Concussion in children and young people
Concussions, a form of mild traumatic brain injury, represent a significant public health challenge, especially in children and young people. These injuries occur as a result of direct or indirect force to the head, leading to a disruption of normal brain function. Concussions are increasingly recognized as common injuries among children and young people, especially those who participate in sports and leisure activities. According to Fried et al. (2022) persistent chronic concussion syndrome (PCS) – characterized by symptoms that last beyond the expected recovery time – is both widespread and underdiagnosed in children after a concussion. They highlight that a significant number of children with mild traumatic brain injuries experience symptoms for several months, which can potentially inhibit their cognitive, physical and emotional development. Ledoux et al.(2024) also emphasize the wide spectrum of concussion cases, including both sports-related and non-sports-related events in children aged 5 to 12 years. The challenge of early identification and intervention for PCS underlines the critical need for better diagnostic tools and increased awareness among caregivers and healthcare professionals.
Concussion and its impact on brain development
A concussion involves complex neurobiological processes, including metabolic, structural and functional disturbances. Kaila N. Parker et al. (2021) elaborate on how traumatic injuries to the developing brain, especially when combined with early life stress, exacerbate neurological vulnerabilities. Concussion causes stretching of the nerve fibers and microstructural damage that causes disturbances in neural communication. This triggers a cascade of metabolic disturbances, including an energy crisis where the supply and demand for glucose in the brain is out of balance. This type of disturbance can be particularly harmful for children and young people, when they are during important stages of development.
Disruptions in neuronal circuits that support executive functions, memory and sensory integration can have long-term consequences. The interaction between the mechanisms of post-concussion injury and multisensory processing was investigated by Sarno et al. (2009). Their study showed that traumatic brain injuries disrupt the integration of sensory input (eg, sight, touch, and hearing), impairing reaction time and overall sensorimotor coordination. For children and young people, such impairments can hinder school performance, social interactions and physical activities, emphasizing the need for interventions that target these challenges.
Symptoms of chronic concussion syndrome
Chronic concussion syndrome in children and adolescents manifests itself through a number of cognitive, physical and emotional symptoms. Fried et al. (2022) categorize these symptoms into three main groups:
- Somatic (eg headache, dizziness and fatigue).
- Cognitive (eg difficulties with memory and concentration).
- Emotional (eg irritability, depression and anxiety).
Ledoux et al. (2024) note that recovery courses for these symptoms vary, with some children improving within weeks, while others experience long-lasting effects. The variation in symptoms and recovery times mean that diagnoses and treatments must be individually adapted.
Tailored neurological rehabilitation
Rehabilitation tailored to the specific needs of children and young people with PCS has been shown to reduce the risk of long-term consequences. Carrick et al. (2015) refer to the effectiveness of an individual and innovative treatment that combines brain and vestibular rehabilitation. Although their study focused on war veterans with PTSD, the principles of adaptive neurological rehabilitation are very relevant to children.
Targeted therapies that address vestibular dysfunctions, balance problems, and cognitive challenges can speed recovery and improve quality of life. By integrating the findings of Sarno et al. (2009), rehabilitation programs should also prioritize multisensory integration to restore sensorimotor coordination. For example, exercises that stimulate sight, touch and hearing can help rebuild neural connections disrupted by a concussion.
Brain Camp specializes in researching and customizing neurological rehabilitation for people of all ages who suffer from persistent chronic concussion syndrome. The aim of our tailor-made rehabilitation is, among other things, to teach the brain to coordinate and process different sensory impressions in a better way so that the brain is more easily able to carry out its tasks effortlessly. In this way, the patient's tolerance to activity and sensory impressions could be gradually improved before the symptoms are triggered or worsen, so that one regains one's quality of life and can participate as normal in life.
Rehabilitation stays with us have helped patients from all over Europe with persistent chronic concussion syndrome and other neurological conditions.
