Montréal, le 21 mars 2024 – Concussions in children six years and under have health consequences even three months after the impact. This is the conclusion of a study led by CHU Sainte-Justine researcher and Université de Montréal professor Miriam Beauchamp. Thanks to a new validated tool that has been developed for the very young, the researcher and her team demonstrated that concussions in young children are associated with significant post-concussive symptoms that are not solely attributable to the general effects of injury. The consequences, still observable three months after the concussion, include known symptoms of concussion, such as headaches, nausea, balance problems and sleepiness, as well as behavioural manifestations that are unique to this age group, such as excessive irritability, increased crying and comfort-seeking behaviours. The results were published today in JAMA Network Open.
An important but still misunderstood health issue
The consequences of concussion are increasingly well documented in adults and school-age children. However, although many young children are seen in the emergency department for concussions, very little is known about the long-term consequences in this population.
To more accurately identify these post-concussive effects, the researcher and her team assessed 303 children between six months and six years of age, of whom 174 had a concussion, 60 sustained an injury without a concussion and 69 had no injury. All children were assessed using the REACTIONS inventory (Report of Early Childhood Traumatic Injury Observations & Symptoms), a validated, developmentally-appropriate tool for young children, to assess a range of post-concussive symptoms. The analyses showed that children who sustained a concussion had more post-concussive symptoms than those with an injury to a limb or who had suffered no injuries, not only at the time of the initial emergency consultation but also 10 days, one month and three months after the event. Even three months after the concussion, the children had more physical symptoms, including headaches, sleep problems, fatigue, noise sensitivity and vision problems.
“The study highlights the importance of developing clear guidelines and a specific protocol for concussion management in young children,” underscored Miriam Beauchamp.
A promising tool for symptom monitoring
This study is the first to prospectively map the trajectory of post-concussive symptoms in young children over a period of three months following a head injury, using a developmentally appropriate measure for early childhood that relies on concrete observations. “Our results suggest that using a tool designed for young children, such as the REACTIONS inventory, which can be used by a parent or in a clinical setting, could help diagnose concussions and track symptoms in young children,” added Dominique Dupont, doctoral student and first author of the article.
About the KOALA cohort
The study uses data from the KOALA cohort (Kids’ Outcomes And Long-term Abilities after early childhood concussion). This prospective, multicentre longitudinal cohort study seeks to document the effect of concussions in early childhood. It involves children from four North American pediatric health centres: CHU Sainte-Justine and the Montreal Children's Hospital (Québec, Canada), the Alberta Children’s Hospital (Alberta, Canada) and the Nationwide Children’s Hospital (Ohio, United States).