By Melissa D. Carter, Attorney at Law
Per the National Council of Youth Sports, more than 44 million youth participate in sports per year. Concussions, a form of a traumatic brain injury, are common in children, with sports and recreation as a leading cause in this age group. For many years, the CDC has advised us that approximately half a million kids visit the Emergency Room every year for concussion related injuries.
A study just published in the June 20, 2016 edition of the medical journal Pediatrics revises the estimate of youth sports concussions upward from ½ million to between 1 and 2 million per year during sports and recreation, and that between 500,000 and 1.2 million concussions are not even reported to any health care providers. Per the CDC, the new study highlights a “substantial gap in how the United States currently estimates the nation’s burden of pediatric concussions, and underscores the need for better surveillance.”
Researchers at the University of Washington and Seattle Children’s, along with colleagues at the University of Colorado, studied data from three large sets of databases that track concussion, MarketScan, the National Electronic Injury Surveillance System, and the National High School Sports Related Injury Surveillance System. The new study set out to determine the “most accurate and precise estimates to date” concerning children and concussion.
Per the new study, between 115,000 and 167,000 children were diagnosed with concussion in the ER per year; 378 were diagnosed by family physicians; and between 500,000 and 1 million children were diagnosed by an athletic trainer. The biggest take-away from this study is that we now know that the overwhelming majority of kids are getting diagnosed outside of the ER, and that the number of concussions among kids is much higher than previously thought.
Deborah Crawley, Executive Director of the Brain Injury Alliance of Washington, states, “Working with youth, coaches and medical providers, BIAWA has been aware of the underreporting of concussions in this state, and nationally, for some time. In the state of Washington, most concussions/brain injuries are tallied through the coding of inpatient discharge, meaning the youth must have been admitted to the hospital for the diagnoses/code of a concussion to count. If a young person is seen at their pediatrician or general practitioner’s office that will never be counted in national statistics. Even more difficult to understand is that emergency room visits are not counted/coded, unless the youth is admitted to the hospital, which is rare for most concussions.”
Hundreds of thousands of kids that are not getting appropriate diagnoses or treatment could be suffering from serious traumatic brain injuries that can cause long-lasting, or even permanent, issues with cognition, memory, education, mood and behavior. This also means that many children are at risk for second impact syndrome, which occurs when a person suffers a concussion and, before the first one has healed, sustains a second head trauma that causes diffuse and rapid cerebral swelling, brain herniation, and often, death.
The American Academy of Pediatrics recommends that parents seek medical evaluation and treatment for children exhibiting symptoms of concussion. The most common symptom is headache, which may also be accompanied (or may not) by dizziness, confusion and/or fatigue after a bump, blow or jar to the head. As a reminder, loss of consciousness or “lights out” are not required for one to take concussions/brain injuries seriously. A vast majority of brain injuries do not involve any loss of consciousness.
President Obama’s 2017 budget includes a request for $5 million to create a National Concussion Surveillance System to track concussions through a national household telephone survey system. 
All concussions are brain injuries, and should be treated appropriately. The law firm of Adler Giersch, PS has been a pioneering advocate in the brain injury community in leading the charge on preventing preventable brain injuries for many years, whether the cause has been through sports, motor vehicle collisions, pedestrian traumas, falls or other causes.
For more information, watch Attorney Richard H. Adler participate in a recent special expert panel interview with Q13 Evening News to discuss the legal aspects of concussion prevention in youth sports:
 Sports and Recreation-Related Concussions in US Youth, Mersine A. Bryan, MD, Ali Rowhani-Rahbar, MD, MPH, PhD, R. Dawn Comstock, PhD, Frederick Rivara, MD, MPH, on behalf of the Seattle Sports Concussion Research Collaborative. (doi: 10.1542/peds.2015-4635).