Alberta's first ever report on traumatic brain injuries (TBI)-including concussions treated in emergency rooms (ER) or hospitals-shows that the overall risk is higher for falls than sports-related injuries.
"For emergency rooms visits, falls of some kind or another-such as slipping, tripping or due to collision or pushing by another person-are the biggest culprit," said Kathy Belton, associate director of the University of Alberta's Injury Prevention Centre, which prepared the report.
Concussion-the most common form of brain injury-accounted for just 2.5 per cent of all emergency room visits between 2011 to 2014, and 1.6 per cent of hospital visits from 2005 to 2014, according to the report by the injury centre in the School of Public Health. Notably, 80 per cent of TBI visits to emergency rooms were for concussion, whereas for hospital admissions, concussions accounted for just 22 per cent of TBI.
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What is a concussion? A concussion is generally defined as a brain injury resulting from a direct blow to the head, face or neck-that may or may not cause loss of consciousness-but must have one or more complex symptoms in a clinical domain from cognitive to emotional. How do you know when a concussion has occurred? "It's the difference between banging your head a little bit-say, running down the stairs, and the skin might hurt a bit and there's a possible headache-to banging your head substantially and experiencing some kind of change of brain function, whether that is seeing stars, not thinking clearly or having persistent headaches," explained Craig. He added that it's always best to visit an emergency department, if only to rule out more serious injury such as bleeding between the brain and skull if there is a concern about altered brain function. |
"Overall, the rates of TBI/concussion are quite low, but our report represents only a fraction of head injuries that occur in Alberta-those treated at hospital. Many go unreported, such as those treated at a doctor's office visit or at home," said Belton.
She added that it's still a very important health issue for certain segments of the population.
The report showed a spike in TBI/concussion in Albertans aged 10 to 29, most often due to sports-related incidents.
"What really surprised us was the second spike we found: elderly people aged 84 and up," added Belton.
"That's because when seniors fall, they don't just break an elbow or a hip-they often suffer head injury. This is an even bigger issue because seniors are more susceptible to brain bleeds."
Head injury treatment is vital
Over the past decade or so, attention to concussion risks, especially in sports, has advanced health research and injury prevention, including the recent identification of the lingering complications that can result.
A Canadian study in 2016 assessing 3,000 concussion patients found that persistent post-concussion symptoms-ongoing physical, cognitive and psychological or behavioural symptoms-were present in 30 per cent of cases after a 28-day followup.
"That means 70 per cent of concussion patients will return to normal in a month; however, 30 per cent will have ongoing symptoms," said William Craig, a U of A emergency room pediatrician and report co-author.
To best treat concussion-and avoid a second incident that can rarely lead to death (or second impact syndrome)-patients need to stop playing and then rest, he added.
"Currently, the thinking is that rest entails a break from any kind of work the brain does, including going to school, and ending any and all screen time."
The top seven causes of TBI/concussion, according to the report, include falls (25 per cent), sports-related injury (12 per cent), motor vehicle injury (four per cent), bicycle and off-road vehicle-related injury (two per cent) and animal ridden injury (one per cent). "Other" injuries accounted for 50 per cent, which included being struck by or against a person or object (non-sports-related).