquired Brain Injury in Children and Youth |
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DEFINITION
An
acquired brain injury is damage to the brain that occurs after
birth and is not related to a congenital disorder, a developmental
disability or a disease process which progressively damages
the brain.
The
damage may be cause traumatically (i.e. from an external force
such as a collision, fall, assault or sports injury) or through
a medical problem or non-progressive disease process which
causes damage to the brain (e.g. infection or anoxia).
SIGNS
AND SYMPTOMS
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COGNITIVE
SYMPTOMS
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PHYSICAL
SYMPTOMS
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BEHAVIOURAL
CHANGES
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Difficulties
associated with:
• Attention/Concentration
• Memory
• Orientation
• Decision-Making
• Problem-Solving
• New learning |
•
Headaches
• Fatigue
• Dizziness
• Uneven gait
• Nausea
• Visual disturbances (e.g. blurring)
• Seizures
• Changes in sleep pattern
• Changes in eating habits |
•
Depression
• Anxiety
• Irritability
• Emotional/impulse control difficulties
• Reduced initiative/motivation |
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DIAGNOSIS
Diagnosing
mild brain injuries in children can be particularly difficult.
Symptoms can mimic other medical probelms and the onset of
symptoms may be delayed and may only be apparent as the child
rached developmental milestones. As a result, emergency difficulaties
may be misunderstood and misattributed (e.g. seen as a behavioural
problem).
A
diagnosis of mild brain injury should be considered when one
or more of the following conditions occur during an injury*:
• Confusion or disorientation
• Amnesia for time around the injury
• Loss of conciousness up to 30 minutes
• Neurological or neuropsychological problems and/or
• After 30 minutes, score of 13-15 on the Glasgow Coma
Scale
*
The Center for Disease Control, Heads Up: Facts for Physicians
about Mild Traumatic Brain Injury (http://www.cdc.gov/doc.do?id=0900f3ec80017619)
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Facts for Physicians
Secondary Prevention of Acquired Brain Injury in Children
and Youth |
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SECONDARY
PREVENTION
Mild
brain injury is associated with diminished reaction time and
therefore children are at a risk for a second injury.
Patients
should be provided with information regarding timing for return
to regular and high-risk activities. It is very important
to avoid subsequent injuries as the effects of each injury
can compound the others. Repeated concussions may result in
"second impact syndrome," which can be fatal,
if the individual does not have sufficient time to heal.
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ACTIVITY
RESTRICTIONS
Experts
have recommended the following activity restrictions following
a mild brain injury*:
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No
Contact Sports for 6 months following injury or discharge
from rehabilitation, including: |
Avoid
high velocity/pressure shifting recreational activities for 6 months after
the injury, such as: |
Lifelong
Avoidance of: |
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•
Tackle football
• Ice hockey
• Wrestling
• Trampoline
• Rugby
• Heading during soccer
• Martial arts
• Lacrosse
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• High diving
• Parachute jumping
• Sky diving
• Adult only roller coasters
• High pressure shifts to bodily system (i.e. scuba diving below one fathom or six feet)
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•
Boxing
• Kick boxing
• Trampoline use in the home or untrained fcility
• Bungee jumping
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When
a bone flap is removed:
•
Young children should wear a helmet at all times (even while
sitting) due to impulsivity
• Where a helmet whenever ambulating (walking) if balance
or protective reactions are impaired
• Avoid contact sports
• Continue helmet use until the bone flap has been replaced
and healed, approximately 12-weeks post-injury |
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*
The Center for Disease Control, Heads Up: Facts for Physicians
about Mild Traumatic Brain Injury (http://www.cdc.gov/doc.do?id=0900f3ec80017619) |
For further information, contact the Toronto ABI Network: (416)
597-3057
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The mission of the The Toronto ABI Network is to provide leadership in furthering equitable, accessible, responsive, cost-effective and quality publicly-funded services and support for persons living with the effects of an acquired brain injury in the Greater Toronto Area.
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